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Federal Contracting Statement
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Arkansas Blue Cross and Blue Shield is a Medicare Advantage organization with a Medicare contract. Arkansas Blue Cross and Blue Shield’s contract with the federal government is renewed annually and the availability of coverage beyond the end of the current contract year is not guaranteed.
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Potential for Contract Termination
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Medi-Pak Advantage plans may not be available to beneficiaries in 2012, because by law, Arkansas Blue Cross can choose to not renew our contract with CMS or reduce our service area and CMS may also refuse to renew the contract, thus, resulting in a termination or non-renewal.
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Medicare Part B Premium
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You must continue to pay your Medicare Part B premium. Limitations, copayments and restrictions may apply.
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Enrollment Limitations
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To enroll in Medi-Pak MA-PD or Medi-Pak MA, individuals must have both Medicare Part A and Part B.
Members may enroll in the plan only during specific times of the year. Please call 1-800-392-2583 (TTY 1-800-370-5869), 8 a.m. to 5 p.m., Monday-Friday for more information.
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Material In Alternative Formats
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Material is available in alternative formats for the visually impaired by calling 1-800-634-6314 (TTY 1-800-370-5869), 8 a.m. to 5 p.m., Monday-Friday.
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Pharmacy Network Limitations
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Medi-Pak Advantage MA-PD members must use in-network pharmacies to receive plan benefits, except under emergency care circumstances, and quantity limitations and restrictions may apply.
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Required Access Information
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You must use plan providers except in emergency or urgent care situations or for out-of-area dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor Arkansas Blue Cross and Blue Shield will be responsible for the costs.
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Private Fee-for-Service Network
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A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. We have network providers (that is, providers who have signed contracts with our plan) for all services covered under Original Medicare. These providers have already agreed to see members of our plan. If your provider is not one of our network providers, then the provider is not required to agree to accept the plan’s terms and conditions, of payment, they may choose not to provide health care services to you, except in emergencies. If this happens, you will need to find another provider that will accept our terms and conditions of payment. Providers can find the plan’s terms and conditions of payment at our website at: arkansasbluecross.com/MedicarePlans.
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Online Enrollment Center
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Medicare beneficiaries may enroll in Medi-Pak Advantage through the CMS Medicare Online Enrollment Center, located at http://www.medicare.gov.
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Medicare Helpline
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Medicare beneficiaries may contact 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week (TTY users should call 1-877-486-2048) or visit http://www.medicare.gov for more information regarding health benefits.
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Hours of Operation
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Call us at 1-877-233-7022, 8 a.m. – 8 p.m., Monday-Friday (TTY: 1-800-370-5869).
You may qualify for extra help with your monthly premium and drug costs.
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Web Page Last Updated: 8/30/2011