Human Resources > Medicare Q&A Center
BCBS has hosted several on-campus retiree information sessions and an interactive webinar. These sessions were intended to provide retirees with additional details and clarifications on benefits under the Medicare Advantage Group Plan offered beginning Jan. 1, 2017.
The list of Frequently Asked Questions (FAQs) below will answer initial questions you may have about the Medicare Advantage plan.
Yes. You are free to use physicians that accept Medicare. For example, if your doctor is affiliated with the Northwestern Memorial Healthcare network and accepts Medicare, you can continue to see him/her. To determine if a doctor accepts Medicare, you can access:
Or you can call Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service: 1-877-299-1008 (TTY/TDD users should call 711) from 8:00 a.m. to 8:00 p.m. Monday-Sunday.
At certain income levels, Medicare requires a surcharge to your monthly Medicare premiums for Part B and prescription drug premiums. Please click on this link for more details: https://www.cms.gov/newsroom/fact-sheets/2020-medicare-parts-b-premiums-and-deductibles
EviCore is contracted with BCBS to provide utilization services for the Medicare Advantage Plan. Please see this link for additional information about the preauthorization services.
If you were enrolled in an Active Medical plan with DePaul or enrolled in the PPO pre 65, then you will receive a 1095-C but the months that show coverage will not include the time enrolled in a Medicare Advantage plan. If you were enrolled in the Medicare Advantage plan for the full year, you will not be receiving a 1095-C from DePaul but may receive one directly from Medicare.
The Medicare Advantage Plan includes prescription drug coverage and has a specific Medicare approved formulary. Please contact Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service at 1-877-299-1008 for specific questions about coverage for your particular medication(s), and to confirm the most up-to-date listing and prescription drug alternatives.
Effective January 1, 2017, DePaul retirees should be using Walgreen’s Mail Order Services. As of January 1, 2017, active mail order prescriptions have been transitioned from PrimeMail to Walgreens. To request a refill, please call Walgreens mail order services directly at 1-877-277-7895.
Please be advised that if your mail order prescription is for a Specialty medication, you should continue using Prime Specialty. Please call Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service at 1-877-299-1008 for more information on Specialty mail order medication processing.
Specialty medications are used to treat more complex and/or rare conditions. They usually require unique handling and administration, and are generally classified as “Tier 5.” Medications are assigned to different categories, or “tiers,” in plan formularies, which may mean different costs to you. Medications in a lower tier will generally cost you less than medications in a higher tier. Click here for a link to the tier chart for an overview of the costs for each tier. Please contact Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service at 1-877-299-1008 for specific questions about coverage for your particular specialty medication(s).
For medications that are not on the formulary list, there is an “exception request” process. You can receive more information regarding this process by calling Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service at 1-877-299-1008. Click here for link to the Exception Form website that includes documents to give to your prescription provider.
All active mail order prescriptions (other than specialty scripts) prior to January 1, 2017 have already been transferred to Walgreens, so new prescriptions will not be necessary. For any first time prescriptions, your provider will need to fax or send the script directly to Walgreens’ mail order service. They can be reached at 1-877-277-7895 for more information about this process.
You can use any contracted pharmacy for regular prescription drug services that is listed in the Blue Cross and Blue Shield of Illinois Medicare Advantage Pharmacy Directory. Contracted pharmacies can be found on the BCBS website or by calling Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service at 1-877-299-1008.
Yes, for most medications. Please call Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service at 1-877-299-1008 to confirm in regards to your specific medication.
Since some of the DePaul prescription benefits include a coinsurance, the price of the drug will be dependent upon the contracted pharmacy rate which may be different by pharmacy. Please review the prescription chart for applicable coinsurance and copay amounts.
Blue Access for Members can be accessed via a link from Blue Cross and Blue Shield of Illinois’ home page: www.bcbsil.com.
No, you would need to create a new log-in using the new group ID number for Medicare Advantage, DP813G. You will not be able to see prior years’ claims.
If you wish to review claims information from 2016 under the retiree carve out program, you should use your previous user name and password.
This information is available for free in other languages. Please call our Customer Service number at 1-877-774-8592 (TTY/TDD users should call 711). We are open between 8:00 a.m. and 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.
Esta información está disponible en otros idiomas de forma gratuita. Comuníquese a nuestro número de Servicio al cliente al 1-877-774-8592 (los usuarios de TTY/TDD deben llamar al 711). Nuestro horario es de 8:00 a.m. a 8:00 p.m., hora local, los 7 días de la semana. Si usted llama del 15 de febrero al 30 de septiembre, durante los fines de semana y feriados, se usarán tecnologías alternas (por ejemplo, correo de voz).
You must continue to pay your Medicare Part B premium. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or
co-payments/co-insurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
HMO, HMO-POS and PPO plans are available in Cook, DuPage, Kane and Will counties. HMO, HMO-POS and PPO plans are provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract. Enrollment in HCSC’s plans depends on contract renewal.
Out-of-network/non-contracted providers are under no obligation to treat our Medicare Advantage 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 customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Prime Therapeutics LLC, a separate company, provides pharmacy benefit management services for [Client].
Prime Therapeutics has contracted with Walgreens, a company independent from Prime Therapeutics and Blue Cross and Blue Shield of Illinois, to provide mail pharmacy services through the PrimeMail by Walgreens Mail Service.