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Would you like a Medicare plan with built-in drug benefits? With Medicare Blue^SM, a Preferred Provider Organization (PPO) plan, you can enjoy all of the benefits that the original Medicare plan offers and more!

Medicare Blue is open to all individuals who have Medicare Part A and Part B, and who live in one of the following South Carolina counties: Aiken, Anderson, Fairfield, Florence, Greenville, Laurens, Lexington, Newberry, Richland, Spartanburg and Union.

How Can I Compare My Options?

You can compare Medicare Blue and the original Medicare plan using our Summary of Benefits. The charts in these booklets list some important health benefits. For each benefit, you can see what our plan covers and what the original Medicare plan covers. Please note the Summary of Benefits doesn't list every service that we cover or list every limitation or exclusion. To get a complete list of our benefits, please review the Evidence of Coverage.

For Upstate Residents (Anderson, Fairfield, Greenville, Laurens, Newberry, Spartanburg and Union)

• Summary of Benefits 
• Evidence of Coverage 

For Midlands Residents (Aiken, Lexington and Richland)

• Summary of Benefits 
• Evidence of Coverage

For Coastal Residents (Florence)

• Summary of Benefits 
• Evidence of Coverage

How Much Does Medicare Blue Cost?

The monthly premium for Medicare Blue is $0 for Upstate residents, $29 for Midlands residents and $100 for Coastal residents.

Can I Choose My Doctors?

BlueCross has formed a network of doctors, specialists and hospitals. To receive full benefits, you must use a doctor or hospital that is part of our network. You can find an up-to-date list of the doctors and hospitals in our network in the Provider Directory.

Where Can I Get My Prescriptions?

BlueCross has formed a network of pharmacies that you must use to receive Medicare Blue prescription drug plan benefits. Medicare Blue prescription drug coverage may not pay for your prescriptions if you use an out-of-network pharmacy, except in certain cases outlined in the Evidence of Coverage. For an up-to-date list of the pharmacies in our network, see our Pharmacy Directory, or search by pharmacy name, state or ZIP code using the Pharmacy Locator.

What Prescriptions Are Covered?

The Medicare Blue prescription drug plan uses a prescription drug list. We may occasionally make changes to the list. For the most current information, see our Comprehensive Formulary (list of covered prescription drugs). To search for a specific drug on this formulary, simply open the formulary and select the Search button in the task bar at the top of the page. Then type the name of the drug in the indicated field and select Search.

Formulary Change Notice - February

Formulary Change Notice - March
Formulary Change Notice - April

Formulary Change Notice - June

Some prescriptions require prior authorization. For a list of these drugs and their authorization forms, please visit our Prior Authorization Drug List.

Can I Change Plans After I Enroll?

You can switch plans during the open enrollment period every year from November 15 to December 31. Medicare may also allow you to change plans under special circumstances, such as if you permanently move out of your plan’s service area; if you get help from your state Medicaid program paying Medicare premiums and/or cost sharing; if you qualify for extra help paying for prescription drugs; or if you enter, live in, or leave a nursing home. To compare Medicare Advantage plans offered in your area, visit the Medicare Personal Plan Finder.

Want to Know More?

• Information on Grievances and Appeals
• Appointment of Personal Representative Form
• Information on Coverage Determinations and Exceptions
• Coverage Determinations and Exceptions Form
• Medication Therapy Management Program
• Utilization Management Programs (This document is currently awaiting approval from CMS.)
• Beneficiary Rights and Responsibilities
• Low Income Subsidy Information (This document is currently awaiting approval from CMS.)
• Our Privacy Practices
• Enrollment Instructions 
• Enrollment Form - Anderson, Fairfield, Greenville, Laurens, Newberry, Spartanburg and Union
• Enrollment Form - Aiken, Lexington and Richland
• Enrollment Form - Florence
• Bank Draft Authorization

   

  Contact Us

  If you don't have coverage with us yet, please contact us:

  Toll free at 1-800-930-2912 (TTY 1-800-681-3846) -- 8:00 a.m. - 8:00 p.m., Monday through Friday

  During our annual open enrollment period from November 15, 2007 to March 1, 2008, our hours are 8:00 a.m. to 8:00 p.m., seven days a week.

  Medicare Advantage Marketing, P.O. Box 100206, Columbia, SC 29223-3206
  
  Current members, please contact us:

  Toll free at 1-800-605-3256 (TTY 1-888-300-7215) -- 8:00 a.m. - 8:00 p.m., Monday through Friday

  During our annual open enrollment period from November 15, 2007 to March 1, 2008, our hours are 8:00 a.m. to 8:00 p.m., seven days a week.

  BlueCross BlueShield of South Carolina, Medicare Advantage, P.O. Box 100191, Columbia, SC 29202-3191
  
  Please call Medicare at 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov for more information about Medicare. You can call this national Medicare helpline 24 hours a day, seven days a week. The TTY/TDD number is 1-877-486-2048 (you need special telephone equipment to use this number). Calls to these numbers are free.

   

  Send premium payments to:

  Attn: CASHIERS, BlueCross BlueShield of South Carolina, Mail Code: AA-G31, P.O. Box 6000, Columbia, SC 29260-6000

   

  BlueCross BlueShield of South Carolina contracts with the federal government.

   

  Last updated: 7/17/08