Call us at 1-800-930-2836 (TTY 711)

Medicare Advantage Plans (also known as Medicare Part C)

This type of insurance covers Original Medicare and more. There are two types of Medicare Advantage plans: Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). Both types usually offer Medicare Prescription Drug Plans (Medicare Part D) as a benefit. When Part C and Part D are offered, they are referred to as a Medicare Advantage Prescription Drug Plan (MAPD). MAPD plans have low monthly premiums and low copays, with additional benefits at no additional costs. Medicare Advantage plans usually offer benefits above Original Medicare like dental coverage, eyewear, hearing aid discounts and more.

Medicare Advantage Health Maintenance Organization (HMO)

Some people are comfortable having one doctor to coordinate their care with specialists and other health care providers. If that’s you, this is an option you may want to consider. With this type of plan, you must choose a primary care physician (PCP) to coordinate your medical needs with in- network providers. With most Medicare HMOs you must use doctors, specialists, or hospitals in the plan’s network in order to receive coverage, except in a few cases, like medical emergencies.

Medicare Advantage Preferred Provider Organization (PPO)

What if you want the savings of a provider network and the flexibility to see doctors outside the network? A Medicare Advantage PPO plan allows you to have them. It lets you save with low out-of-pocket costs when you use in-network providers, and have the option to use health care providers out-of-network. In addition, these types of plans have annual limits on out-of-pocket costs. After you reach the limit, these plans pay 100% of covered services for the rest of the year.

Medicare beneficiaries may also enroll in BlueCross Total (PPO), BlueCross Secure (HMO), BlueCross Rx Value (PDP) and BlueCross Rx Plus (PDP) through the CMS Online Enrollment Center at www.medicare.gov.

BlueCross BlueShield of South Carolina is a Medicare Advantage PPO and HMO plan with a Medicare contract. BlueCross Rx Value and BlueCross Rx Plus are stand-alone prescription drug plans with a Medicare contract. Enrollment in BlueCross Total, BlueCross Secure, BlueCross Rx Value or BlueCross Rx Plus depends on contract renewal.

You must continue to pay your Part B premium. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, copayments or coinsurance may change on January 1 of each year.

Out-of-network/non-contracted providers are under no obligation to treat BlueCross BlueShield of South Carolina Medicare members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call Customer Service or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Current members should call Customer Service at 1-855-204-2744 for additional information. (TTY users should call 711). Hours are seven days a week, 8 a.m. to 8 p.m., Oct. 1, 2019, to Mar. 31, 2020.  Monday – Friday, 8 a.m. to 8 p.m. all other times.

If you are not a member, call us at 1-800-930-2836 (TTY users should call 711). We are available for phone calls from October 1 to December 31; you can call us 8 a.m. to 8 p.m., 7 days a week. From January 1 to September 30, we’re here 8 a.m. to 6 p.m., Monday through Friday. Calls to this number are answered by a licensed insurance agent.

BlueCare and Blue Select are not connected with or endorsed by the U.S. Government or the Federal Medicare Program. These policies have limitations and exclusions.