BlueCross BlueShield of South Carolina

Plan Details

How Do I Compare My Options?

You can compare Medicare Blue^SM (PPO) 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.

Find the right health or prescription drug plan for you.

For Upstate Residents and Midlands

(Abbeville, Aiken, Anderson, Calhoun, Cherokee, Chester, Clarendon, Edgefield, Fairfield, Greenville, Greenwood, McCormick, Laurens, Lexington, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union and York)

Summary of Benefits
Evidence of Coverage

For Coastal and Rural Residents

(Allendale, Bamberg, Barnwell, Beaufort, Berkeley, Charleston, Chesterfield, Colleton, Darlington, Dillon, Dorchester, Florence, Georgetown, Hampton, Horry, Jasper, Kershaw, Lancaster, Lee, Marion, Marlboro, Williamsburg)

Summary of Benefits 
Evidence of Coverage

How Does a PPO Plan work?

The PP0 plan pays instead of Medicare. You will pay amounts that the PP0 plan does not pay, which are called copayments and coinsurance. A PP0 plan does not pay after Medicare pays its share. Original Medicare will not pay for your health care while you are enrolled in a PP0 plan. You must continue to pay your Medicare Part B premium.

What If a Network Provider Leaves the Plan?

Sometimes a specialist, clinic, hospital or other network provider you are using might leave the plan.  Medicare Blue (PPO)  will notify you if one of your providers leaves our network within 30 days of the termination of contract.

More Important Information

• Information on Grievances and Appeals 
• Beneficiary Rights and Responsibilities
• Benefits Not Covered 
• Our Privacy Practices
• Best Available Evidence Policy 
• Ending Your Membership in the Plan

How to Contact Us

Toll-free phone number: 1-800-930-2912 (TTY 1-800-681-3846) 
Customer service representatives will be available to answer your calls from 8 a.m. - 8 p.m. (Eastern Standard Time), seven days a week.
Fax number: (803) 264-9581
Address: Medicare Advantage, BlueCross BlueShield of South Carolina, P.O. Box 100191, Columbia, SC 29202-3191

A PPO plan with a Medicare contract.

Last updated: 3/29/10
MOO54_WBPPO10 (2/2010)