Notices and Disclaimers

BlueAdvantage is a PPO plan with a Medicare contract. Enrollment in BlueAdvantage depends on contract renewal.

The information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments and restrictions may apply.

Benefits, premium, copayments and coinsurance may change on January 1 of each year.

You must continue to pay your Medicare Part B premium.

BlueCross BlueShield of Tennessee's Medicare contract is renewed annually. The availability of coverage beyond the end of this contract year is not guaranteed.

Members may enroll in the plan only during specific times of the year. Contact BlueCross BlueShield of Tennessee for more information.

Individuals must have both Part A and Part B to enroll.

All services must be covered by Medicare or your plan and received from network providers for these cost sharing amounts to apply. With the exception of emergencies or urgent care, it will cost more to get care from out-of-network providers. For detailed information on a BlueAdvantage℠ plan and its limitations, copayments and restrictions, please review the Evidence of Coverage.

BlueAdvantage plans cover both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.

You must use network pharmacies to access your prescription drug benefits, except under non-routine circumstances; quantity limitations and restrictions may apply.

BlueAdvantage has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area.

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Premium, copays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

Out-of-network/non-contracted providers are under no obligation to treat BlueAdvantage members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our member service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

TruHearing® is a registered trademark of TruHearing, Inc. All other trademarks, product names, and company names are the property of their respective owners. TruHearing is an independent company that provides hearing services for BlueCross BlueShield of Tennessee. TruHearing does not provide BlueCross branded products and services.

Medicare Supplement is not connected with or endorsed by the U.S. Government or federal Medicare program.

Disaster Assistance
Natural disasters are unpredictable, but as a BlueCross BlueShield plan member you can count on getting the care you need. If the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your area, you will still get care from your plan.

Do not wait – go to the nearest facility to get help. Your health and safety are the most important things. We’ll help take care of the rest.
Generally, during a disaster, you can get care from out-of-network providers at in-network cost-sharing. If you cannot use a network pharmacy during a disaster, please contact us. We can help you identify options for obtaining your prescription drugs, such as at an out-of-network pharmacy if appropriate.

If you have any questions, please contact us.

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