Important Information About Medicare Plans

Blue Cross Blue Shield of Michigan and Blue Care Network are PPO, HMO-POS, HMO and PDP plans with Medicare contracts. Enrollment in Medicare Plus Blue, BCN Advantage and Prescription Blue depends on contract renewal. 

Every year, Medicare evaluates plans based on a 5-star rating system. 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. 

Out-of-network/non-contracted providers are under no obligation to treat Medicare Plus Blue and BCN Advantage members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. 

Premiums vary by county. You must continue to pay your Medicare Part B premium. You may enroll in only one Part D plan at a time. 

Disaster policy

In the event the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your geographic area, be assured that Blue Cross Blue Shield of Michigan and Blue Care Network will continue to provide benefits based on the plan you are enrolled in. You will still be able to visit your doctor, urgent care facility or hospital if needed. Generally, during a disaster, your plan will allow you to obtain care from out-of-network providers at in-network cost-sharing. Our website will be updated if a disaster or public health emergency has occurred.

BCN Advantage HMO-POS and HMO plans

For more information, call the number on the back of your member ID card from 8 a.m. to 8 p.m., Monday through Friday, with weekend hours Oct. 1 through March 31. TTY users should call 711. Certain services are available 24/7 through our automated telephone response system. You may also write to: BCN Advantage, Mail Code C103, P.O. Box 5043 Southfield, MI 48086-5043.

Medicare Plus Blue PPO or Prescription Blue PDP

For more information, please contact Blue Cross Blue Shield of Michigan at 1-888-563-3307. TTY users call 711. Hours are: 8 a.m. to 9 p.m. Eastern time, Monday through Friday, April 1 through Sept. 30, with weekend hours Oct. 1 through March 31.

Medicare Plus Blue PPO and Prescription Blue PDP

Our network includes Michigan retail pharmacies, representing many of Michigan's pharmacies. Nationwide, most chain pharmacies are in our network, as well as long-term care and home infusion pharmacies and Indian/Tribal/Urban (Indian Health Service) pharmacies. 

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. Quantity limitation and restrictions may apply. 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 Member Services at 1-877-241-2583, 8 a.m. to 9 p.m. Eastern time, Monday through Friday, April 1 through Sept. 30, with weekend hours Oct. 1 through March 31. TTY users call 711. Certain services available 24/7 through our automated telephone response system. You may also write to: Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Mail Code X521, Detroit, MI 48226. 

Optum Rx® is an independent company providing home delivery pharmacy and other pharmacy benefit management services to Blue Cross Blue Shield of Michigan and Blue Care Network.

 

Y0074_BCBSMBCNWebDsclmr_C FVNR 0923

Page Last Updated Sat Sep 30 22:00:00 EST 2023