Member Plan Tools

  • You+Blue

This is your online source designed especially for you for important information about your health and benefits. We encourage you to register for BlueAccess. Through this secure website, you can check the status of your medical claims, review your Explanation of Benefits, order replacement ID cards, and learn about services your coverage includes and more. Register now to see what BlueAccess has to offer.

BLUEACCESS REGISTRATION

With all-in-one Medicare plan from BlueCare Plus, you can make sure we cover everything you need. Use these helpful tools for finding doctors, pharmacies and medication coverage.

As always, we are here to answer your questions. You can reach us by calling 1-800-332-5762 (TTY users should call 711)

Benefits & Coverage

Benefits & Coverage

Evidence of Coverage
The Evidence of Coverage describes your Medicare health benefits, services and prescription drug coverage as a member of our plan.

BlueCare Plus 2018 Evidence of Coverage
Annual Notice of Changes 2018 (ANOC)

Summary of Benefits
The Summary of Benefits describes in detail what medical conditions and services will be covered, for what amounts and your financial responsibilities.

 BlueCare Plus 2018 Summary of Benefits

Provider & Pharmacy Directories
More Information about BlueCare Plus’ Directories

If you need help finding a network provider, please call BlueCare Plus Customer Service 1-800-332-5762 or access one of the directories above or you may access our online provider directory at Find a Doctor. If you would like a provider directory mailed to you, you may call the number above, or request one at the website link provided above or email us.

BlueCare Plus Member Rights
Questions on coverage decisions or appeals? You can get answers and information here.

BlueCare Plus Out of Network Coverage
It is important to know which providers are part of our network because, with limited exceptions, while you are a member of our plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, when you are out of the area), out-of-area dialysis services, and cases in which BlueCare Plus (HMO SNP) authorizes use of out-of-network providers. See Chapter 3 of the Evidence of Coverage (Using the plan’s coverage for your medical and other covered services) for more specific information about emergency, out-of-network, and out-of-area coverage.

The plan covers emergency care or urgently needed care that you get from an out-of-network provider. For more information about this, and to see what emergency or urgently needed care means, see the Evidence of Coverage Section 3.

If you need medical care that Medicare requires our plan to cover and the providers in our network cannot provide this care, you can get this care from an out-of-network provider. You will need to obtain authorization from the plan prior to seeking this care. In this situation, we will cover these services as if you got the care from a network provider. For information about getting approval to see an out-of-network doctor, see Section 2.4 of the Evidence of Coverage. Kidney dialysis services that you get at a Medicare-certified dialysis facility when you are temporarily outside the plan’s service area.

Pharmacy

Pharmacy

Formulary
The formulary is a comprehensive list of prescription drugs covered by your plan, BlueCare Plus.
2018 Formulary
Formulary Archive

Locate a Pharmacy
Pharmacy Locator
Just a few clicks and you’ll find the closest pharmacies in your area.

Mail-Order Pharmacy
Many members save on their prescriptions with our mail-order program — you might find savings too!
DrugSource Prescription Request Form

Other Documents
Part D Out of Network Coverage
BlueCare Plus Pharmacy Claim Form
Part D Prior Authorization Criteria
Step Therapy Criteria
Coverage Determination
Request for Clinical Redetermination
Quality Assurance
Transition Policy

Saving at the Pharmacy
BlueCross BlueShield of Tennessee often partners with suppliers to offer free and discounted necessities to help staying healthy more affordable.

Do you need a blood sugar monitor?

We offer free blood glucose monitors for our members. The program is easy to use, just click and print the coupon for either a free Bayer® or OneTouch® monitor and take it to your pharmacy.

Have Questions about Your Medicines? Ask a Specialist Pharmacist.
You don’t have to wonder if a drug could cause side effects or an interaction. A Specialist Pharmacist can answer your questions.

Help from a Specialist Pharmacist is available to you at no extra cost. It’s part of your health plan’s benefits. And it’s just a phone call away.

Why Call a Specialist Pharmacist?
Specialist Pharmacists are part of a team that gives you advice and helps you get the most from your benefits.

They understand medicines used to treat conditions like:

  • High blood pressure
  • Diabetes
  • High cholesterol
  • Cancer
  • Asthma

Talk to a Specialist Pharmacist Today
Call 1-877-680-4878, Monday through Friday, from 9 a.m. until 7 p.m. ET (except holidays) to talk to a Specialist Pharmacist. TTY users should call 1-800-716-3231.

Health & Wellness

Health & Wellness

BlueCross BlueShield of Tennessee provides the following benefits and tools to BlueAdvantage and BlueElite℠ Plan Members to help members live healthier lives.

SilverSneakers® Fitness Center Membership
Health Guide for Seniors
My Health & Wellness

Member Discount Program
Save more with our exclusive member discounts.* Members can save money on a variety of health and wellness products and services. See what’s available now.

Over The Counter (OTC) Drugs
BlueCare Plus has designed this benefit to save time and money as well as help support your overall wellness and health. The items available can be viewed through Drug Source, Inc., and purchased using your OTC benefit and delivered right to your door.

Other Resources
There are plenty of great online resources for Medicare information. As you partner in health, we recommend these sites for Tennessee Medicare Beneficiaries and their families. Here’s the list.

Did You Know?
BlueCross BlueShield of Tennessee has been proud to support the Tennessee Senior Olympics for more than 30 years.

*BlueCare Plus members are eligible for our member discount program, but they are not part of the plan’s medical and prescription drug benefits.

Tools

Tools

Find A Doctor
Quickly find doctors, specialists, hospitals or other health care facilities in our network. You’ll be able to print your personalized search, including directions to their offices.

Locate a Pharmacy
Pharmacy Locator
Just a few clicks and you’ll find the closest pharmacies in your area.

This page was updated on October 1, 2017