Blue Care Network of Michigan: Individual enrollment

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BCN Advantage » Enrolling is easy » Individual enrollment

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

You’re eligible for Medicare Part A and Part B if:

You’re 65 or older
You’ve been disabled and receiving benefits for more than 24 months
You’re entitled to Railroad Retirement benefits or Railroad Retirement disability benefits
You suffer from end-stage renal disease or another qualifying condition such as Lou Gehrig’s disease (ALS)

In general, you are eligible to enroll in a Medicare Part D plan when you are entitled to Part A or enrolled in Part B and you permanently reside in the Part D plan’s service area. 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.

When can someone new to Medicare enroll in BCN Advantage HMO?

Your first opportunity to enroll in a Medicare Advantage plan occurs when you become entitled to Medicare. The Initial Coverage Election Period is a seven-month period that begins three months before the month in which you turn 65 and ends three months after your birthday month. If you are eligible for Medicare due to a disability and have both Medicare Part A and Part B, the ICEP begins three months before your 25th month of disability benefits and ends the month after your 25th month of disability benefits. Whether you’re eligible for Medicare because of age or disability, you can enroll in a Medicare Advantage plan any time during the applicable ICEP.

The Initial Enrollment Period for Part D is the period during which you are first eligible to enroll in a Part D plan. If you are entitled to Part A and enrolled in Part B and you permanently reside in BCN Advantage's 31-county service area, you may enroll in a BCN Advantage plan that includes Part D benefits during the IEP for Part D.

When can someone who already has Medicare enroll in BCN Advantage?

Every year, you have two opportunities to change plans or insurance providers.

The Annual Election Period

The AEP occurs between November 15 and December 31 each year. At this time, you can:

Enroll in a Medicare Advantage plan for the first time
Change Medicare Advantage plans
Enroll in a Part D prescription drug plan
Change your Part D prescription drug plan
Return to Original Medicare

Changes you make during the AEP are effective on January 1 of the following year.

The Open Enrollment Period

The OEP occurs between January 1 and March 31 each year. During the OEP, you may be able to make one change to the Medicare plan you chose. The changes you can make are limited and are based on the type of coverage you have as of January 1.

If you have a Medicare Advantage plan with Part D prescription drug coverage (also called an MA-PD plan), you may switch to another MA-PD plan.
If you have an MA-PD plan, you may switch to Original Medicare with a stand-alone Part D prescription drug plan, also called a PDP.
If you have Original Medicare and a PDP plan, you may switch to an MA-PD plan
If you have a Medicare Advantage plan with no prescription drug coverage (also called an MA or MA-only plan), you may switch to another MA-only plan.

During the OEP, you cannot add or drop the Part D prescription drug benefit or switch from one PDP plan to another.

Are there other times when someone enrolled in Medicare can change plans?

Yes. Examples include:

Open Enrollment Period New

When you become eligible for Medicare Advantage, you may make one MA OEPNEW election during the period that begins the month you become entitled to both Part A and Part B and ends on the last day of the 3rd month of entitlement, or on December 31 of the same year, whichever occurs first.

Open Enrollment Period Institutionalized

If you move into a skilled nursing facility, long-term care facility or other facility that Medicare considers an “institution,” you may make an unlimited number of switch requests for Medicare Advantage plans or Original Medicare during your stay. This period of continuous enrollment, called OEPI , ends two months after you move out of the institution. Enrollment changes made during the OEPI become effective on the first day of the month following the receipt of the enrollment application.

Special Election Periods

Special Election Periods provide an opportunity to enroll or switch plans outside of the annual enrollment periods. Examples of SEPs include:

If you permanently move outside your plan’s service area, you may change plans one month prior to your move and two months afterward.
If you lose coverage from your employer group, group retiree plan or COBRA, you are entitled to an SEP that begins the month you are advised of your loss of creditable coverage. This SEP ends two months after your loss of creditable coverage.
If you qualify for Low Income Subsidy benefits and do not receive Medicaid benefits, you may enroll in a Part D plan during an SEP that begins the month you become eligible for LIS and lasts as long as you are eligible for LIS. This SEP allows you to enroll in, or disenroll from, a Part D plan at any time.

For more information regarding Special Election Periods please call us at 877-469-2583. TTY users should call 800-481-8704. Representatives are available to answer your questions from 8 a.m. to 8 p.m. Eastern Time, seven days a week.

Important information about this plan

BCN Advantage HMO 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 continue to pay your Medicare Part B premium.

You must use plan providers except in emergent or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor BCN Advantage HMO will be responsible for the costs. Out-of-network services authorized by BCN Advantage HMO will be covered.

If you are enrolled in BCN Advantage HMO 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. 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 Service at 800-450-3680, 8 a.m. to 8 p.m., seven days a week. TTY users should call 800-430-3211. You may also write to: BCN Advantage HMO, 2311 Green Road, Ann Arbor, MI 48105.

The BCN Advantage HMO benefit information provided is not comprehensive. Additional information should be requested before making a decision about your coverage. For full information on BCN Advantage HMO benefits, current members should call our Customer Service department at 800-450-3680, from 8 a.m. to 8 p.m., seven days a week. TTY users should call 800-430-3211. Prospective members should call 877-469-2583, from 8 a.m. to 8 p.m., seven days a week. TTY users should call 800-481-8704.

Benefits, formulary, pharmacy, network, premium and/or coinsurance may change on Jan. 1, 2011. Please contact BCN Advantage HMO for details.

If you decide to have your BCN Advantage HMO 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.

BCN Advantage HMO is issued by Blue Care Network, which contracts with the federal government. BCN Advantage HMO’s contract with CMS is renewed annually and the availability of coverage beyond the end of the contract year is not guaranteed.

BCN Advantage HMO^SM is a health plan with a Medicare contract.

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page modified 09/30/2009