Philadelphia Gas Works offers PPO option with Blue Medicare Advantage

Philadelphia Gas Works will offer a PPO, Medicare Advantage plan with Blue Medicare Advantage (BMA) effective September 1, 2023. Retirees with Medicare Parts A and B are eligible to enroll in the Medicare Advantage plan. This passive PPO plan allows retirees to receive services from any provider, as long as the provider accepts Medicare. The provider reimbursement schedule amount for Medicare Advantage claims will be in accordance with the contract for your local plan. The Medicare Advantage plan offers the same hospital and medical benefits that Medicare covers. It also covers additional benefits that Medicare does not, such as an annual routine physical exam, routine hearing, LiveHealth Online,* and SilverSneakers^®. * 

The prefix on the Philadelphia Gas Works member ID cards will be J2H. The cards will also show the Philadelphia Gas Works logo, along with the PPO icon for BMA on the front. Providers may submit claims electronically using the electronic payer ID for the BMA plan in their state or submit a UB-04 or CMS-1500 form to the BMA plan in their state. Claims should not be filed with original Medicare. Contracted and non-contracted providers may call the provider services number on the back of the member ID card for benefit eligibility, prior authorization requirements, and any questions about Philadelphia Gas Works member benefits or coverage. 

Detailed prior authorization requirements also are available to contracted providers by accessing the Provider Self-Service Tool at Availity.com. *