Frequently asked questions
Choosing and enrolling
How do Medicare Advantage plans differ from Original Medicare?
Generally, a Medicare Advantage plan (Medicare Part C) offers more coverage than Original Medicare.
Many people think Original Medicare alone is enough coverage without realizing that it usually pays for only 80% of many costs. In general, you pay a 20% coinsurance and deductibles for services received under Medicare.
A Medicare Advantage plan may:
- Simplify your coverage, with only one benefit plan and one membership card
- Offer more benefits than Original Medicare covers
- Have different cost-sharing (for example, copays and coinsurance) than Original Medicare
- Offer out-of-pocket cost limits on some services
- Provide Part D prescription drug coverage
- Use provider networks, which means that you will generally have lower costs if you use doctors and hospitals within the plan's network.
- Charge a monthly premium in addition to the Part B premium
When can I enroll?
Start thinking about Medicare before you are eligible. You will want to give yourself time to understand your options, ask questions, and feel confident about your choices before the deadline. Use this helpful enrollment timeline.
How do I enroll in a plan?
You have five ways to enroll in a Blue Chip for Medicare plan. With every choice, remember that we're always happy to help.
- On the phone: Call our enrollment line at 1-877-969-2583 (TTY: 711).
- In Your Blue Store: Visit us at any Your Blue Store location to enroll with help in person.
- Informational meeting: Come to one of our meetings to learn about your options and complete an enrollment form on the spot. Find an event near you and RSVP.
- Online: Find the plan you have in mind and enroll on the BCBSRI website. Or you can enroll through the Centers for Medicare & Medicaid Services (CMS) Online Enrollment Center.
- Paper form: Find enrollment forms on our forms page. Print the one you need, fill it out. and mail it back to us.
Can I change my plan?
The simple answer is yes. But you're only able to switch your plan at certain times. The Medicare Advantage Annual Enrollment Period, from October 15 – December 7 each year, is when you can make changes to your coverage for it to be effective on January 1 of the next year. If you have had a change in your circumstance, you might be eligible for a Special Enrollment Period.
Can someone help me sign up?
Absolutely! BCBSRI Medicare Specialists understand how Medicare works, so they can:
- Check to make sure you are enrolling in the plan that works best for you
- Answer all of your questions
- Help you fill out your enrollment form
Or come to one of our Medicare educational seminars. Meet your local BCBSRI Medicare team, we can answer all your questions and help you enroll.
Can I get dental coverage through BCBSRI?
Absolutely. All of our Medicare Advantage plans include optional dental coverage, and we sell standalone dental plans.
Can I get help paying for a plan?
Programs do exist to help pay for your costs. My Advocate Helps can provide you with education and assistance for enrolling into Medicare Savings Programs (MSP) and for Part D Extra Help. Call 1-866-866-7680 (TTY: 1-877-644-3244).
Using your benefits
Primary care referrals mean you're never alone
Your primary care provider (PCP) helps you make important decisions and can coordinate your care with your entire healthcare team. As a Medicare Advantage member, your PCP will coordinate referrals when you see a specialist, have a test, and receive some other services.
While your PCP will help you make many important healthcare decisions by giving you referrals, some covered services don't require a referral, including*:
- Mental health and substance use services
- Emergency and urgent care services
- Retail health clinics
How do I find a PCP?
Use find a doctor and search for "PCP" to find a provider near you.
What are these documents you mailed me?
You will receive several mailings from BCBSRI, especially in October, just before the Annual Enrollment Period when you can change your coverage.
- Annual Notice of Changes (ANOC) – This document contains any benefit changes to your plan from the previous year.
- Evidence of Coverage (EOC) – This document contains details about your Medicare health care and prescription drug coverage for the current plan year.
- Provider directory – This is a comprehensive list of all of the providers in the Medicare Advantage network.
- Summary of benefits – This is a quick summary of the key benefits of your Medicare Advantage plan.
How do I pay my bill?
Pay online or by mail – your choice. View details on each option.
Where can I find the form I need?
What is my member ID card? What if I lose it?
Your BCBSRI member ID card shows your doctor and other providers that you're part of the nation's most trusted health plan. It includes information about your plan and much more. See what everything on your card means, and find answers to common questions.
What are preferred pharmacies?
When you pick up prescriptions at one of these pharmacies, your out-of-pocket costs may be lower than what you would pay at a "standard" pharmacy. See which major retailers and independent pharmacies are preferred.
What is Your Blue Store?
BCBSRI has shown its commitment to personal help by opening Your Blue Stores in Cranston, East Providence, Lincoln, and Warwick. All members can ask questions, get answers, and join no-cost virtual fitness classes.
Do you offer a gym discount?
$0 national gym membership – With the new Silver&Fit® gym membership you get access to a variety of home fitness kits and a nationwide network of fitness centers. Select from over 14,000 fitness centers across the country and more than 45 local fitness centers, including most of the RI YMCA and Anytime Fitness locations.
Where do I find my prescription history?
Log in to your online account and you will see a button that says "Go to myPrime.com."
How do I check on a claim?
You can find your claims in your online account.
*See a complete list, as well as important information regarding referrals, in your plan’s evidence of coverage. You can find it on our forms page.