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Legal

CMS Disclaimer

Blue Cross and Blue Shield of Georgia, Inc. is a Medicare Advantage Organization and a Prescription Drug Plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of Georgia, Inc. depends on contract renewal.


Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. is a Medicare Advantage Organization with a Medicare contract. For Dual-Eligible Special Needs Plans: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. is a D-SNP 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 information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.


This information is available for free in other languages. Please call our Customer Service number, (TTY: 711), 8 a.m. to 8 p.m., seven days a week, October 1 to February 14 (except holidays); 8 a.m. to 8 p.m., Monday – Friday, February 15 to September 30 (except holidays).


Esta información está disponible sin cargo en otros idiomas. Por favor llame a nuestro número de Servicio al Cliente , (TTY: 711), de 8 a. m. a 8 p. m., los 7 días de la semana (excepto los días feriados) desde el 1° de octubre hasta el 14 de febrero, y de 8 a. m. a 8 p. m., de lunes a viernes (excepto los días feriados) del 15 de febrero hasta el 30 de septiembre.


本資訊另免費提供其他語言版本。請致電聯絡我們的客戶服務部 (聽語障用戶請致電:711),服務時間為 10 月 1 日至 2 月 14 日,週一至週日(節假日除外),上午 8 點到晚 8 點;2 月 15 日至 9 月 30 日,週一至週五(節假日除外),上午 8 點到晚 8 點。

Grievances and Appeals Disclaimer

Evidence of Coverage Disclaimer

Evidence of Coverage:

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 may be available in other formats. Please call Customer Care for details.

For information on provisions for non routine access to covered Part D drugs at out-of-network pharmacies, including limits and financial responsibility for access to these drugs please reference your Evidence of Coverage, or call Customer Care.

Customer Service

Disclaimer for the "Find a Pharmacy" search tool:

If you are not a member, you can use this "Find a Pharmacy" search tool to locate the pharmacies in your area that participate in our Medicare Advantage Prescription Drug (MA-PD) or Medicare Part D (PDP) Plans.

If you are already a plan member with Medicare Part D coverage, you can use this "Find a Pharmacy" search tool to search for participating pharmacies and obtain contact information and driving directions.

Our plans feature more than 68,814 pharmacies in our network. Generally, you must use network pharmacies to receive plan coverage. Our network includes both pharmacies with preferred cost sharing and standard cost sharing. You are never far from one of our network pharmacies; but to pay a lower amount, you should go to one of the pharmacies with preferred cost sharing. Pharmacies with standard cost sharing are still in our network but do not offer the discounted prices available at pharmacies with preferred cost sharing. 

Please note that the pharmacies listed in the search are only the network pharmacies with preferred cost-sharing. There may be network pharmacies with standard cost-sharing within the search criteria.

Please review the following information about the pharmacy network for specific plans:

  • The Anthem MediBlue Dual Advantage (HMO SNP) pharmacy network offers limited access to pharmacies with preferred cost sharing in Kern county, CA. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call 1-888-230-7338 TTY: 711 or consult the online pharmacy directory at www.anthem.com/ca/shop.
  • The Anthem MediBlue Access (PPO) pharmacy network offers limited access to pharmacies with preferred cost sharing in Mathews county, VA. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call 1-866-827-9866 TTY: 711 or consult the online pharmacy directory at www.anthem.com/shop.
  • The Anthem MediBlue Access (PPO) pharmacy network offers limited access to pharmacies with preferred cost sharing in Columbia, Dodge, Marathon, Marinette, Oconto, Portage, Waupaca and Waushara counties, WI. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call 1-855-690-7802 TTY: 711 or consult the online pharmacy directory at www.anthem.com/shop.

Members: Please note that our plans have contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area. In addition, even though a pharmacy is listed in network, this does not guarantee that the pharmacy is still in the network.

When searching for a pharmacy, please note that if you are enrolled in a health plan that does not include Medicare Part D prescription drug coverage, the pharmacies for your health plan are listed in this directory since they also provide one or more prescription drugs that are covered under your health benefits (because they are covered under Medicare Part B, not Part D). If you are not sure whether you have Part D coverage, please refer to your Summary of Benefits or Evidence of Coverage, or call Customer Service or the phone number listed on the back of your member ID card.

You can get prescription drugs shipped to your home through our network mail-order delivery program. You also have the choice to sign up for automated mail-order delivery. Typically, you should expect to receive your prescription drugs within 10 business days from the time that the mail-order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please call Customer Service at the phone number listed for your plan, or call the Customer Service phone number listed on your Member ID card. Customer Service representatives are available to answer your call directly from 8 a.m. to 8 p.m., 7 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. Our automated system is available anytime for self-service options, including after hours, weekends, and holidays.

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/or enrolled in Medicare Part B and you live in the service area. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. With some exceptions you can only enroll during certain times of the year.

If you decide to switch to premium withhold or move from premium withhold to direct bill, it could take up to three months for it to take effect and you will ultimately be held responsible for those premiums.

Medicare beneficiaries may enroll in Medicare Advantage Prescription Drug (MA-PD) plans and Medicare Part D (PDP) plans through the CMS Medicare Online Enrollment Center, located at www.medicare.gov. For more information please contact Customer Service.

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 for details.

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;
  • The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778;
  • or Your State Medicaid Office.

If you have qualified for additional assistance for your Medicare Prescription Drug Plan costs, the amount of your premium and cost at the pharmacy will be less. Once you have enrolled in Medicare Part D coverage, Medicare will tell us how much assistance you are receiving, and we will send you information on the amount you will pay. If you are not receiving this additional assistance, you should contact 1-800-MEDICARE (TTY/TTD users call 1-877-486-2048), your state Medicaid Office, or local Social Security Administration Office to see if you might qualify.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Disclaimer for "Find your covered drugs" search tool:

What Prescription Drugs are Covered?
A drug list (also called a formulary) is a list of drugs selected by us in consultation with a team of health care providers, which represent prescription therapies believed to be a necessary part of a quality treatment program. Your plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy and other plan rules are followed.

The Medicare Advantage with Prescription Drug (MA-PD) plans and Medicare Prescription Drug plans (PDPs) cover both brand-name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs and are approved by the Food and Drug Administration (FDA) to be as safe and effective as brand-name drugs.

Note: The drug list may change during the year. All changes are subject to the policy issued by the Centers for Medicare and Medicaid Services (CMS) and can only occur when specific guidelines are met.

For information on how to obtain an exception to the plan’s drug list, utilization management tools, or tiered cost-sharing please reference your Evidence of Coverage or contact Customer Service.

The drug costs displayed represent a 30 day supply, and are only estimates. Actual costs may vary based on the specific quantity, strength and/or dosage of the drug.

For information on provisions for non routine access to covered Part D drugs at out-of-network pharmacies, including limits and financial responsibility for access to these drugs please reference your EOC, or call Customer Service.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Plan Documents Disclaimer

Additional Information about the Medicare Advantage (MA), Medicare Advantage Prescription Drug (MA-PD)  and Prescription Drug (PDP) Plans:

Grievances, Appeals and Exceptions Information

Service Area Disclaimer -GA

In Georgia, the service area for BCBSGa Blue MedicareRx (PDP) is the entire state of Georgia.

In Georgia, these are the service areas for Medicare Advantage with Prescription Drug (MA-PD) plans:

BCBSHP MediBlue Dual Advantage (HMO SNP) plan – Contract H5422 007:
Our service area includes these counties in Georgia:
Bryan,  Burke, Chatham, Clayton, Columbia,  DeKalb, Effingham, Forsyth, Fulton, Glascock, Gwinnett, Harris, Jefferson, McDuffie, Muscogee, Richmond, Rockdale, Talbot, and Warren

BCBSHP MediBlue Plus (HMO) plan – Contract H5422 008:
Our service area includes these counties in Georgia:
Bryan, Burke, Chatham, Clayton, Columbia, DeKalb, Effingham, Forsyth, Fulton, Glasscock, Gwinnett, Harris, Jefferson, McDuffie, Muscogee, Richmond, Rockdale, Talbot, and Warren

BCBSHP MediBlue Prime Select (HMO) plan – Contract H5422 009:
Our service area includes these counties in Georgia:
Clayton, DeKalb, and Fulton

BCBSGa MediBlue Access (PPO) plan – Contract H9947 005-001:
Our service area includes these counties in Georgia:
Bibb, Meriwether, Peach, Toombs, and Twiggs

BCBSGa MediBlue Access (PPO) plan – Contract H9947 005-002:
Our service area includes these counties in Georgia:
Forsyth, Fulton, Harris, Jones, Liberty, Muscogee, Newton, Rockdale, and Talbot

Full Legal MA and MAPD Disclaimer - GA

Legal Disclaimer for Medicare Advantage with Prescription Drug (MA-PD) plans:

PPO plans:
Blue Cross and Blue Shield of Georgia, Inc. is an LPPO plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of Georgia, Inc.depends on contract renewal. Blue Cross and Blue Shield of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Legal Disclaimer for Medicare Advantage with Prescription Drug (MA-PD) plans:

HMO plans:
Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an HMO with a Medicare contract. Enrollment in Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.,depends on contract renewal. Blue Cross and Blue Shield of Georgia, Inc., and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

HMO SNP plans:
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. Blue Cross and Blue Shield of Georgia and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

Full Legal Prescription Drug Plans Disclaimer - GA

Legal Disclaimer for Medicare Part D plans:

Blue Cross and Blue Shield of Georgia, Inc. is a PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of Georgia, Inc. depends on contract renewal. Anthem Insurance Companies Inc. (AICI) has contracted with the Centers for Medicare & Medicaid Services (CMS) to offer Medicare Prescription Drug Plans (PDPs) noted above or herein AICI is the state-licensed, risk-bearing entity offering these plans. AICI has retained the services of its related companies and authorized agents/brokers/producers to provide administrative services and/or to make the PDPs available in this region. Blue Cross and Blue Shield of Georgia, Inc. and AICI are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

Enrollment Instructions

How to Enroll  in a Plan:     
You have three options for enrolling: online, by phone, or by mail or fax.
If you choose to print the enrollment form, and then apply by mail or fax, review the Enrollment Instructions for information on where to submit the form.

Legal Disclaimer Terms of Use - GA

This online store is owned and operated by Blue Cross and Blue Shield of Georgia. By using this online store, you acknowledge and agree to abide by all of these terms of use.  The insurance products described in this online store are offered only to persons over the age of 18 and who are residents of Georgia. You must be a resident of the state where the policy is offered.  The Medicare Supplement products are not connected with or endorsed by the U.S. Government or the federal Medicare program.  The purpose of this communication is the solicitation of insurance.  Contact will be made by an insurance agent or an insurance company if you submit a request for more information or an application. This site is intended for consumer and informational use only. We do not guarantee to provide you coverage and we reserve the right to reject your application based on applicable enrollment and eligibility criteria specific to Medicare Advantage, Part D or Medicare Supplement Products.  Do not cancel your existing insurance until you receive written confirmation from Blue Cross and Blue Shield of Georgia that your application has been approved and your policy is in effect.  Your completion of the online enrollment process constitutes your acceptance of the applicable policy should we approve your application. Your enrollment/acceptance constitutes your authorization for the initial and recurring premium payment by credit card or automatic bank draft, should you select those methods. 

The insurance product that we offer to you through this online store is based, in part, on the zip code that you provide. You accept sole responsibility for entering the proper zip code into the shopping experience. You are responsible for maintaining the confidentiality of your username and password for this online store and for restricting access to your computer.  You acknowledge and agree that neither Blue Cross and Blue Shield of Georgia nor any of its affiliates will have any liability to you for any unauthorized application, enrollment or credit card transaction made using your username and password if such transaction occurs before you have notified us of possible unauthorized use and we had a reasonable period of time to act on that notice. Further, we may suspend or cancel your account or your access to the Site at any time even without receiving notice from you if we suspect that your account and/or password is being used in an unauthorized or fraudulent manner. Blue Cross and Blue Shield of Georgia may, in its sole discretion, change, suspend or terminate, temporarily or permanently, the online store (in part or in full), for any reason, without notice and without liability to you.  If another party is providing information on behalf of the consumer as part of the application or enrollment process, the party meets applicable laws regarding authorized representatives, and the party entering such information hereby agrees to accept all liability that may arise from providing us inaccurate information and/or selecting the proper/improper product.

DISCLAIMER OF WARRANTIES: YOU AGREE THAT ALL CONTENT PROVIDED ON OR THROUGH THIS ONLINE STORE IS PROVIDED “AS IS”.  BLUE CROSS AND BLUE SHIELD OF GEORGIA AND ITS AFFILIATES DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED.  BLUE CROSS AND BLUE SHIELD OF GEORGIA, ITS AFFILIATES AND RELATED ENTITIES, NOR ANY OF THEIR RESPECTIVE EMPLOYEES, AGENTS, THIRD PARTY CONTENT PROVIDERS OR LICENSORS WARRANT THAT THIS ONLINE STORE WILL BE UNINTERRUPTED, TIMELY, SECURE OR ERROR FREE; THAT ANY DEFECTS OR ERRORS WILL BE CORRECTED; THAT THE CONTENT OR SERVICE IS FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. LIMITATION OF LIABILITY: NEITHER BLUE CROSS AND BLUE SHIELD OF GEORGIA NOR ITS EMPLOYEES SHALL BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES RESULTING FROM THE USE OR INABILITY TO USE THIS SITE.