BLUE CROSS MEDICARE ADVANTAGE DUAL CARE
Cómo usar su cobertura
Learn how to use your new Dual Care Plus Plan from Blue Cross and Blue Shield of New Mexico.
Using Your Blue Cross Med Advantage Dual Care Plus (HMO SNP)SM
Queremos que aproveche al máximo su cobertura nueva. En esta sección, encontrará recursos que le ayudarán a comenzar, aprovechar al máximo sus beneficios, usar recursos en línea, aprender acerca de las reclamaciones y mucho más.
Llámenos antes de llamar a Medicare. Because Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM is your Medicare plan, you should call us with all your questions. Our Member Services team will let you know if your question can be answered by Medicare. Llame a Servicio al Cliente al número que figura en su tarjeta de asegurado.
Bienvenido a su cobertura
- Enrollment Confirmation: Before you can start using your plan, Medicare must approve your enrollment. This will take about 10 business days. You’ll get an acknowledgment letter and a confirmation letter once approved. A continuación, le enviaremos su tarjeta de asegurado.
- Welcome Kit: Includes your plan’s drug formulary, the Evidence of Coverage form and other helpful information. Learn more about the Welcome Kit
Buscar un profesional
- Provider Search: To maximize benefits, use in-network providers. We can help you choose a primary care provider (PCP) in your plan's network. Buscar un profesional médico
- Set up your Annual Wellness Visit once coverage is active.
Coseguros y copagos
- Understanding Costs: Coinsurance is a percentage of the bill you pay. Los copagos son un monto fijo que usted paga al momento de recibir el servicio.
Cobertura de medicamentos con receta
- Drug Formulary and Pharmacy Search: You will have online access to a Drug Formulary, which is a list of drugs that are covered. You can share the formulary with your doctor and talk about the drugs you take now. Más información
- Prior Authorization: Also, learn about how drugs are placed into tiers based on cost, prior authorization, quantity limits and more. Más información sobre autorizaciones previas
- Drug Plan Transition: If you’re new to our plan, find out how to get a limited supply of your medication that isn’t covered Learn about drug plan transition
- Medication Therapy Management: Find out if the drug you take is safe, works well and fits your lifestyle at no additional cost to eligible members. Más información sobre medication therapy management
- Medicare Prescription Payment Plan: This program can offer help with managing your out-of-pocket costs. Averigüe más acerca de la Pago de medicamento con receta de Medicare
Quick Facts About Claims and More
- Claims Filing: Your provider and pharmacist will usually file any claims for services or prescriptions you received. Once the claim is filed, you will get a statement called the Explanation of Benefits (EOB) from us. How often you receive it depends on how often you get care or fill your prescriptions.
- What is an EOB? The EOB is a statement, not a bill. Sencillamente, detalla lo que usted pagó e indica el nivel de beneficios que usó.
- How to use an EOB: Review these to be sure they are correct. If you think there are errors on your EOB statement, or you think you are the victim of fraud, please call the number on the back of your member ID card.
Aviso anual de cambios
You will get your Annual Notice of Change in October. This will tell you what changes will be made to your plan for the next year, starting January 1st. It will outline any expected premium or benefit changes.
MEDICARE ADVANTAGE DUAL CARE PLUS
Servicios
Puede acceder a programas de bienestar y a recursos que le ayudarán a cuidar su salud.
MEDICARE ADVANTAGE DUAL CARE PLUS
Beneficios adicionales de salud y bienestar
Blue Cross Medicare Advantage Dual Plus plans offer a number of benefits above and beyond standard insurance benefits. La disponibilidad, el costo y el nivel de cobertura varían según la cobertura, por lo que le sugerimos que elija la que mejor se ajuste a lo que necesita.
Los siguientes son algunos de los beneficios adicionales de salud y bienestar que ofrecemos con nuestras coberturas.
Cobertura dental
Coverage for preventive and comprehensive dental care is available through some Blue Cross Medicare Advantage Dual Care plans.
Cobertura para el cuidado de la vista
Some plans include coverage for routine eye exams with an allowance toward frames and lenses or contact lenses.
Hearing Coverage
Hearing is important to being present with your loved ones and friends. Some plans may provide coverage for hearing exams plus allowances or discounts on hearing aids.1
1 MDLIVE operates and administers the Virtual Visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE y el logotipo de MDLIVE son marcas registradas de MDLIVE, Inc. y no pueden ser utilizados sin una autorización por escrito.
2 For medical emergencies, call 911. Este programa no reemplaza la atención médica que recibe de un médico. Consulte con su médico si tiene alguna pregunta o inquietud sobre su salud.
3 Convey Health Solutions, Inc. is an independent company that provides administrative services for over-the-counter supplemental benefits for Blue Cross and Blue Shield of New Mexico.
4 Blue365 is a discount program only for Blue Cross and Blue Shield of New Mexico members. Esto NO es un seguro. Los descuentos solo se otorgan a través de proveedores que formen parte de este programa. BCBSNM no garantiza los servicios ni los productos de este programa ni hace afirmaciones o recomendaciones con respecto a ellos. BCBSNM se reserva el derecho a cancelar o cambiar estos programas en cualquier momento y sin aviso. La relación entre los proveedores de Blue365 y BCBSNM es la de contratistas independientes. BCBSNM no aprueba, representa ni garantiza ninguno de los productos o servicios que estos ofrecen.
5 SilverSneakers® is a wellness program owned and operated by Tivity Health, Inc., an independent company. Tivity Health y SilverSneakers® son marcas comerciales registradas de Tivity Health, Inc., o de sus subsidiarias o afiliadas en los EE. UU. u otros países.
6 The benefits mentioned are Special Supplemental Benefits for the chronically ill (SSBCI). To be eligible for SSBCI benefits, you must have one or more of the following chronic conditions: cardiovascular disorders, chronic heart failure, diabetes, and stroke. Note that even if you have one or more of the listed chronic conditions, you are not guaranteed access to SSBCI benefits because other eligibility and coverage criteria also apply. Contact us to confirm eligibility for this benefit.
7 ModivCare Solutions, LLC, is an independent company that administers transportation services for Blue Cross and Blue Shield of New Mexico.
8 TruHearing is a registered trademark of TruHearing, Inc., which is an independent company providing discounts on hearing aids.