Blue Medicare HMO Blue Medicare PPO

Resources and Forms

Get essential resources for Medicare providers, including Medicare payer sheets, online provider manual and newsletters.

Policies and Responsibilities

Review BCBSNC's Blue Medicare PPO and Blue Medicare HMO policies and provider responsibilities to our Medicare members.

Medical Management Programs and Services

Get information on the programs and services designed to help maintain high quality care for Blue Medicare PPO and Blue Medicare HMO members.

Formulary

Search for a drug in BCBSNC's Medicare formulary.

Medical Policies

Search for a medical policy or guideline for Medicare providers.

Prior Plan Approval

Find out which services need prior plan approval and how to request it.

Provider Appeals

Get details and instructions for filing a post-service provider appeal.

Provider Appeal FAQs

Get answers to common questions about Medicare provider appeals.

Electronic Commerce

Connect with other providers online to research claims, benefits and eligibility information.

Contact Us

Questions about providing care for Blue Medicare PPO and Blue Medicare HMO members? Contact us for answers.

Blue Cross and Blue Shield of North Carolina (BCBSNC) is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. BCBSNC does not discriminate based on color, gender, religion, national origin, age, race, disability, handicap, sexual orientation, genetic information, source of payment or health status as defined by the Centers for Medicare & Medicaid Services (CMS). All qualified Medicare beneficiaries may apply. You must be entitled to Medicare Part A and enrolled in Medicare Part B and must reside in the CMS-approved service area. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or another third party. BCBSNC is an independent licensee of the Blue Cross and Blue Shield Association.