Introducing Blue Medicare
Blue Cross and Blue Shield of North Carolina (BCBSNC) is the parent company of PARTNERS National Health Plans of North Carolina, Inc. (PARTNERS), a health care company based in Winston-Salem. If you're not already familiar with PARTNERS, this Medicare Advantage organization provides HMO and PPO plans for approximately 43,000 people within the state.
Recently, PARTNERS received a license to identify itself as an affiliate of the Blue Cross and Blue Shield Association. This affiliate designation allows PARTNERS HMO and PPO products to be branded with the Blue Cross and Blue Shield symbols, replacing the Medicare Choice HMO and Medicare Options PPO products with the new Blue Medicare HMOSM and Blue Medicare PPOSM.
Beginning January 1, 2008, both Blue Medicare HMO and Blue Medicare PPO will be available in 37 counties in North Carolina, including areas within the Triangle, Triad and Charlotte regions. Blue Medicare HMO and Blue Medicare PPO are replacement products for PARTNERS Medicare Choice HMO and Medicare Options PPO.
Effective January 1, 2008, Blue Medicare HMO and Blue Medicare PPO members have new identification cards featuring a "blue" look. These new cards display the Blue Cross and Blue Shield symbols and are for members who have health care coverage with PARTNERS. This means that when arranging health care and/or submitting claims for services provided to Blue Medicare HMO and Blue Medicare PPO members, PARTNERS in Winston-Salem remains the main contact. Even with this change, we’ve worked to make the member cards distinctive, so you can easily determine whether a claim or question should be directed to PARTNERS or BCBSNC. Please see the sample card image below:
Blue Medicare sample card image
With a quick glance of the front of the card, you can see in the upper right hand corner that the member has a Blue Medicare plan and the type of plan the member has chosen is also specified.* Just below that, you’ll see an area shaded in blue that highlights the plan as offered by PARTNERS, which is identified as a BCBSNC company. On the left hand side of the card, you'll note that the Blue Medicare member’s ID includes an alpha prefix. Blue Medicare alpha prefixes are unique to Blue Medicare members and always end with the letter J. The following alpha prefixes identify Blue Medicare plan types:
YPWJ - Blue Medicare HMO
YPFJ - Blue Medicare PPO
YPJJ - Blue Medicare HMO for Reynolds American Inc. retirees
It’s easy to distinguish between Blue Medicare HMO members and Blue Medicare PPO members. Just look at the alpha prefix at the beginning of the member’s Blue Medicare identification code. The alpha prefix YPWJ lets you know that the member’s coverage type is an HMO plan. If you see YPFJ, you’ll know the coverage type is PPO. Additionally, Reynolds American Inc. retirees have a customized alpha prefix of YPJJ, making them easy to identify as having an individualized HMO plan. Any time that you are presented with one of these alpha prefixes, you’ll know that the claims and health care services are administered by PARTNERS.
The back of a Blue Medicare member’s identification card provides further information about arranging health care services and claim submission with PARTNERS. The cards also display the PARTNERS claims mailing address and telephone service lines.
*Providers should be aware that neither an individual’s possession of a Blue Medicare member identification card nor information contained in this mailing represents a guarantee of member’s benefits, eligibility or coverage in a Blue Medicare plan. A member’s actual Blue Medicare eligibility and benefits should always be verified in advance of providing services.
Important information about Blue Medicare: