Turning 65?
As you become eligible for Medicare, it's important to prepare. The Social Security Administration advises people to file for Medicare benefits three months before the month in which they turn age 65.
If you already receive Social Security, you will automatically be enrolled in Medicare Parts A and B. If not, you need to apply.
To make an appointment, call the Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m. Monday through Friday. TTY users should call 1-800-325-0778. You can also apply in person at your local Social Security office.
By applying in advance, the effective date will be the first day of the month in which you turn 65. For people with birth dates on the first day of the month, the effective date will be the first day of the month prior to their birth date. The Social Security Administration will send you a red, white and blue Medicare ID card with your Parts A and B effective date.
Don't delay applying for Medicare. The Centers for Medicare & Medicaid Services, the government program that administers Medicare, applies a financial penalty to persons who don't apply for Medicare coverage during their first eligibility period.
Already enrolled in Medicare?
Each year you have a choice on whether to keep or change your Medicare coverage. The health care reform laws passed in 2010 changed the enrollment periods during which you can choose a plan, effective January 2011. Here's a brief overview of these changes.
Enrollment periods
Every year, you have an opportunity to change plans or insurance providers
Annual election period
The annual election period in 2011 will occur between Oct. 15 and Dec. 7 for coverage that begins Jan. 1, 2012. During this time, you can:
- Change Medicare Advantage plans
- Enroll in a Part D prescription drug plan
- Change your Part D prescription drug plan
- Return to Original Medicare
Changes made will be effective Jan. 1, 2012.
Annual Disenrollment Period
The legislation provides for a 45-day annual disenrollment period from Jan. 1 through Feb. 14. During this time, you can only drop your Medicare Advantage plan and return to Original Medicare. If you exercise this option, you will also be able to add a Part D prescription drug plan. You won’t able to switch between Medicare Advantage and/or Part D prescription drug plans.
Special election periods
Special election periods provide an opportunity to enroll in or switch plans outside of the annual enrollment periods. You may be eligible for a special enrollment period if:
- You permanently move outside your plan's service area. You may change plans one month prior to your move and two months afterward.
- You lose coverage from your employer group, group retiree plan or COBRA. You're entitled to a special enrollment period that begins the month you are advised of your loss of creditable coverage. This special enrollment period ends two months after your loss of creditable coverage.
- You qualify for extra help to pay for your prescription drug costs (known as low-income subsidy benefits) and you don't receive Medicaid benefits. You may enroll in a Part D plan during a special enrollment period that begins the month you become eligible for LIS benefits, and lasts as long as you are eligible for LIS benefits. This special enrollment period allows you to enroll in, or disenroll from, a Part D plan at any time.
- You live in an institution, like a nursing home.
Contact Member Services for more information about the special enrollment period.
We expect changes driven by the health care reform laws to continue to evolve. As they do, you can count on us to make them — and their impacts on you – as easy to understand as possible.
Still have questions? Call us!
Call 1-877-469-2583 from 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704.
Current members
Call the Member Services number on the back of your ID card.
Prospective members
Call 1-877-469-2583 from 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704.
Want us to call you? Just let us know!
H9572 S5584_W_12BCBSMAdvantageWebR2 CMS Approved 04262012
Medicare Plus Blue PPOSM is a health plan with a Medicare contract. Prescription Blue PDPSM is a stand-alone prescription drug plan with a Medicare contract.
Medicare Plus Blue PPO
Medicare Plus Blue PPO is available to all Medicare beneficiaries who are Michigan residents and are entitled to receive services under Medicare Part A and enrolled in Part B.
With the exception of emergency or urgent care, it will cost more to get care from non-plan or non-preferred providers. Your responsibility will be greater out-of-network when the out-of-network coinsurance is based on the Medicare allowed amount and the contracted amount is lower. You may receive services from any provider who accepts Original Medicare. Your out-of-pocket costs will be lower if you choose a network provider. To find a network provider, visit www.bcbsm.com/medicare/provdirectory.shtml.
Prescription Blue PDP
Prescription Blue PDP is available to all Medicare beneficiaries who are Michigan residents entitled to receive services under Medicare Part A and/or enrolled in Part B.
Medicare Plus Blue PPO and Prescription Blue PDP
Premiums vary by county. You must continue to pay your Medicare Part B premium.
Limitations, copayments and restrictions may apply.
Our network includes approximately 2,300 Michigan retail pharmacies, of which 86 percent are network pharmacies. Nationwide, most chain pharmacies are in our network, as well as long-term care and home infusion pharmacies and Indian/Tribal/Urban (Indian Health Service) pharmacies.
In general, benefits are only available at contracted network pharmacies. Plan drugs may be covered in special circumstances, for instance, illness while traveling outside of the plan's service area where there is no network pharmacy. You may have to pay more than your normal cost sharing amount if you get your drugs at an out-of-network pharmacy. Quantity limitation and restrictions may apply. In addition, you will likely have to pay the pharmacy's full charge for the drug and submit documentation to receive reimbursement from Blue Cross Blue Shield of Michigan. For additional information on network pharmacies, please call Member Services at 1-877-469-2583, 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704. You may also write to: Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Mail Code X435, Detroit, MI 48226.
If you decide to have your plan premium withheld from your Social Security check or deducted from your checking or savings account, it may take up to three months for the automatic deduction to begin. If your premium amount is currently withheld from your Social Security check or deducted from your checking or savings account and you wish to receive a monthly bill instead, the change may also take up to three months to become effective. During this time, you will be responsible for paying your premium.
The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on Jan. 1, 2013.
Medicare beneficiaries may enroll in Medicare Plus Blue PPO, BCN Advantage HMO-POS or Prescription Blue PDP through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. For more information, please contact Blue Cross Blue Shield of Michigan at 1-877-469-2583, 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704.
You may only enroll in Medicare Plus Blue PPOSM or Prescription Blue PDPSM during specific times of the year. To learn more about enrollment periods, please contact Member Services.
