Frequently Asked Questions

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If I purchase this plan, am I losing my Medicare coverage?

No. Medicare Advantage plans are part of the Medicare program. These plans are administered by private insurance companies under contract with the Medicare program.

Why do I have to pay my Medicare Part B premium if this replaces my Medicare and Medicare isn’t paying my claims?

BlueCross BlueShield of Tennessee and other Medicare Advantage insurance companies have a contract with Medicare to provide your Medicare Part A and B coverage. As part of this contract, the plan receives payments from Medicare to cover the cost of your benefits. Your Medicare Part B premium, along with the premium you pay for the plan, make up the total premium needed to provide your Medicare Advantage benefits.

Will I still show my Medicare card when receiving health care services?

No, if you enroll in this plan you will show your BlueAdvantage PFFS ID card each time you receive health care services. However you should keep your Medicare card in a safe place.  You will need to show your Medicare card if you receive hospice care.

Does BlueAdvantage PFFS cover the same types of services as Original Medicare?

Yes, BlueAdvantage PFFS will cover the same types of services that Original Medicare covers, plus some additional services not covered by Original Medicare. Please see the Summary of Benefits for a comparison of covered services. Hospice care is still covered under Original Medicare and you should show your Medicare Card for hospice care.

Once I select a Medicare Advantage plan, can I change plans later?

Yes, during Medicare-specified enrollment periods.  Each year you can start over with a different plan during the Annual Coordinated Election Period, November 15 through December 31 for coverage beginning January 1 of the following year. Additionally, you have the opportunity to change one time during Open Enrollment, January 1 to March 31.  Please be aware that your options during the Open Enrollment Period are limited based on the type of plan you are enrolled in the year prior to January 1. Once the Open Enrollment Period ends on March 31, you may not make any more plan changes until the next Annual Coordinated Election Period, unless you qualify for a Special Enrollment Period. Please see Eligibility and Enrollment Periods for more information.

Can I enroll in a BlueAdvantage PFFS medical-only plan and purchase a separate prescription drug plan for my Medicare Part D coverage?

Yes. If you want prescription drug coverage, you can enroll in BlueRx, our standalone prescription drug plan, or purchase prescription drug coverage from another insurance company. More Info

You may also want to consider one of our BlueAdvantage PFFS plan options with prescription drug coverage included. More Info

Is there a waiting period before benefits will be paid on pre-existing medical conditions?

No, there isn’t a pre-existing condition (d) waiting period . 

Will out-of-state doctors accept my BlueAdvantage PFFS plan if I’m traveling?

With BlueAdvantage PFFS you may seek care from any health care provider that accepts Medicare payments and the terms, conditions and payment rates of our plan. However, you must present your BlueAdvantage PFFS ID card before you receive services. All the same terms and conditions apply to in state and out-of-state doctors.

What happens to my coverage if BlueCross BlueShield of Tennessee leaves the Medicare program? Can I go back to Original Medicare Part  A and Part B?

All health plans with Medicare contracts agree to stay with the Medicare program for a full year. Coverage from a particular plan beyond the current year is not guaranteed. 

Each year plans can decide if they wish to continue for another year. The Centers of Medicare & Medicaid Services can also decide not to renew a plan’s contract. If a plan leaves the Medicare program, you will not lose Medicare coverage. You will receive notification 90 days in advance along with information about your other Medicare coverage options.

Will BlueAdvantage PFFS monthly premiums or benefits change next year? 

The BlueAdvantage PFFS contract is renewed annually with Medicare. The premiums, benefits, copays and coinsurance amounts can change annually. Members will receive an Annual Notice of Change in the mail prior to Nov. 15 for changes effective the following Jan. 1. Also, remember everyone has the opportunity to change plans each year during the Annual Coordinated Election Period (Nov. 15 to Dec. 31).