Notices and Disclaimers

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BlueCare Plus Tennessee, an Independent Licensee of the BlueCross BlueShield Association. BlueCare Plus Tennessee is an HMO Special Needs Plan (SNP) with a Medicare contract and a contract with the Tennessee Medicaid program.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments and restrictions may apply.

Benefits, premiums, copayments and coinsurance may change on January 1 of each year.

The formulary, provider network and pharmacy network may change at any time. You will receive notice when necessary.

Enrollment in BlueCare Plus Tennessee depends on contract renewal. The availability of coverage beyond the end of this contract year is not guaranteed.

Individuals must have Part A, Part B and Medicaid cost-sharing assistance to enroll.

All services must be covered by Medicare or BlueCare Plus HMO D-SNP plan and received from network providers.  With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers. For a complete list of benefits as compared to Original Medicare, please see the Summary of Benefits. For detailed information on BlueCare Plus plan and its limitations, copayments and restrictions, please review the Evidence of Coverage available below.

2018 Evidence of Coverage

You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers BlueCare Plus will not be responsible for the costs.

BlueCare Plus covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.

You must use network pharmacies to access your prescription drug benefits, except under non-routine circumstances; quantity limitations and restrictions may apply.

BlueCare Plus has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area.

BlueCare Plus has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2016 based on a review of BlueCare Plus Model of Care.

BlueCare Plus is not responsible for the content of their social media pages or the websites of any downstream entity that provides information on the Plan/Part D Sponsor’s behalf.

Notice: TennCare is not responsible for payment for these benefits except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits.

Disaster Assistance
Natural disasters are unpredictable, but as a BlueCross BlueShield plan member you can count on getting the care you need. If the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your area, you will still get care from your plan.

Do not wait – go to the nearest facility to get help. Your health and safety are the most important things. We’ll help take care of the rest.
Generally, during a disaster, you can get care from out-of-network providers at in-network cost-sharing. If you cannot use a network pharmacy during a disaster, you may be able to fill your prescription drugs at an out-of-network pharmacy.
If you have any questions, please contact us:
BlueCare Plus – 1-800-332-5762, TTY: 711

This page was updated on October 1, 2017