2013 Using and managing your plan | BCN Advantage

Evidence of Coverage

Your Medicare Advantage plan is provided by Blue Care Network through an agreement with your current employer, or former employer or union.

Your group plan may have a special rider that determines your cost of service, on which your liability and benefit coverage is based. Call your group plan administrator or BCN Advantage℠ Customer Service for additional information about your group plan health care benefits, schedule of benefits and summary plan description.

Essential information to understand and use your benefits is included in your Evidence of Coverage booklet and group-specific benefit chart. Your Evidence of Coverage is our contract with you. It explains how to get your Medicare services through BCN Advantage. It also explains your rights, benefits, and responsibilities as a member of the plan.

Find out how to get the most from your coverage

Member benefits seminars
Learn more and RSVP (PDF)

If your group plan provides a rider that amends your coverage and applies a copayment, coinsurance and/or a deductible to specific services, the rider takes precedence over the Evidence of Coverage.

Extra help: low-income subsidy

People with limited incomes may qualify for extra help to pay for their prescription drug costs. For more information about this extra help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day seven days a week. TTY users should call 1-877-486-2048.

Forms

For additional forms and resources, such as mail order pharmacy forms, advanced directive forms, Healthy Advantage Rewards program forms, reimbursement forms and more, visit our forms library.

View forms

Formulary

A formulary is a list of drugs covered by the plan selected to meet member needs. It covers both generic and brand-name drugs.

For more information on how to fill your prescriptions, please refer to your Evidence of Coverage. If your group plan provides a rider that amends your coverage and applies a copayment, coinsurance and/or a deductible to specific services, the rider takes precedence over the Evidence of Coverage. Please contact your benefit administrator for information about your plan benefits.

Member discounts and wellness programs

We offer a variety of programs to promote good health, safety and savings.

View discounts and programs

Member publications

View issues of Your Health Advantage magazine

Provider/Pharmacy Directory

The BCN Advantage network includes many primary care physicians, hospitals, pharmacies and other providers. Here are lists of contracted physicians and pharmacies.

Online Health Care Provider Search for BCN Advantage

For more information on using your benefits in and out of the service area, see the Getting care at home and when you travel information.

H5883_BCNAdvantageWebR5.4 Pending CMS Approval

Important Plan and Benefit Information

Important information for BCN Advantage group plans

The references to BCN Advantage℠ HMO-POS Evidence of Coverage and riders on this Web site are intended as an overview of BCN Advantage HMO-POS group products. This is not a contract. An official description of benefits is contained in applicable BCN Advantage Evidence of Coverage and riders. Payment amounts are based on the BCN-approved amount, less any applicable deductible and/or copayment amounts required by the plan. Services must be provided or arranged by the member's primary care physician or health plan.

If you are enrolled in a BCN Advantage plan with Part D prescription drug coverage, 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, call Customer Service at the number on the back of your BCN Advantage ID card. Service hours are 8 a.m. to 8 p.m., Monday through Friday, with weekend hours Oct. 1 through Feb. 14. TTY users should call 711. You may also write to: BCN Advantage, 2311 Green Road, Ann Arbor, MI 48105.

BCN Advantage HMO-POS is a health plan with a Medicare contract and is open to all Medicare beneficiaries with both Medicare Part A and Part B who enroll as part of a group. The group sponsor or member must continue to pay the Part B premium. Members must use BCN Advantage HMO-POS providers for covered services. Benefits are subject to exclusions and limitations. This coverage is provided pursuant to a contract with the federal government. Our contract with the federal government is renewed annually; the availability of coverage beyond the current contract year is not guaranteed.

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2013 Group plan coverage

Using and managing your plan