Last updated: 04/14/2014

H4152_2013webstie330 CMS Approved 02202013

Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Visit Contact Us.

Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year.

You must continue to pay your Medicare Part B premium.