Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

The Group Retiree Medicare Advantage membership is experiencing a high volume of enrollment, and as we continue to grow, we wanted to send these reminders for our PPO plans for Anthem Blue Cross and Blue Shield (Anthem). Group Retiree Medicare Advantage memberships may include the National Access Plus benefit, which allows retirees to receive services from any provider, as long as the provider is eligible to receive payments from Medicare and accepts the member’s PPO plan. These PPO plans also offer benefits that original Medicare doesn’t cover, including an annual routine physical exam, hearing, vision, chiropractic care, acupuncture, LiveHealth Online^* and SilverSneakers^®.^*

 

If you are already part of our Medicare Advantage PPO network, thank you. The frequently asked questions (FAQ) document under “Article Attachments” on the right will be helpful as you grow your practice and serve members who may be new to our Group Retiree PPO plans.

 

Out-of-network providers are paid Medicare allowable rates for covered services, less the member’s copay, coinsurance, and/or deductible. No contract is required.

With the National Access Plus benefit, the member’s cost share doesn’t change — whether local or nationwide, doctor or hospital, in- or out-of-network.

* Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield. AIM Specialty Health is an independent company providing some utilization review services on behalf of Anthem Blue Cross and Blue Shield. LiveHealth Online is the trade name of Health Management Corporation, an independent company, providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. Tivity Health, Inc. is an independent company providing the SilverSneakers fitness program on behalf of Anthem Blue Cross and Blue Shield. Aspire Health is an independent company providing palliative care services on behalf of Anthem Blue Cross and Blue Shield. CoverMyMeds is an independent company providing electronic prior authorization services on behalf of Anthem Blue Cross and Blue Shield. Surescripts is an independent company providing electronic prior authorization services on behalf of Anthem Blue Cross and Blue Shield. myNEXUS is an independent company providing claims processing and network management for providers providing home health services on behalf of Anthem Blue Cross and Blue Shield. Specialty Condition Management Powered by IngenioRx is an independent company providing targeted disease management services on behalf of Anthem Blue Cross and Blue Shield.
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