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 a 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).
Evidence of Coverage
The Evidence of Coverage describes your Medicare health benefits, services and prescription drug coverage as a member of our plan.
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.
Provider & Pharmacy Directories
More Information about BlueCare Plus’ Directories
If you need help finding a network provider, please call BlueCare Plus Member Service 1-800-332-5762 or access our Find a Doctor Tool online. If you would like a provider directory mailed to you, you may call the number 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 Chapter 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 Chapter 3, Section 2.4 of the Evidence of Coverage.
We update our formularies (drug lists) each year. Take a few minutes to see how your 2018 list of covered drugs compares to your new 2019 list.
Locate a Pharmacy
Just a few clicks and you’ll find the closest pharmacies in your area.
Many members save on their prescriptions with our mail-order program — you might find savings too!
DrugSource Prescription Request Form
Part D Out of Network Coverage
BlueCare Plus Pharmacy Claim Form
2018 Part D Prior Authorization Criteria
2019 Part D Prior Authorization Criteria
Step Therapy Criteria
Request for Clinical Redetermination
Saving at the Pharmacy
BlueCare Plus 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 $0 cost-share blood glucose monitors for our members. The program is easy to use, just click and print the coupon for either a free Ascensia® 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:
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.
BlueCare Plus provides the following benefits and tools to help members live healthier lives.
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.
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.
*BlueCare Plus members are eligible for our member discount program, but they are not part of the plan’s medical and prescription drug benefits.
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.
This page was updated on October 1, 2018