Laserfiche WebLink
The benefit information provided is a summary of what we cover and what you pay. To get a <br />complete list of services we cover, call us and ask for the "Evidence of Coverage." To get a complete <br />list of the drugs we cover, call us and ask for the List of Covered Drugs ("Formulary'). You may also <br />view the "Evidence of Coverage" and "Formulary' for this plan on our website, <br />www.floridablue.com/medicare. <br />If you want to know more about the coverage and costs of Original Medicare, look in your current <br />Medicare & You handbook. View it online at www.medicare.gov or get a copy by calling <br />1 -800 -MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call <br />1-877-486-2048. <br />Who Can join? <br />You and your dependent(s) can join this plan if you are a retired employee of the group, and the <br />following conditions are met: <br />• You and your dependent(s) are entitled to Medicare Part A and enrolled in Medicare Part B <br />■ You and your dependent(s) live in the plan service area, and <br />■ You are identified as an eligible participant by your former employer <br />Neither you nor your dependent(s) are eligible for this plan if: <br />• You are an active employee of the group, or <br />■ You are a retired employee of the group with a dependent who is an active employee of the <br />group and has coverage through the group's plan for active employees <br />Our service area is nationwide. It includes all fifty states, the District of Columbia and the United <br />States territories. <br />Which doctors, hospitals, and pharmacies can I use? <br />We have a network of doctors, hospitals, pharmacies, and other providers. If you use providers that <br />are not in our network to receive medical services, you may pay more for these services. If you use <br />pharmacies that are not in our network to fill your covered Part D drugs, the plan will generally not <br />cover your drugs. <br />You can see our plan's provider and pharmacy directory on our website <br />(www.floridablue.com/medicare). Or call us and we will send you a copy of the provider and <br />pharmacy directories. <br />Have Questions? Call Us <br />If you are a member of this plan, call us at 1-800-926-6565, TTY: 1-800-955-8770. <br />If you are not a member of this plan, call us at 844 -BLUE -MED (844-258-3633), TTY: 1-800-955- <br />8770. <br />o From October 1 through March 31, we are open seven days a week, from 8:00 a.m. to <br />8:00 p.m. local time, except for Thanksgiving and Christmas <br />o From April 1 through September 30, we are open Monday through Friday, from 8:00 <br />a.m, to 8:00 p.m. local time, except for major holidays <br />328 <br />