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Terms and conditions

BCBSM's terms and conditions apply to Michigan and out-of-state providers when treating Medicare Plus Blue PFFSSM members.


Treating Medicare Plus Blue members from other Blue plans

Private fee-for-service plan members may seek services from any health care provider who is willing to treat them and who accepts the terms and conditions associated with the member's contract.


When you treat a member from another Blue private fee-for-service plan, the terms and conditions associated with that plan apply, not BCBSM's. For example, when you treat a Highmark Blue Cross Blue Shield Medicare Advantage member, Highmark's terms and conditions apply.


Terms and conditions Web tool

Blue Cross Blue Shield of Michigan, in cooperation with the Blue Cross Blue Shield Association, is providing the Terms and conditions Web tool, giving providers easy access to the appropriate terms and conditions for a Medicare Advantage member. Providers can use this tool by following these 3 easy steps:

  1. Enter the first 3 letters of the member's ID number on the BCBS Medicare Advantage PFFS card.
  2. For example: If the first 3 letters of the member's ID number are "XDV," you will need to select an appropriate plan name in the drop down box.
  3. Click "GO" to view the BCBS Medicare Advantage PFFS plan's terms and conditions.

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Plan: 
 

 

GO

If you experience any difficulties, please contact 1-800-676-BLUE.
 

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