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Blue Medicare HMO is a Medicare Advantage plan that includes health care benefits with or without prescription drug coverage in one plan. Blue Medicare HMO is offered by PARTNERS National Health Plans of North Carolina, Inc. - the first Medicare Advantage organization in North Carolina and a subsidiary of Blue Cross and Blue Shield of North Carolina. Blue Medicare HMO and Blue Medicare HMO plans can help simplify the management of your Original Medicare benefits, and provide quality coverage and excellent customer service.
Plan highlights
- $0 monthly premium plan available as well as other low monthly premiums
- Predictable copayments for doctor office visits
- Benefits that are at least as good as Original Medicare, and
some benefits that are richer than Original Medicare, including:
- Medicare prescription drug coverage
- Inpatient / outpatient coverage
- Skilled nursing facility coverage
- Home health care coverage
- Worldwide emergency medical coverage
- Ambulance coverage
- Urgent care coverage
- Preventive care
- Plus, you have access to health and wellness program resources - and much more!
2008 Benefit information
Individual members
For more details about your Blue Medicare HMO plan, view the appropriate information below:
- Summary of Benefits for Blue Medicare HMO plans
- Evidence of Coverage
Low-income assistance
If you have Medicare and Medicaid, you already qualify for low-income assistance. If you do not qualify for Medicaid, you may still qualify for some assistance. The amount of assistance will depend on your income and resources and will be applied to the cost of the Medicare prescription drug coverage portion of your Blue Medicare HMO plan. You may be able to get extra help to pay for your prescription drug premiums and costs.
To see if you qualify for getting extra help, call 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week or the Social Security Administration at 1-800-772-1213, 7 a.m. - 7 p.m., Mon. - Fri. TTY/TTD users should call 1-800-325-0778 or your local North Carolina Medicaid Office.
If you do qualify for additional assistance for your Medicare prescription drug coverage costs, the amount of your premium and cost at the pharmacy will be lower. Once you have enrolled in a Blue Medicare HMO plan, Medicare will tell us how much assistance you are receiving and we will send you information on the amount you will pay.
Group members
If you are a retiree and receive a Blue Medicare HMO plan through your employer group, refer to your group's specific Summary of Benefits booklet or Evidence of Coverage for details on your benefits.
Medicare prescription drug coverage
All Blue Medicare HMO plans (except medical only) include either enhanced or standard Medicare prescription drug benefits. With access to a large pharmacy network, you are covered for a broad range of generic, brand name and specialty drugs including many of the most popular prescription drugs used by seniors.
Please refer to our drug list to see if your drug is covered. You can also print out the drug list and take it to your doctor to discuss whether generic alternatives are available for your prescriptions.
Using your health and wellness resources
Blue Medicare HMO offers a variety of health and wellness resources for members. You can take advantage of valuable resources and programs available to you at no additional cost:
- Health management programs for specific chronic conditions
- Case management services for specific chronic conditions
- Telephone learning center (TLC), a toll free health information line available 24 hours a day, 7 days a week
- Preventive care guidelines to help you determine what kinds of immunizations, screenings and check-ups you should receive each year
- Annual flu shot program
- Medication therapy management program (MTMP), designed for certain members to help ensure that covered Part D drugs are appropriately used to optimize therapeutic outcomes by improving medication use and reducing the risk of adverse drug events, including adverse drug interactions
Available in 37 counties in North Carolina
Blue Medicare HMO is available in select counties across North Carolina within the service area approved by the Centers for Medicare & Medicaid Services (CMS).
| Alamance | Cumberland | Johnston | Stanly |
| Alexander | Davidson | Mecklenburg | Stokes |
| Alleghany | Davie | Nash | Surry |
| Ashe | Durham | Northampton | Wake |
| Avery | Forsyth | Orange | Watauga |
| Cabarrus | Gaston | Person | Wilkes |
| Caldwell | Guilford | Randolph | Yadkin |
| Caswell | Halifax | Richmond | |
| Catawba | Hoke | Rockingham | |
| Chatham | Iredell | Rowan |
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Blue Medicare HMO and Blue Medicare PPO plans are offered by PARTNERS National Health Plans of North Carolina, Inc., a subsidiary of Blue Cross and Blue Shield of North Carolina (BCBSNC). PARTNERS is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. Plans are administered by BCBSNC. BCBSNC and PARTNERS do 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 and PARTNERS are independent licensees of the Blue Cross and Blue Shield Association.
The information on this page is current as of 02/04/08.