Frequently asked questions

Choosing and enrolling

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

Learn more

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.

You have five ways to enroll in a Blue Chip for Medicare plan. With every choice, remember that we're always happy to help.

  1. On the phone: Call our enrollment line at 1-877-969-2583 (TTY: 711).
  2. In Your Blue Store: Visit us at any Your Blue Store location to enroll with help in person.
  3. 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.
  4. 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.
  5. Paper form: Find enrollment forms on our forms page. Print the one you need, fill it out. and mail it back to us.

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.

Also, the Centers for Medicare and Medicaid Services (CMS) allows 5-Star plans to offer an additional SEP. Since CMS rated all of our 2023 Medicare Advantage plans 5-Stars, our members have the additional opportunity to switch from one BCBSRI Medicare Advantage plan to another.

  • Online - request a change
  • Mail - complete the Plan Change Request Form in its entirety, and then mail it to:

    Blue Cross & Blue Shield of Rhode Island
    Attn: Medicare Advantage Membership Department
    500 Exchange Street
    Providence, RI 02903-2699

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

Just call, click, or come by

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.

Absolutely. All of our Medicare Advantage plans include dental coverage as part of the plans.

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

Use find a doctor and search for "PCP" to find a provider near you.

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.

Pay online or by mail – your choice. View details on each option.

Learn more

We have collected almost any form you will need on our forms page. If you don't find what you need, our Medicare Concierge team is always happy to help.

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.

Your ID card

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.

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.

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.

Locate a store near you

$0 national gym membership – With the Silver&Fit® gym membership you get access to a variety of home fitness kits and a nationwide network of fitness centers. Select from over 16,500 fitness centers across the country and more than 50 local fitness centers, including most of the RI YMCA and Anytime Fitness locations.

Log in to your online account and you will see a button that says "Go to myPrime.com."

Log in

You can find your claims in myBCBSRI, 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.

Contact us

We can help

You don’t have to be an expert in this stuff. We’re here to help you when you need it—even on weekends. Just call, click, or come by.

You’re considering BCBSRI for Medicare–that’s great

Here’s where we can help.

Call us

Contact the Medicare Sales team at 1-800-505-2583 (TTY: 711). Hours: Monday through Friday, 8:00 a.m. to 8:00 p.m. (Open seven days a week, 8:00 a.m. to 8:00 p.m., October 1 – March 31.) You can use our automated answering system outside of these hours.

Come by

Get answers in person at Your Blue Store

Find a store near you

You’re already a BCBSRI Medicare member – lucky you

Here’s where we can help.

Call us

Call the Medicare Concierge team at (401) 277-2958 or 1-800-267-0439 (TTY: 711). Hours: Monday through Friday, 8:00 a.m. to 8:00 p.m.; Saturday, 8:00 a.m. to noon. (Open seven days a week, 8:00 a.m. to 8:00 p.m., October 1 - March 31.) You can use our automated answering system outside of these hours.

Come by

Get answers in person at Your Blue Store

Find a store near you