If you don't participate with Medicare

If you do not participate with Medicare, you can still become a deemed provider with Medicare Plus Blue PFFS^SM plan.

 

Limiting charge

If you participate with Medicare, the limiting charge may not be applied and you may collect only applicable coinsurance and copayment amounts.

 

If you do not participate with Medicare and you do not accept our terms and conditions, the limiting charge may be applied in emergency situations (for example, when the patient is not able to inform the provider that he or she is a Medicare Plus Blue PFFS member or when the provider could not access our terms and conditions).

 

In these instances, BCBSM will pay the limiting charge plus the Medicare-approved amount, minus any applicable member copayment or coinsurance amount. Providers may not otherwise charge or bill the members.