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Looking for an individual plan?

Blue Medicare PPO

Visiting the doctor in 2008

As a Blue Medicare PPO member, you have the freedom to choose in- or out-of-network providers and specialists without a referral. While you need to select a primary care physician (PCP) to coordinate your care, you can still visit a doctor outside of the network; however, you will be responsible for more of the cost for out-of-network services.

Using your Medicare prescription drug coverage

Blue Medicare PPO offers two plans, both with the same Medicare prescription drug benefits. Both the Enhanced PPO plan and the Enhanced Plus PPO plan include enhanced drug benefits. The enhanced drug benefit offers more comprehensive coverage than Medicare's standard plan. It covers the same generic, brand name and specialty prescription drugs as the standard plan, but with no deductible. It also includes covered generic prescription drugs in the coverage gap.

NOTE:  The Centers for Medicare & Medicaid Services (CMS) classify Blue Medicare PPO as a Medicare Advantage prescription drug plan because it includes medical coverage and prescription drug coverage. BCBSNC also offers stand-alone Medicare prescription drug plans - without medical coverage. Beneficiaries cannot enroll in a Medicare Advantage prescription drug plan and enroll in a stand-alone Medicare prescription drug plan at the same time.

To learn more about using your Medicare prescription drug coverage, please review the links below:

Using your health and wellness resources

Find out how you can take advantage of resources and programs available to you at no additional cost:
  • Health management programs for specific chronic conditions
  • Case management services
  • Telephone Learning Center (TLC)
  • Preventive care guidelines
  • Annual flu shot information
  • Medication therapy management program (MTMP)

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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 02/11/08.