Blue Care Network of Michigan: Individual enrollment

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Are you eligible for Medicare?

For more information call:
1-877-469-2583
TTY 1-800-481-8704
Seven days a week
8 a.m. to 8 p.m. Eastern Time

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren’t yet 65, you might also qualify for coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:

You already get retirement benefits from Social Security or the Railroad Retirement Board.
You are eligible to get Social Security or Railroad benefits but haven't yet filed for them.
You or your spouse had Medicare-covered government employment.

If you are under 65, you can get Part A without having to pay premiums if you have:

Received Social Security or Railroad Retirement Board disability benefits for 24 months.
End-Stage Renal Disease and meet certain requirements.

For more information about Medicare eligibility, please visit Medicare.gov.

Please note that even though full retirement age is 65, you can sign up for Medicare up to three months before your 65th birthday.

Important information about this plan

BCN Advantage HMO-POS℠
BCN Advantage HMO-POS is available in these counties: Allegan, Barry, Bay, Calhoun, Clinton, Eaton, Genesee, Gratiot, Ingham, Ionia, Jackson, Kalamazoo, Kent, Lapeer, Livingston, Macomb, Midland, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Ottawa, Saginaw, Shiawassee, St. Clair, Tuscola, Van Buren, Washtenaw and Wayne. Premiums vary by county. You must have both Part A and B and continue to pay your Medicare Part B premium.

You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor BCN Advantage HMO-POS will be responsible for the costs, and your care may cost more than in-network pricing. Limitations, copayments and restrictions may apply.

If you are enrolled in BCN Advantage HMO-POS Basic, Option 2 or Option 3, you must use a network pharmacy to access your prescription drug benefit, except under non-routine circumstances when you cannot reasonably use a network pharmacy. Quantity limitations and restrictions may apply. Our pharmacy network includes the majority of chain pharmacies, mail order through Medco or Walgreens, as well as long-term care and home infusion pharmacies. For additional information on network pharmacies, please call Customer Services at 1-800-450-3680, 8 a.m. to 8 p.m., seven days a week. TTY users should call 1-800-430-3211. You may also write to: BCN Advantage HMO-POS, P.O. Box 5184, Mail Code A103, Southfield, MI 48086-5184

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2012.

If you decide to have your BCN Advantage HMO-POS 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.

Medicare beneficiaries may enroll in BCN Advantage HMO-POS through the CMS Medicare Online Enrollment Center located at http://www.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. Beneficiaries may only enroll during specific times of the year. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week;
The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or
Your State Medicaid Office.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for up to one hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

Please call customer service at the number listed above to have any information verbally translated into another language.

A health plan with a Medicare contract.

H5883_BCNAdvantageWebR2 CMS Approved 05242011

page modified 09/23/2011