Blue Medicare HMO Blue Medicare PPO

Resources and Forms

Get essential resources for Medicare providers, including Medicare payer sheets, online provider manual and newsletters.

Policies and Responsibilities

Review BCBSNC's Blue Medicare PPO and Blue Medicare HMO policies and provider responsibilities to our Medicare members.

Medical Management Programs and Services

Get information on the programs and services designed to help maintain high quality care for Blue Medicare PPO and Blue Medicare HMO members.

Formulary

Search for a drug in BCBSNC's Medicare formulary.

Medical Policies

Search for a medical policy or guideline for Medicare providers.

Prior Plan Approval

Find out which services need prior plan approval and how to request it.

Provider Appeals

Get details and instructions for filing a post-service provider appeal.

Provider Appeal FAQs

Get answers to common questions about Medicare provider appeals.

Electronic Commerce

Connect with other providers online to research claims, benefits and eligibility information.

Contact Us

Questions about providing care for Blue Medicare PPO and Blue Medicare HMO members? Contact us for answers.

Blue Cross and Blue Shield of North Carolina is an HMO, PPO, and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability or geographic location within the service area. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area.