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Provider resources and information

Responsibilities of primary care physicians (PCP) in 2008

Effective 1/1/2008, Blue Medicare HMO and Blue Medicare PPO members have the freedom to choose in-network providers and specialists without a referral. Members are still expected to select a primary care physician (PCP). Members are encouraged to visit their PCP before seeing a specialist. In this way, Blue Medicare HMO and Blue Medicare PPO PCPs are still able to coordinate generally for the overall care management for their patients.

  • Family practice/General practice doctors provide care for infants, children, adolescents and adults in the areas of community medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery.
  • Internists (Internal medicine) provide service for treatment of diseases in adults. Normally, they do not deliver babies, treat children or perform surgery.
  • Pediatricians typically treat children from birth up to the age of sixteen.
  • Geriatric doctors provide care for older adults.

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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.

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