The list of Frequently Asked Questions (FAQs) below will answer initial questions you may have about the Medicare Advantage plan.
Enrollment / Coverage
7. Can I use the same doctors I used with my previous medical 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.
10. Where is the group number on my ID card?
There is no group number on your Medicare Advantage ID card, as one is not necessary to receive services from providers under the Medicare Advantage plan. When seeking services, the alpha prefix “XOD” and your ID# are sufficient for providers to submit claims for processing.
11. When will the bills for Medicare Advantage be sent out?
The bills are mailed on or around the 15th of the month, for the upcoming month's premium, unless you have a credit linked to your account. Please call Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service: 1-877-299-1008 if you have any questions about your Medicare Advantage bill.
12. Can I pre-pay my Medicare Advantage monthly premiums?
Yes. You can pay from one month to one year in advance by submitting the extra payment(s) with your monthly premium statement. The extra amount will show as a credit and be applied to your plan each month until the credit runs out. You can confirm receipt of the extra payments by contacting Blue Cross and Blue Shield of Illinois’ Medicare Advantage Customer Service at 1-877-299-1008 14 days after mailing in your payment. Blue Cross and Blue Shield of Illinois can also
set-up an ACH monthly debit from your checking or savings account. Information on a monthly debit approach can be found in your BCBS welcome kit. Please click on the Automatic
Premium Payment Form link
; or contact Customer Service for assistance.
Prescription Drug Coverage
15. Will my prescriptions be covered?
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.
16. Who is the prescription mail order vendor?
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.
17. What are “Specialty” medications?
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).
18. What can I do if my medication is not on the Medicare formulary list?
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.
Blue Access for Members ("BAM")
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. See important notice on anti-discrimination