Blue Medicare PPO is a preferred provider organization plan that offers health care benefits and prescription coverage in one plan. Blue Medicare PPO is offered by PARTNERS National Health Plans of North Carolina, Inc., the first Medicare Advantage organization in North Carolina. PARTNERS is a subsidiary of Blue Cross and Blue Shield of North Carolina. Plans are administered by BCBSNC. Blue Medicare HMO and Blue Medicare PPO 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 PPO plan, view the appropriate information below:

• Summary of Benefits for Blue Medicare PPO plans 
• Evidence of Coverage
  • Blue Medicare PPO - Enhanced 
  • Blue Medicare PPO - Enhanced plus 

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 PPO 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 PPO 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 PPO 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 PPO plans include either enhanced or enhanced plus 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 PPO 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
• 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 targeted 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 PPO is available in select counties across North Carolina within the service area approved by the Centers for Medicare & Medicaid Services (CMS).