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.
If your group plan provides a rider that amends your coverage and applies a copay, 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.
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.
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 copay, 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.
The BCN Advantage network includes many primary care physicians, hospitals, pharmacies and other providers. Here are lists of contracted physicians and pharmacies.
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.
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