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 Care
- 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 drug coverage, or a Blue Medicare Rx PDP plan, you can learn more about what's covered on our Medicare prescription drugs page.
Your Evidence of Coverage (EOC) includes details about your coverage, including what you pay for drugs. Read your plan's EOC to learn about your drug coverage and payment details.
Your Formulary (or drug list) also includes important information about your prescription drug 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 drug. Our pharmacy network includes:
- Retail
- Long-term care
- Home infusion
- Indian Health Service/Tribal/Urban Indian Health Program (I/T/U)
- Specialty
- Mail-order through Amazon Pharmacy
Your costs for some drugs may be less at pharmacies that offer preferred cost-sharing.
SilverSneakers®3 is a fitness and health platform that gives you access to thousands of gyms and studios, including community fitness centers and popular gyms like O2, Planet Fitness, and YMCAs.4
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, 5 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 portal to activate your Blue FlexCard.
Many of our Medicare Advantage plans make it easy to get to and from doctor appointments or the pharmacy to pick up prescriptions.1 With the non-emergency medical transportation benefit, you'll get:
- Flexible options to book a ride in advance or on demand
- Wheelchair-accessible vans and non-emergency ambulances as needed
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
Get extra help with daily tasks in your home with a pre-screened network of professional caregivers.1 Depending on your plan, you may have access to:
- Dedicated staff who can work with you to understand your needs, including your schedule and caregiver preferences
- Personalized caregiver matching within one to two weeks
- A variety of in-home support services, such as help with meal preparation, bathing, medication reminders, and more
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.6 You will begin seeing your rebate or premium reduction within two months of enrollment.7
If you need help with your premium payments, there are assistance programs available.
