MEDICAID WITH MEDICARE (BLUECARE PLUS) RESOURCES

A few extras you might need

Learn more about your benefits, find member discounts and get the most out of your plan.

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YOUR ID CARDS
Let’s get to know which cards you’ll need

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BENEFITS FOR BLUECARE PLUS MEMBERS
We can help you

BlueCare Plus members can call 1-800-332-5762 (TTY: 711)1-800-332-5762 (TTY: 711) to sign up for these benefits.

Leave the cooking to us

After a stay in the hospital, cooking might not be possible at first. That’s where we come in.

Your care team can help you get two meals a day for up to seven days after your hospital stay. And it won’t cost you anything extra.

Choose your meals from a broad, nutritious menu | BCBS of Tennessee

Choose your meals from a broad, nutritious menu

Have your meals delivered to you | BCBS of Tennessee

Have your meals delivered to you

Put your meals in the refrigerator for up to 14 days | BCBS of Tennessee

Put your meals in the refrigerator for up to 14 days

Get a ride to your health appointments

We want to make getting to your appointments a little easier.

As a BlueCare Plus member, you get up to 100 one-way rides or 50 two-way rides every year.

Get rides for things like:

  • Health care provider visits
  • Pharmacy refills
  • Diagnostic imaging
  • Hospital stays
Get a ride to appointments up to 50 miles away | BCBS of Tennessee

Get a ride to appointments up to 50 miles away

 Schedule your ride 72 hours before your appointment | BCBS of Tennessee

Schedule your ride 72 hours before your appointment

Call 1-855-681-5032 (TTY: 711) to schedule a ride | BCBS of Tennessee

Call 1-855-681-5032 (TTY: 711)1-855-681-5032 (TTY: 711) to schedule a ride

We’re here to help you reach your health and fitness goals.

You get:

  • Access to fitness centers locally and nationwide
  • Group exercise classes perfect for all fitness levels
  • Social activities
Exercise at home or at a local fitness center | BCBS of Tennessee

Exercise at home or at a local fitness center

Keep track of your fitness goals | BCBS of Tennessee

Keep track of your fitness goals

Access healthy diet and fitness tips | BCBS of Tennessee

Access healthy diet and fitness tips

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Find the forms and documents you might need

If you want to look at your drug list or just find a form, you can see all your documents here.

SEE DOCUMENTS & FORMS

Getting the drugs you need

See if your drugs are covered, have them delivered to your home and talk to a pharmacist one-on-one.

SEE PHARMACIES & PRESCRIPTIONS
YOUR RIGHTS AS A MEMBER
You have the right to

Don’t be afraid to ask us to cover something that you and your doctor feel you need. We take every request seriously and want you to get the care that’s right for you.

How do I ask for medical services?

You, your doctor or your representative can contact us about providing coverage for medical care. If we will not cover your request then we will tell you in writing why not and how to appeal this decision.

Call:
1-800-332-5762 (TTY:711)1-800-332-5762 (TTY:711)
8:00 a.m. to 9:00 p.m. EST, 7 days a week

If asked to leave a message, your call will be returned the next business day.

Fax:
1-888-725-6849

Mail:
BlueCross BlueShield of Tennessee
BlueCare Plus Operations
1 Cameron Hill Circle Ste 0002
Chattanooga, TN 37402-0002

How do I ask for prescriptions?

You, your physician or your representative should fill out a Request for Medicare Prescription Drug Coverage Determination form and send by mail or fax.

Call:
1-800-332-5762 (TTY:711)1-800-332-5762 (TTY:711)
8:00 a.m. to 9:00 p.m. EST, 7 days a week

If asked to leave a message, your call will be returned the next business day.

Fax:
1-423-591-9514

Mail:
BlueCross BlueShield of Tennessee
Medicare Part D Coverage Determinations and Appeals
1 Cameron Hill Circle, Suite 51
Chattanooga, TN 37402-0051

You will normally get a decision in 14 days. If you think your health could be seriously harmed by waiting that long, you can request a decision within 72 hours. These fast requests can be requested by a you, your representative, or any doctor — even if they are not affiliated with BlueCare Plus.

If we’ve made a decision you don’t agree with, you can ask us to reconsider (or “file an appeal”). We’ll look again at a service or prescription we’ve denied within 60 days of our original decision.

How do I file an appeal for medical services?

You or your representative will need to send a letter or complete the Appeals Form and contact us.

Mail:
BlueCare Plus Member Appeals
1 Cameron Hill Circle, Suite 0042
Chattanooga, TN 37402

If you have any questions about the appeal process, our team is ready to listen and help.

Call:
1-800-332-5762 (TTY:711)1-800-332-5762 (TTY:711)

How do I file an appeal for prescriptions?

You, your physician or your representative should fill out a Request for Medicare Prescription Drug Coverage Redetermination form and send by mail or fax.

Call:
1-800-332-5762 (TTY:711)1-800-332-5762 (TTY:711)
8:00 a.m. to 9:00 p.m. EST, 7 days a week

If asked to leave a message, your call will be returned the next business day.

Fax:
1-423-591-9514

Mail:
BlueCross BlueShield of Tennessee
Medicare Part D Coverage Determinations and Appeals
1 Cameron Hill Circle, Suite 51
Chattanooga, TN 37402-0051

If you aren’t satisfied with the quality of care you received through your plan, a network provider or pharmacy, you can file an official complaint (or grievance).

How do I submit a complaint?

A grievance is a type of complaint you make about your plan or one of the network providers or pharmacies. This includes complaints concerning the quality of your care. You have to submit your complaint no later than 60 days after the event.

To get started, complete a Grievance Form and fax it to us.

Fax:
1-423-535-5270

If you have a complaint about a coverage decision or a claim denial, you have the right to ask us to reconsider a decision. The Medicare Beneficiary Ombudsman is a person who reviews complaints (also called “grievances”) and helps resolve them. To contact the Medicare Beneficiary Ombudsman: call 1-800-MEDICARE or 1-800-633-42271-800-633-4227, TTY: 1-877-486-20481-800-486-2048 for more information visit medicare.gov. Or you can fill out Medicare's complaint form to send feedback about issues with your Medicare plan.

If you need help filing an appeal, you can assign someone like a family member, friend, advocate, attorney or any doctor to represent you. They can:

  • Get information about your claim
  • Submit evidence
  • Make requests
  • Give or receive notices about the appeal

How do I appoint a representative?

Both you and your representative need to sign, date and fill out the Appointment of Representative form. Then, send in the signed form with your coverage decision request.

Mail:
BlueCare Plus Member Appeals
1 Cameron Hill Circle, Suite 0042
Chattanooga, TN 37402

Fax:
1-888-416-3026

We want to help you understand your responsibilities and ours when it comes to leaving your plan (or disenrollment).

When can I end my membership?

BlueCare Plus members have a special election period once per quarter during the quarters that begin in January, April and July. Some people who are eligible for BlueCare Plus may have additional limits on when they can enroll. This includes people who might be at-risk for substance use disorders. For more details, see Chapter 10 of your Evidence of Coverage.

If you have any questions, give us a call.

Call:
1-800-332-5762 (TTY:711)1-800-332-5762 (TTY:711)

Can I be disenrolled from my plan?

Your health is important to us, but we would have to end your membership in the plan if any of the following happens:

  • You don't stay continuously enrolled in Medicare Part A and Part B.
  • You lose your Medicaid coverage.
  • You move out of the service area for more than six months.
  • You no longer meet the specific special needs status.
  • You become incarcerated.
  • You lie about or withhold information about other insurance you have that provides prescription drug coverage.
  • You intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility.
  • You continuously behave in a way that is disruptive and makes it difficult for us to provide medical coverage for you and other members of our plan.
  • You let someone else use your membership card to get medical care.
  • You enroll in the Program of All-inclusive Care for the Elderly (PACE).