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2012 Medicare Blue (PPO)

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

Medicare Blue (PPO) is open to all South Carolina residents who have Medicare Part A and Part B.

How Much Does Medicare Blue Cost?

The monthly premium for Medicare Blue (PPO) is $0 for Upstate and Midlands residents and $34 for Coastal and Rural residents. If you currently pay a premium for Medicare Part A and/or Medicare Part B, you must continue paying your premium in order to keep Medicare Part A and/or Medicare Part B and remain a member of this plan.

Can I Choose My Doctors?

BlueCross has formed a network of doctors, specialists and hospitals. To receive full benefits:

  • You must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, out of the area), out-of-the-area dialysis services and cases in which Medicare Blue (PPO) authorizes use of non-network providers.
  • You must receive all routine care from plan providers.

You can find an up-to-date list of the doctors, vision care providers, hospitals and pharmacies in our network in the Provider/Pharmacy Directory or search using our Doctor and Hospital Finder.

To search for providers participating in the Medicare Advantage network in other states, you can use the Blue National Doctor & Hospital Finder. Be sure to choose Medicare Advantage PPO as the product type.

Vision care benefits are only available through ophthalmologists, optometrists and opticians in the Avesis network. On behalf of BlueCross, Avesis provides a vision care provider network. Avesis is an independent company. To access the most recent list of vision care providers, visit the Provider Locator. (This link leads to a third party website. That company is solely responsible for the contents and privacy policy on its site.)

Can I Change Plans After I Enroll?

Enrollment in this plan is generally for the entire year. You may leave this plan or make changes during the Annual Election Period from October 15 to December 7. 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
  • If you enter, live in or leave a nursing home

The Medicare program rates how well health plans perform in different categories (for example, ratings in customer service and detecting and preventing illnesses). On www.medicare.gov you can compare the ratings for Medicare for plans in your area by selecting “Compare Medicare Prescription Drug Plans” or “Compare Health Plans and Medigap Policies in Your Area.” You can also get a copy of the ratings by calling us at 1-888-645-6025 (TTY 1-888-645-6023) - 8 a.m. to 8 p.m., seven days a week. 

Submit feedback to Medicare about your BlueCross Medicare Advantage plan.

A PPO plan with a Medicare contract.

Last updated: 11/17/11
H4209_WBPPO12 CMS Approved 10172011