Important Information for Group MedicareBlueSM Rx (PDP) and Group MedicareBlue PPO (Regional PPO) Members
Group MedicareBlue PPO (Regional PPO) and Group MedicareBlue Rx (PDP)
Coverage is available to members of an employer or union group and separately issued by one of the following plans: Wellmark Blue Cross and Blue Shield of Iowa,* Blue Cross and Blue Shield of Minnesota,* Blue Cross and Blue Shield of Montana,* Blue Cross and Blue Shield of Nebraska,* Blue Cross Blue Shield of North Dakota,* Wellmark Blue Cross and Blue Shield of South Dakota,* and Blue Cross Blue Shield of Wyoming.*
* Independent licensees of the Blue Cross and Blue Shield Association.
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; or
- The Social Security Office at 1-800-722-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users call 1-800-325-0778; or
- Your State Medicaid Office.
Group MedicareBlue PPO (Regional PPO) and Group MedicareBlue Rx (PDP) members must use contracted network pharmacies to access their prescription drug benefit, except under non-routine circumstances when they cannot reasonably use network pharmacies. Members who use pharmacies outside the network will pay any difference in the non-network pharmacy’s charge and the plan’s allowable charge. Types of network pharmacies include: retail, mail order, long-term care, and Indian/Tribal/Urban. For more information about mail-order service or to obtain additional network pharmacy information call Customer Service at the numbers listed below or access our website at www.YourMedicareSolutions.com. Or send a request in writing to Group MedicareBlue PPO (Regional PPO) Member Service, P.O. Box 8556, Philadelphia, PA 19101-8556 or Group MedicareBlue Rx (PDP) Customer Service, P.O. Box 3178, Scranton, PA 18505.
Benefits, formulary, network pharmacies, premium, and/or copayments/coinsurance may change on January 1, 2011. Please contact Group MedicareBlue PPO (Regional PPO) or Group MedicareBlue Rx (PDP) for details.
If you have special needs, this document is available in alternative formats. Please call Customer Service at the phone numbers listed below for more information.
Group MedicareBlue PPO (Regional PPO)
Group MedicareBlue PPO (Regional PPO) is a Medicare-approved regional PPO plan. You are eligible to enroll in Group MedicareBlue PPO (Regional PPO) if you are entitled to Medicare Part A and enrolled in Medicare Part B, live in the plan service area, and are identified as an eligible plan participant by your employer or union. You must continue to pay your Medicare Part B premiums (and Part A, if applicable) if not otherwise paid for by Medicaid or another third party. The Group MedicareBlue PPO (Regional PPO) prescription drug benefit is only available to members of the Group MedicareBlue PPO (Regional PPO) plan. If you are already enrolled in a Medicare Advantage Prescription Drug plan, you must receive your Medicare prescription drug benefit through that plan.
Group MedicareBlue PPO (Regional PPO) has formed a network of doctors, specialists, and hospitals. You can use any provider who is part of our network or you may go to doctors out of the network. However, you may have to pay more for services received out of the network, except in emergency/urgent care situations. Group MedicareBlue PPO (Regional PPO) provides reimbursement for all covered benefits regardless of whether they are received in- or out-of-network. The providers in our network can change at any time. For a current Provider Directory contact Group MedicareBlue PPO (Regional PPO) Customer Service at the number listed below or visit our web site at www.YourMedicareSolutions.com.
Group MedicareBlue PPO (Regional PPO)’s contract with CMS is renewed annually, so enrollment in Group MedicareBlue PPO (Regional PPO) after 2010 cannot be guaranteed.
Group MedicareBlue PPO (Regional PPO) Member Services: 1-888-457-3009, daily, 8 a.m. to 8 p.m. Central Time. TTY users call 1-888-457-3005. You have the option to speak with a licensed sales representative when you call this number.
Group MedicareBlue Rx (PDP)
Group MedicareBlue Rx (PDP) is a Medicare-approved Part D sponsor. You are eligible to enroll in Group MedicareBlue Rx (PDP) if you are entitled to Medicare benefits under Part A or enrolled in Medicare Part B and live in the plan service area. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. You may be enrolled in only one Part D plan at a time. If you are enrolled in a Medicare Advantage plan, you may not join Group MedicareBlue Rx (PDP) unless you are a member of a Private-Fee-For-Service MA plan (PFFS) that does not provide Medicare prescription drug coverage, a Medicare Savings Account MA plan (MSA), or an 1876 Cost Plan.
Group MedicareBlue Rx (PDP) Customer Service: 1-877-838-3827, daily, 8 a.m. to 8 p.m. Central and Mountain Time. TTY users call 1-866-213-9262. You have the option to speak with a licensed sales representative when you call this number.
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Individual Members