Services and Programs for Medicare Advantage Members
Are you a current member with a PPO, HMO, or Part D plan?
and then enter the required username and password information in the secure Member Log In at www.bcbsga.com
to view 2015 and 2014 member documents. Or, you can call Customer Service
if you have questions about your plan.
If you are looking for plans effective January 1, 2015, please note that a Dual Eligible Special Needs D-SNP plan is available in select areas in Georgia.
Not yet a member?
Learn more about the services and programs available to our members:
| Find a doctor – Click here to find information on the doctors that are available to you |
The more you know, the better you’ll feel.
We know how important it is to find the information you need to make decisions about your health.
| Register now. Our 24/7online tools provide the information you need when it’s most convenient for you. Just register, then log on for customized health tips and tools that will help you take control of your health. You may be surprised at all of the health management programs, health news and tools you’ll find that can give you greater ability to make more informed health care decisions.|
Medicare Advantage members can call to talk with trained registered nurses any time of the day or night to help:
| Answer your general health questions.|
| Assess your symptoms.|
| Determine the right care for you at the right time.|
Medicare Advantage Annual Healthy Checklist
Preventive care is one of the most important things you can do for your health. Early detection is often the key to successful treatment. Medicare Advantage Members can download and print the Healthy Checklist and take it to the doctor to help track preventive care screenings.
Medicare Advantage Preventive Service for Members
Important preventive care screenings — 100% covered!
When you use a network provider, the screenings listed below are covered 100%! So are your yearly wellness exams, flu and pneumonia shots, and even smoking-cessation counseling. For a complete list of covered screenings, see the Summary of Benefits.
| Prostate cancer|
| Colorectal cancer|
Care Management is here for you, for your special medical needs.
If you are dealing with the challenges of a chronic condition or a major health issue, you may benefit from our care management services. We can help you manage your health by providing friendly reminders or making sure you connect with your doctor. If you qualify for case management, we have nurses and social workers who will help you:
| Coordinate your preventive care.|
| Assist with learning how to manage your health condition(s).|
| Find out about other services, such as lifestyle coaching.|
| Access community resources like home care agencies or transportation services.|
| Understand your doctor’s discharge instructions, if you are leaving the hospital.|
SilverSneakers® Fitness Program
Your fitness program is at no additional cost to you!
The SilverSneakers® Fitness Program, a product of Healthways, is the nation’s leading exercise program designed exclusively for older adults.
| Through the SilverSneakers® program, you can use any of the participating locations across the nation. For members residing more than 15 miles outside of the participating fitness network, the program also offers a self-directed at home program alternative to engage you in sustainable physical activity. Visit www.silversneakers.com for more information, or call 1-888-423-4632 (hearing-impaired members call the National Relay Service: 711), Monday through Friday 8 a.m. to 8 p.m. EST to speak with a customer services representative.|
| While most plans include the SilverSneakers® Fitness Program, it is not available with all Medicare Advantage Plans. Please check your Summary of Benefits to confirm that the program is included with the plan you select. |
| Gym memberships or other fitness programs that do not meet the SilverSneakers® Fitness Program criteria are excluded.|
The SilverSneakers® Fitness Program provided by Healthways, Inc., an independent company. SilverSneakers® is a registered mark of Healthways, Inc.
We review your claims on a regular basis and make confidential recommendations to help you keep track of your health as well as look for potential issues. We’ll send you MyHealth Notes in the mail that:
| Track your routine tests and checkups. |
| Detect risk issues from the drugs you’re taking (if needed, we will alert you and your doctor right away).|
| Remind you to make your next appointment or keep up with preventive care.|
| Tell you about money-saving tips.|
You can see your Medicare Advantage vision benefits online, check eligibility, view claim information, download an out-of-network claim form, and search for providers. Need assistance? Call the Blue View Vision Insight Customer Care Center at 1-877-635-6403, or the number on the back of your ID card, to speak to a representative Monday through Saturday, 7:30 AM to 11:00 PM ET and Sunday 11:00 AM to 8:00 PM ET.
Discounts and Savings for you and your family members
SpecialOffersSM from Blue Cross and Blue Shield of Georgia rewards you with a range of discount programs from our vendors*.
As our Medicare Advantage plan member, you have access to special savings and discounts available to you directly from providers of alternative medicine therapies and health products that are not covered under your health plan. Once you join our plan, register and then log in to the secure member portal
and look for “Discounts”. Please refer to your sales kit for examples of the special savings and discounts.
* Vendors and offers are subject to change without prior notice. Blue Cross and Blue Shield of Georgia does not endorse and is not responsible for the products, services or information provided by the Special Offers vendors. Arrangements and discounts were negotiated between each vendor and Blue Cross and Blue Shield of Georgia for the benefit of our members.
Find out more by visiting Medicare’s fraud prevention and education website. Click the link below to do your part:
Have questions? Let’s talk.
To reach a licensed insurance agent, call us at 1-888-208-9892, TTY/TDD 711, 8 a.m. to 8 p.m., 7 days a week.
You may also call Customer Service
to learn more about our plans, 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas), from October 1 through February 14; and Monday through Friday (except holidays) from February 15 through September 30.
Blue Cross and Blue Shield of Georgia, Inc. is an LPPO plan and a PDP with a Medicare contract. Enrollment in Blue Cross and Blue Shield of Georgia, Inc. depends on contract renewal.
Blue Cross and Blue Shield Healthcare Plan of Georgia, Inc. is an HMO plan with a Medicare contract. Enrollment in Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. depends on contract renewal.
Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. is a D-SNP plan with a Medicare contract and a contract with the Georgia Medicaid program. Enrollment in Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. depends on contract renewal.
This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed. You are eligible to enroll if you are entitled to Medicare Part A and enrolled in Medicare Part B and you live in the service area. You must continue to pay your Medicare Part B premium. With some exceptions you can only enroll during certain times of the year.
The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
Limitations, copayments, and restrictions may apply.
Benefits, formulary, pharmacy network, provider network, premium and or co-payments/co-insurance may change on January 1 of each year.
To obtain an aggregate number of grievances, appeals and exceptions filed or for full information on benefits, please call Customer Service
Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment and any applicable conditions associated with using the plan benefits.
If you have special needs, our Plan documents are available in other formats. Please call Customer Service
Y0071_15_22536_R CMS Approved 12/2/2014
Last Updated 11/21/2014