Important information about this plan

BCN Advantage Group 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 Group HMO will be responsible for the costs. Out-of-network services authorized by BCN Advantage Group HMO will be covered.

If you are enrolled in BCN Advantage Group 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 Group HMO, 2311 Green Road, Ann Arbor, MI 48105.

The BCN Advantage Group 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 Group 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 group members should call 866-966-2583, from 8 a.m. to 8 p.m., seven days a week. TTY users should call 800-431-7944.

Benefits, formulary, pharmacy, network, premium and/or coinsurance may change on Jan. 1, 2011. Please contact BCN Advantage Group 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 Group HMO is issued by Blue Care Network, which contracts with the federal government. BCN Advantage Group HMO’s contract with CMS is renewed annually and the availability of coverage beyond the end of the contract year is not guaranteed.