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Important Legal Information and Disclaimers

Blue Medicare HMO, Blue Medicare PPO, and Blue Medicare Rx (PDP) Members

My Benefits

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Benefits Overview
  • Newly covered Services
    Please click here to see a list of new benefits.
  • Visiting the Doctor and Other Providers1
    Your primary care physician (PCP) will coordinate your health care. You're not required to see your PCP before visiting a specialist, but it's strongly recommended so that your PCP is fully aware of the medical care you're receiving. Learn more about choosing a PCP and how to access your health care.
    • For Blue Medicare HMO, you must use plan providers1, except in emergency/urgent care situations, or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers, neither Original Medicare nor Blue Medicare HMO is responsible for the costs.
    • Member liability with Blue Medicare PPO may be greater for services received out of network than services received in network. Many out-of-network services are subject to coinsurance, which is based on the Medicare allowed amount and not on the potentially lower contract amount. With the exception of emergency or urgent care, it may cost more to get care from non-plan or non-preferred providers. Out-of-network/non-contracted providers are under no obligation to treat Blue Cross NC members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services
  • Using Medicare Prescription Drug Coverage
    If your plan includes Medicare prescription drug coverage, learn how easy it is to fill your prescriptions at a local pharmacy or through mail order. In order to obtain the greatest savings on your prescription medications, please visit one of our preferred network providers.
  • Star Ratings

Plan Offerings By County

1 Formulary, pharmacy network, and provider network may change at any time. You will receive notice when necessary.

Important Legal Information and Disclaimers

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®, SM Marks of the Blue Cross and Blue Shield Association. SM1 Mark of Blue Cross and Blue Shield of North Carolina.

The information on this page is current as of 10/1/2017.

Y0079_7833 CMS Approved 10172017