In addition to our medical and prescription drug plans, we offer members a variety of programs designed to promote good health, safety and savings.
Value-added programs for Medicare Plus Blue PPOSM, Medicare Plus Blue PFFSSM and Prescription Blue PDPSM members
Programs exclusively for Medicare Plus Blue PPOSM and Medicare Plus Blue PFFSSM members
Value-added services are available for current members as well as for people who enroll in our Medicare Advantage Plans for 2010.
For Medicare Plus Blue PPOSM, Medicare Plus Blue PFFSSM and Prescription Blue PDPSM members
Take an alternative approach with Naturally BlueSM
Naturally Blue — We've partnered with Healthways WholeHealth Network Inc. to offer our members discounts on a wide range of complementary and alternative health services, natural products and magazines through a national network. By showing your Blues ID card, you can save as much as 30 percent when you visit a Naturally Blue network practitioner. Goods and services include:
BlueSafe is an injury prevention program for BCBSM members. By showing their Blues ID card, members can save 20 percent at Michigan Dunham's Sports for safety items. BlueSafe also entitles members to a 10 percent discount on selected regularly priced merchandise. This offer cannot be combined with any other offer or used on the Dunham's Web site.
Members can also save 20 percent at Michigan Wright & Filippis stores on all home medical equipment not covered by their health coverage.
A new partnership with Social Service Coordinators, a private social service agency, helps BCBSM identify members who may be eligible for Medicare Savings Programs or Part D assistance and then helps them enroll.
MSPs are federally-funded, state-administered programs that help Medicare beneficiaries with their health care costs. MSPs pay a portion, or, in some cases, the entire Medicare Part B premium; and they may also pay certain plan copayments. SSC field coordinators help members complete the application and gather the necessary documentation for enrollment. Upon request, SSC will send a representative to meet with the member in his or her home.
For more information, call SSC's Outreach Center at 866-631-5967, 9 a.m. to 6 p.m., Monday through Friday. TTY users should call 1-877-644-3244.
Programs exclusively for Medicare Plus Blue PPOSM and Medicare Plus Blue PFFSSM members
Discounted dental services
In addition to our dental benefits, as a value-added service, you can also choose to see a DenteMax dentist for services that aren't covered by Medicare Plus Blue PPOSM or Medicare Plus Blue PFFSSM. They offer discounts on noncovered services like:
Additional cleanings, exams and X-rays
Crowns
Dentures and bridge work
Check with your DenteMax dentist or visit dentemax.com to verify that your dentist participates in this discount program.
BlueHealthConnection® is a health management program designed to help members stay healthy, get better or improve their quality of life while living with an illness. BlueHealthConnection includes telephone-based nurse health coaches, targeted outreach, case and disease management, Web-based wellness information and an online personal health risk appraisal. This 24/7 umbrella of care gives members the information, tools and assistance they need to make informed health care choices and optimize their health.
Quit the Nic is a free, telephone-based program to support members' efforts to quit smoking. Members work with a nurse health coach who helps them enroll in the program, gets them started by setting a quit date and discusses how to prepare for that day. The nurse also guides members through a series of motivational topics and talks about ways to head off a relapse.
We know that being healthy includes achieving peace of mind, feeling in control and enjoying an active lifestyle.
We support your health every day, not just at the doctor's office. That's why we're pleased to offer you Blue365®.
Blue365 complements your health plan by giving you resources that help make it easier and more affordable to live a healthier lifestyle. Get exclusive discounts on products and services like:
Gym memberships
Nutrition and weight loss programs
Elective procedures like LASIK
Healthy vacation getaways
Be active. Be healthy. Blue365 can help.
The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Blue Cross Blue Shield of Michigan grievance process.
Medicare Plus Blue PPOSM and Medicare Plus Blue PFFSSM are health plans with Medicare contracts. Prescription Blue PDPSM is a stand-alone prescription drug plan with a Medicare contract.
Medicare Plus Blue PPOSM Medicare Plus Blue PPOSM is available to all Medicare beneficiaries who are Michigan residents who reside within the plan's 75-county service area and are entitled to receive services under Medicare Part A and enrolled in Part B.
Medicare Plus Blue PPOSM is available in these counties: Alcona, Alger, Allegan, Alpena, Arenac, Baraga, Barry, Bay, Berrien, Branch, Calhoun, Cass, Chippewa, Clare, Clinton, Crawford, Delta, Dickinson, Eaton, Genesee, Gladwin, Gogebic, Gratiot, Hillsdale, Houghton, Huron, Ingham, Ionia, Iosco, Iron, Isabella, Jackson, Kalamazoo, Kent, Keweenaw, Lake, Lapeer, Lenawee, Livingston, Luce, Mackinac, Macomb, Manistee, Marquette, Mason, Mecosta, Menominee, Midland, Missaukee, Monroe, Montcalm, Montmorency, Muskegon, Newaygo, Oakland, Oceana, Ogemaw, Ontonagon, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Sanilac, Schoolcraft, Shiawassee, St. Clair, St. Joseph, Tuscola, Van Buren, Washtenaw, Wayne, Wexford.
With the exception of emergency or urgent care, it will cost more to get care from non-plan or non-preferred providers. Your responsibility will be greater out-of-network when the out-of-network coinsurance is based on the Medicare allowed amount and the contracted amount is lower. You may receive services from any provider who accepts your Medicare Plus Blue PPOSM ID card. Your out-of-pocket costs will be lower if you choose a network provider. To find a network provider, visit bcbsm.com/medicare/search.shtml.
Medicare Plus Blue PPOSM provides reimbursement for all covered benefits regardless of whether they are received in-network, as long as they are medically necessary.
Medicare Plus Blue PFFSSM Medicare Plus Blue PFFSSM is available to all Medicare beneficiaries who are Michigan residents entitled to receive services under Medicare Part A and enrolled in Part B.
A Medicare Advantage private fee-for-service plan works differently than a Medicare supplement plan. Your doctor or hospital can continue to treat you if it agrees to accept our terms and conditions of payment, and thus may choose not to treat you, with the exception of emergencies. If your doctor or hospital does not agree to accept our payment terms and conditions, they may choose not to provide health care services to you, except in emergencies. Providers can find the plan's terms and conditions on our Web site at bcbsm.com/ma. You can also read more about how private fee-for-service plans work for you in our downloadable flyer (PDF 160K).
Prescription Blue PDPSM Prescription Blue PDPSM is available to all Medicare beneficiaries who are Michigan residents entitled to receive services under Medicare Part A and/or enrolled in Part B.
Medicare beneficiaries enrolled in a Medicare Advantage PFFS plan that includes Medicare prescription drugs or any Medicare Advantage coordinated care (HMO or PPO) plan will be automatically disenrolled from the HMO, PPO or Medicare Advantage PFFS plan if they enroll in a prescription drug plan; and Medicare beneficiaries enrolled in a private fee-for-service plan (PFFS) that does not include Medicare prescription drug coverage, a Medicare Advantage Medicare Savings Account (MSA) plan or an 1876 Cost plan may enroll in a prescription drug plan and will not be automatically disenrolled from the PFFS, MSA or 1876 Cost plan.
Medicare Plus Blue PPOSM, Medicare Plus Blue PFFSSM and Prescription Blue PDPSM
Premiums vary by county. You must continue to pay your Medicare Part B premium.
In Michigan, 86 percent of pharmacies are network pharmacies; nationwide, more than 80 percent of pharmacies are in the network, including the majority of chain pharmacies, as well as long-term care and home infusion pharmacies and Indian/Tribal/Urban (Indian Health Service) pharmacies (Source: 2010 Pharmacy Directory). In general, benefits are only available at contracted network pharmacies. Plan drugs may be covered in special circumstances, for instance, illness while traveling outside of the plan's service area where there is no network pharmacy. You may have to pay more than your normal cost sharing amount if you get your drugs at an out-of-network pharmacy. In addition, you will likely have to pay the pharmacy's full charge for the drug and submit documentation to receive reimbursement from Blue Cross Blue Shield of Michigan. For additional information on network pharmacies, please call Customer Service at 1-877-469-2583, 8 a.m. to 8 p.m., seven days a week. TTY users should call 1-800-481-8704. You may also write to: Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Mail Code X435, Detroit, MI 48226.
If you decide to have your plan premium withheld from your Social Security check or deducted from your checking or savings account, it may take up to three months for the automatic deduction to begin. If your premium amount is currently withheld from your Social Security check or deducted from your checking or savings account and you wish to receive a monthly bill instead, the change may also take up to three months to become effective. During this time, you will be responsible for paying your premium.
The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. This is an advertisement; for more information contact the plan Benefits, formulary, pharmacy, network, premium and/or coinsurance may change on Jan. 1, 2011. Please contact Blue Cross Blue Shield of Michigan for details.
In addition to enrolling through this Web site, Medicare beneficiaries may enroll in Medicare Plus Blue PPOSM, Medicare Plus Blue PFFSSM or Prescription Blue PDPSM through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at medicare.gov. For more information, please contact Blue Cross Blue Shield of Michigan at 1-877-469-2583, 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704. You may only enroll in Medicare Plus Blue PPOSM, Medicare Plus Blue PFFSSM or Prescription Blue PDPSM during specific times of the year. To learn more about enrollment periods, please contact Customer Service.
This document is available in alternate formats or languages. For more information, call 1-877-469-2583, 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704.
Medicare Plus Blue PPOSM, Medicare Plus Blue PFFSSM and Prescription Blue PDPSM are issued by Blue Cross Blue Shield of Michigan, which contracts with the federal government. Medicare Plus Blue PPOSM, Medicare Plus Blue PFFSSM and Prescription Blue PDP'sSM contracts with CMS are renewed annually and the availability of coverage beyond the end of the contract year is not guaranteed.
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:
1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day, seven days a week;
The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
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