How to enroll in MyBlue Medigap℠

2013 plan information

It’s easy to enroll in MyBlue Medigap. You can:

• Calculate your rate and enroll online now.
• Download an enrollment application (PDF), print it, fill it out and return it to us at:
  Mail Code C411
  Blue Care Network of Michigan
  P.O. Box 5043
  Southfield, MI 48086-5043
• Call us at 1-877-469-2583 to enroll over the phone. Representatives are available to assist you from 8 a.m. to 8 p.m. seven days a week.
• Contact an insurance agent authorized to sell Blue Care Network policies.

If you’re currently covered by a Blue Cross Blue Shield of Michigan or a Blue Care Network of Michigan group plan, please call 1-877-469-2583 or contact your Blue Care Network agent for information on how to enroll in the MyBlue Medigap plan. Indicate that you’re switching to a Medigap plan from your current coverage. We’ll help you enroll and ensure that you have no lapse in coverage.

If you are currently enrolled in a Medicare Advantage plan and wish to enroll in Medigap, you must disenroll in writing from Medicare Advantage before enrolling in Medigap. You can disenroll from Medicare Advantage only at certain times of the year. Call your Medicare Advantage customer service department for information on how to disenroll from that plan and prevent a lapse in coverage.

If you’re covered under a health policy from any other insurer, do not cancel that coverage until you receive your MyBlue Medigap certificate and are sure you want to keep it. We will mail a booklet to you that includes your certificate when we enroll you in the plan.

MyBlue Medigap offers access to any hospital, doctor or other health care provider in the U.S. or its territories that accepts Medicare assignment. The plan does not require members to use a specified provider network. MyBlue Medigap is a Medigap plan administered by Blue Care Network. Certain factors may affect the monthly premium cost: geographic location of the applicant’s residence, age, gender, height, weight and whether the applicant uses tobacco. Neither Blue Care Network nor agents authorized to sell Blue Care Network policies are connected with Medicare.