Blue Medicare Advantage
New to Blue Medicare Advantage?
Your Blue Medicare Advantage benefits
Your Blue Medicare PPO℠ and HMO℠ medical benefits include:
- Inpatient hospital care and outpatient services, including mental health facilities
- Primary care provider and specialist visits
- Preventive care
- Emergency care
- Diagnostic tests and radiological services
- Vision, dental, and hearing services1
Your Evidence of Coverage (EOC) includes details about your coverage, including what you pay for services. Read your plan's EOC to learn about your coverage and payment details.
As a Blue Medicare PPO or HMO member, you may have access to more than 80,000 providers2 state-wide.
Our provider network includes:
- Hospital systems like Atrium, Cone Health, Duke Health, Mission Health, Novant, and UNC Health Care3
- Independent providers
- Outpatient hospital facilities and ambulatory surgical centers
- Skilled nursing facilities
When you search for an in-network provider, you can find out details about the practice like hours, languages spoken, and office accessibility.
If you have a Blue Medicare PPO or HMO with prescription medication coverage, or a Blue Medicare Rx PDP plan, you can learn more about what's covered on our Medicare prescription medications page.
Your Evidence of Coverage (EOC) includes details about your coverage, including what you pay for medications. Read your plan's EOC to learn about your medication coverage and payment details.
Your Formulary (or medication list) also includes important information about your prescription medication coverage. Visit the Forms Library to view your plan's Formulary.
Blue Medicare Advantage℠ and Blue Medicare Rx℠ members can go to any pharmacy in our network to pick up a prescription medication. Our pharmacy network includes:
- Retail
- Long-term care
- Home infusion
- Indian Health Service/Tribal/Urban Indian Health Program (I/T/U)
- Specialty
- Mail-order
Your costs for some medications may be less at pharmacies that offer preferred cost-sharing.
SilverSneakers®4 a fitness and health platform that gives some Blue Medicare Advantage HMO℠ members access to thousands of gyms and studios, including community fitness centers.5, 6
At no additional cost, Medicare members get access to:
- The gym(s) of your choice
- Access to amenities like pickleball courts and pools
- Local in-person classes designed for seniors
- On-demand and live at-home virtual fitness classes and workshops
- A fitness app designed to help you meet your fitness goals
Buy your health and wellness items from the over-the-counter (OTC) catalog or use your Blue FlexCard in-store at in-network retailers, including Harris Teeter, Walmart, and more.1 7 Order online, by phone, or mail.
The amount available to spend each year varies by plan.1 Visit the Forms Library to view your EOC and learn more.
Log in to your member portalto activate your Blue FlexCard.
Support for members and their caregivers includes:1
- Tools and resources about senior living, in-home care, finances, and more
- Secure ways to store and share important documents, calendars, and medication information
- A team of care advocates available by phone, email, or chat to provide one-on-one support and guidance
After being discharged from an inpatient stay at a hospital or other medical facility, your plan may cover a meal program. You won’t have to worry about cooking meals for the covered timeframe.
If your plan covers this benefit and you qualify to use it after discharge from an inpatient stay, a case manager will contact you to ask if you want to use the benefit.
If you say yes, your case manager will send a referral to our meal vendor, who will call you to set up delivery.
Blue Medicare PPO and Blue Medicare HMO members are covered for emergency services in the US and around the world.1
Traveling within the US or to Puerto Rico? Members may have access to the networks of other participating Blue Cross and Blue Shield Medicare Advantage PPO plans.
About your Part B premium
With all Medicare Advantage plans, you must continue to pay your Part B premium. With some Medicare Advantage plans, you'll receive a portion of this premium back as a rebate in your Social Security check, or you will be billed a lower Part B premium, depending on how you pay.8 You will begin seeing your rebate or premium reduction within two months of enrollment.9
If you need help with your premium payments, there are assistance programs available.
