During this year’s Medicare Annual Election Period (AEP), Blue Cross & Blue Shield of Rhode Island (BCBSRI) offered our first Medicare Advantage (MA) PPO plan. The new plan is the HealthMate for Medicare PPO plan (HealthMate). This plan offers the freedom to choose the providers and pharmacists the patient wants to see. The members who selected this plan will have the flexibility of having their health insurance with them when they travel nationwide.
Reimbursement for out-of-area members with a MA PPO plan through their home plan will now be reimbursed at the BCBSRI contractual rates for MA. The HealthMate plan includes:
- No referrals
- An open pharmacy network
- Access to the national Blue Cross & Blue Shield PPO network
As a reminder, your office should log onto our secure provider portal to review members’ benefits and eligibility to verify the type of Medicare plan they chose for January 2020. If you have any questions regarding this new MA plan, please contact Provider Relations at