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How Medicare Advantage plans work
Blue Medicare HMO and Blue Medicare PPO are Medicare Advantage prescription drug plans that include medical coverage and prescription drug coverage. PARTNERS contracts with the federal government to manage your Original Medicare benefits and offer you enhanced medical benefits and Medicare prescription drug coverage.
Medicare makes a monthly payment to PARTNERS for each member. The plan uses this payment to pay claims for services provided through contracted primary care providers, specialists and hospitals to members.
PARTNERS will manage your Original Medicare benefits and with most plans, can provide you with medical benefits and Medicare prescription drug coverage — all in one plan. There is virtually no paperwork!
How your Medicare prescription drug benefits work
Learn how the Medicare prescription drug benefits work and view a side-by-side comparison of the enhanced and standard drug benefits of the Blue Medicare HMO and Blue Medicare PPO plans.Policies and procedures for your Medicare prescription drug benefits
Blue Medicare HMO and Blue Medicare PPO provide you all the rights under federal law and CMS regulations for your Medicare prescription drug benefits.Learn more about:
- Coverage determinations, appeals and grievances
- Quality assurance policies and procedures
- Notice of possible contract termination
- Transition process
- Out–of–network coverage
- Member rights and responsibilities
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 02/20/08.