With your Medicare HMO A type of Medicare managed care plan where a group of doctors, hospitals, and other health care providers agree to give health care to Medicare beneficiaries for a set amount of money from Medicare every month. You usually must get your care from the providers in the plan. Blue PlusRx plan, you'll choose a primary care provider A doctor who is trained to give you basic care. In many Medicare managed care plans, you must see your primary care doctor before you see any other health care provider. (PCP) from our Medicare HMO Blue network. Your PCP will coordinate your care and refer you to any in-network specialists you may need.
You must use in-network providers except in the following circumstances:
Urgently needed care from out-of-network providers when network providers are temporarily unavailable or inaccessible, e.g., when you are temporarily outside of the plan's service area
Kidney dialysis services that you get at a Medicare-certified dialysis facility when you are temporarily outside the plan's service area
For more information, please refer to the 2013 Medicare HMO Blue PlusRx Evidence of Coverage (EOC) agreement.
If you already have a primary care provider and want to learn whether he or she is already a part of our network, just visit Find a Doctor.
You can also call us at 1-800-200-4255 (TTY: 1-800-522-1254) 8:00 a.m. to 8:00 p.m. ET:
October 1 — February 14: 7 days a week
February 15 — September 30: Monday through Friday