New to Blue Medicare Advantage?
If this is your first time having a Medicare Advantage plan, let us guide you through the next steps to get the most out of your plan.
Your Blue Medicare Advantage benefits
Medical 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.
Provider network
As a Blue Medicare PPO or HMO member, you may have access to more than 60,000 providers2 state-wide.
Our provider network includes:
- Hospital systems like Atrium, Cone Health, Duke Health, Mission Health, Novant, and UNC Health Care.
- Independent providers.
- Advanced Primary Care providers Carelon Health and Galileo Health.
- Outpatient Hospital Facilities and Ambulatory Surgical Centers.
- Skilled Nursing Facilities.
You can learn more about each provider, including their hours, languages spoken, and office accessibility, on our Provider Search Tool.
Prescription drug benefits
If you have a Blue Medicare PPO℠ or HMO℠ with Prescription Drug coverage, 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 Guide.
Fitness
FitOn Health3 is a fitness and health platform that gives you access to 13,000+ gyms and studios, including popular gyms like O2, Life Time, YMCAs and more.4With $112 per month to spend, we’re giving you the flexibility to choose the best fitness options for you. Use the funds on:
- The gym(s) of your choice (even if it’s not in the FitOn network)
- In-person classes
- Premium FitOn equipment like yoga mats, dumbbells and more
Plus, enjoy unlimited use of the digital platform with live and on-demand classes from expert instructors, activity tracking, nutrition programs and more.
Up to $400 over-the-counter benefit
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.5 Order online, by phone, or mail.
Non-emergency medical transport
Many of our Medicare Advantage plans make it easy to get to and from doctor appointments.6 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 caregivers
Many of our Medicare plans come with support for both members and their caregivers:
- 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
In-home assistance
Get extra help with daily tasks in your home with a pre-screened network of professional caregivers.6 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 1 to 2 weeks
- A variety of in-home support services, such as help with meal preparation, bathing, medication reminders, and more
Personal emergency response system
Get help with the push of a button. Your plan may include a wearable device that will connect you with a call center that will get you the emergency services you need. Most devices also include fall detection, GPS tracking and an app to alert family or caregivers.
Meals benefit
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.
Home safety devices ($0 copay)
Each year, you can receive two home safety devices at no cost to you. Home safety devices include night lights, grab bars, anti-slip mats and more. Order your two devices from our Home Safety Device catalog online, by phone or mail order. Devices must be ordered from the approved list using the designated provider.
Travel coverage
Blue Medicare PPO and Blue Medicare HMO members are covered for emergency services in the US and around the world.
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.
Blue Connect member portal
Access your benefits anytime, anywhere. With Blue Connect℠ you can manage your plans, track claims, get a copy of your ID card and so much more.
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.7 You will begin seeing your rebate or premium reduction within two months of enrollment.8
If you need help with your premium payments, there are assistance programs available.
Advanced Primary Care
With a Medicare Advantage plan, you can save time by using Advanced Primary Care (APC). APC puts you in the driver's seat by allowing you to schedule primary care appointments and most specialty care needs at the same place.
Disclosures:
Blue Cross and Blue Shield of North Carolina is an HMO, HMO-POS, PPO and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal.
Blue Cross and Blue Shield of North Carolina Senior Health DBA Blue Cross and Blue Shield of North Carolina is an HMO-POS D-SNP plan with a Medicare contract and a NC State Medicaid Agency Contract (SMAC). Enrollment in Blue Cross and Blue Shield of North Carolina Senior Health depends upon contract renewal.
Blue Medicare Supplement plans offered: Plan A: BMS A, 1/24, Plan G: BMS G, 1/24, Plan HI DED G: BMS HDG, 1/24, Plan K: BMS K, 1/24, Plan N: BMS N, 1/24.
Blue Medicare Supplement is not endorsed by or affiliated with the United States Government or the federal Medicare program.
The federal government requires all Medicare Advantage members to continue paying their Part B premium each month.
Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability, sexual orientation or source of payment. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area.
Links marked with an external site icon indicate that you're leaving BlueCrossNC.com and Blue Cross and Blue Shield of North Carolina's plan information. The site you're going to is either a third-party vendor contracted with Blue Cross NC to provide services or an external website independent of Blue Cross NC.
To view PDF documents, you need to download and install Adobe Acrobat Reader on your computer.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. These tools are offered for your convenience and should be used only as reference tools. You should consult your own legal counsel, tax advisor or personal physician as applicable throughout your health care experience.
Out-of-network / non-contracted providers are under no obligation to treat Plan members, except in emergency situations. 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.
The Blue FlexCard is issued by Stride Bank, N.A., Member FDIC, pursuant to license by Mastercard International. Stride Bank is an independent company offering debit card services and is solely responsible for its products.
Blue Cross NC contracts with independent companies to provide supplemental benefits. Those companies are responsible for the services they provide. They do not provide Blue Cross or Blue Shield products or services. Marks and trade names are property of their respective owners.
Change Healthcare is an independent company providing revenue and payment cycle management on behalf of Blue Cross and Blue Shield of North Carolina.
FitOn Health is an independent company providing health and fitness services on behalf of Blue Cross and Blue Shield of North Carolina.
CareLinx is an independent company providing in-home care solutions on behalf of Blue Cross and Blue Shield of North Carolina.
TruHearing is an independent company providing hearing health and hearing aids on behalf of Blue Cross and Blue Shield of North Carolina.
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Not available on all plans.
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Internal data, May 2023.
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Blue Cross NC contracts with independent companies to provide supplemental benefits. Those companies are responsible for the services they provide. They do not provide Blue Cross or Blue Shield products or services. Marks and trade names are property of their respective owners.
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In-network gyms are subject to change.
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In-network stores are subject to change.
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Available on select Medicare Advantage plans.
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The federal government requires all Medicare Advantage members to continue paying their Part B premium each month.
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If it takes two months to receive your rebate, your first rebate or premium reduction will include the amount for the first month as well.
Current as of 07/12/2024 | Y0079_12997_M CMS Accepted 10202024 | U36079, 6/24
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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