Plan & Administrative Changes/Updates for Providers:
Click here for important Medicare Advantage updates!
Blue Value is a Medicare Advantage HMO health plan offered within a select service area. Blue Value features all the health coverage services offered by Original Medicare, and some extra services Original Medicare does not offer, such as annual physical exam, vision benefits and a fitness center membership, see the 2012 Summary of Benefits or the 2013 Summary of Benefits.
Members must seen non-emergency care from provider network, see Provider Finder
Authorization requirement apply for specific services. See Summary of Benefits for pre-authorization details.
Members of the BlueValue plan have a Medicare Part D prescription drug benefit as part of the plan, see the Prescription Drug Formulary
FAST TRACK APPEALS
Medicare beneficiaries and providers have certain rights and protections related to financial liability under the Medicare Advantage (MA) Programs. Financial liability, appeal rights, and protections are communicated to beneficiaries through notices given by providers or the MA health plan. Download the forms and instructions below.
Blue Cross Blue Shield encourages our providers to participate in the CMS and HHS quality improvement initiatives. To learn more about these initiatives or find new announcements, please visit www.cms.hhs.gov/home/medicare.asp and scroll to the bottom under browser by Special Topic.