2012 Using and managing your plan | Blue Care Network Advantage

Information for current individual plan members.

Evidence of Coverage and Summary of Benefits

Essential information to understand and use your benefits is included in your Evidence of Coverage booklet. Your Evidence of Coverage is an important legal document that explains how to get your Medicare services through BCN Advantage℠. It also explains your rights, benefits, and responsibilities as a member of the plan.

View Evidence of Coverage for Individual Members: BCN Advantage Elements (PDF)
View Evidence of Coverage for Individual Members: BCN Advantage Basic, Class and Prestige (PDF)
Learn about the new Additional Preventive Services benefits we've added at no cost to you. (PDF)

The Summary of Benefits is a chart of your plan benefits compared to Original Medicare. It is a shorter reference and provides you with a brief description of your coverage.

View Summary of Benefits Report (PDF)

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. Formulary Updates is a list of drugs that have been added to, removed from, or updated in our formulary.

For more information on how to fill your prescriptions, please refer to your Evidence of Coverage.

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 issue 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.

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.

A health plan with a Medicare contract. BCNAdvantageWebR4.3 pending CMS approval

Important information about these plans

Important plan information

BCN Advantage℠ 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 emergency 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 will be responsible for the costs. Out-of-network services authorized by BCN Advantage will be covered. Our point-of-service benefit allows you to get care from providers not in our network under certain conditions. If you are traveling outside of Michigan, you are covered under our point-of-service BlueCard® benefit and can access out-of-network doctors, specialists, or hospitals that participate with Blues plans. You may receive most plan-covered services at in-network out-of-pocket cost sharing. You may need to pay higher cost-sharing for routine care from non-network providers.

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 1-800-450-3680, 8 a.m. to 8 p.m., seven days a week. TTY users should call 711. You may also write to: BCN Advantage, 2311 Green Road, Ann Arbor, MI 48105.

The BCN Advantage benefit information provided on this website is not comprehensive. Additional information should be requested before making a decision about your coverage. For full information on BCN Advantage benefits, current members should call our Customer Service department at 1-800-450-3680, from 8 a.m. to 8 p.m., seven days a week. TTY users should call 711. Prospective members should call 1-877-469-2583, from 8 a.m. to 8 p.m., seven days a week. TTY users should call 1-800-481-8704.

Benefits, formulary, pharmacy, network, premium and/or coinsurance may change on Jan. 1, 2013. Contact BCN Advantage for details.

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

Individual plan coverage

Using and managing your plan