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 may choose to either 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 each year occurs between Oct. 15 and Dec. 7 for coverage that begins Jan. 1 of the coming year. 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 at the end of the year will be effective Jan. 1 of next year.
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 be able to switch from one Medicare Advantage and/or Part D prescription drug plan to another.
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 9 p.m. Eastern time, Monday through Friday, Feb. 15 through Sept. 30; 8 a.m. to 9 p.m. Eastern time, seven days a week, Oct. 1 through Feb. 14. TTY users call 711.
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 9 p.m. Eastern time, Monday through Friday, Feb. 15 through Sept. 30; 8 a.m. to 9 p.m. Eastern time, seven days a week, Oct. 1 through Feb. 14. TTY users call 711.
Want us to call you? Just let us know!
H9572 S5584_W_Apr13BCBSMAdvWeb CMS Approved 04292013
Medicare Plus Blue PPOSM, BCN Advantage HMO-POSSM and BCN Advantage HMO FocusSM are health plans with Medicare contracts. 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 an estimated 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 1-877-241-2583, 8 a.m. to 8 p.m. Eastern time, Monday through Friday, with weekend hours Oct. 1 through Feb. 14. TTY users call 711. Certain services available 24/7 through our automated telephone response system. TTY users call 711. You may also write to: Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Mail Code X510, 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 is a brief summary, not a complete description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and or copayments/coinsurance may change on Jan. 1 of each year.
Medicare beneficiaries may enroll in Medicare Plus Blue PPO, BCN Advantage HMO-POS, BCN Advantage HMO or Prescription Blue PDP through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. BCBSM does not control Medicare's website and is not responsible for its content.
For more information, please contact Blue Cross Blue Shield of Michigan at 1-877-469-2583. TTY users call 711. Hours are: 8 a.m. to 8 p.m. Eastern time, Monday through Friday, with weekend hours Oct. 1 through Feb. 14. TTY users call 711. Certain services available 24/7 through our automated telephone response system.
You may only enroll in Medicare Plus Blue PPO or Prescription Blue PDP during specific times of the year. To learn more about enrollment periods, contact Member Services.
BCN Advantage HMO-POS
BCN Advantage HMO-POS is available in these counties: Allegan, Barry, Bay, Calhoun, Clare, Clinton, Crawford, Eaton, Genesee, Gladwin, Grand Traverse, Gratiot, Huron, Ingham, Ionia, Isabella, Jackson, Kalamazoo, Kalkaska, Kent, Lapeer, Livingston, Macomb, Mecosta, Midland, Missaukee, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Ottawa, Roscommon, Saginaw, St. Clair, Sanilac, Shiawassee, Tuscola, Van Buren, Washtenaw and Wayne. Premiums vary by county. You must continue to pay your Medicare Part B premium.
You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers, neither Medicare nor BCN Advantage will be responsible for the costs. Out-of-network services authorized by BCN Advantage will be covered. Our point-of-service benefit allows you to get care from providers not in our network under certain conditions. If you're traveling outside of Michigan, you're covered under our point-of-service BlueCard benefit and can access out-of-network doctors, specialists or hospitals that participate with Blues plans. You may receive most plan-covered services at in-network out-of-pocket cost sharing. You may need to pay higher cost-sharing for routine care from non-network providers.
If you are enrolled in BCN Advantage ClassicSM or PrestigeSM plans, you must use a network pharmacy to access your prescription drug benefit, except under non-routine circumstances when you cannot reasonably use a network pharmacy. Our pharmacy network includes the majority of chain pharmacies, mail order through Medco Pharmacy® (now a part of the Express Scripts family of pharmacies) or Walgreens, as well as long-term care and home infusion pharmacies. For additional information on network pharmacies, call Customer Service at 1-800-450-3680, 8 a.m. to 8 p.m., seven days a week. TTY users call 711. You may also write to: BCN Advantage, 2311 Green Road, Ann Arbor, MI 48105.
BCN Advantage HMO Focus
BCN Advantage HMO Focus is available only to residents of Wayne County. You must use BCN Advantage Focus plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers, neither Medicare nor BCN Advantage will be responsible for the costs. You must continue to pay your Medicare Part B premium. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments and restrictions may apply. Medicare beneficiaries may also enroll in BCN Advantage through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. BCN Advantage's contract with CMS is renewed annually and the availability of coverage beyond the end of the contract year is not guaranteed. Benefits, formulary, pharmacy, network, premium and/or coinsurance may change on Jan. 1 of each year.
BCN Advantage HMO Focus plan members must use a network pharmacy to access their prescription drug benefit, except under non-routine circumstances when they cannot reasonably use a network pharmacy. Our pharmacy network includes the majority of chain pharmacies, mail order through Medco Pharmacy® (now a part of the Express Scripts family of pharmacies) or Walgreens, as well as long-term care and home infusion pharmacies. For more information call the Customer Service number on the back of your ID card from 8 a.m. to 8 p.m., Monday through Friday, with weekend hours October 1 through February 14. TTY users should call 711. Certain services are available 24/7 through our automated telephone response system. You may also write to: BCN Advantage, 2311 Green Road, Ann Arbor, MI 48105.
The BCN Advantage benefit information provided on this website is not complete. Additional information should be requested before making a decision about your coverage. For full information on BCN Advantage benefits, current members should call our Customer Service department at 1-800-450-3680, from 8 a.m. to 8 p.m., seven days a week. TTY users call 711. Prospective members should call 1-877-469-2583. TTY users call 711. Hours are: 8 a.m. to 9 p.m. Eastern time, Monday through Friday, Feb. 15 through Sept. 30; 8 a.m. to 9 p.m. Eastern time, seven days a week, Oct. 1 to Feb. 14.
Benefits, formulary, pharmacy, network, premium and/or coinsurance may change on Jan. 1 of each year. Contact BCN Advantage for details.
If you decide to have your BCN Advantage 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. Medicare beneficiaries may enroll in BCN Advantage through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at medicare.gov. For more information, contact BCN Advantage at 1-877-469-2583. TTY users call 711. Hours are: 8 a.m. to 9 p.m. Eastern time, Monday through Friday, Feb. 15 through Sept. 30; 8 a.m. to 9 p.m. Eastern time, seven days a week, Oct. 1 to Feb 14.
Legacy Medigap
Legacy 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. Legacy Medigap is a Medigap health insurance policy administered by Blue Cross Blue Shield of Michigan. Neither Blue Cross Blue Shield of Michigan nor agents authorized to sell Blue Cross Blue Shield of Michigan policies are connected with Medicare.
