Blue Cross Medicare AdvantageSM



Print

The Blue Cross Medicare Advantage Plan offers all of the coverage of Original Medicare — plus benefits not covered by Medicare or most Medicare Supplement insurance plans, including built-in prescription drug coverage.

  • The Blue Cross Medicare Advantage (HMO) plan offers health coverage to members who reside in Bernalillo, Sandoval, Torrance and Valencia counties.
  • The Blue Cross Medicare Advantage (PPO) plan offers health coverage to members who reside in Bernalillo, Cibola, Guadalupe, Los Alamos, Mora, Rio Arriba, Sandoval, Santa Fe, San Miguel, Socorro, Torrance and Valencia counties.

Our strong brand recognition and our historical relationship with Medicare makes BCBSNM an excellent choice for Medicare eligible individuals seeking new health coverage opportunities. Blue Cross Medicare Advantage maintains and monitors a network of participating providers including physicians, hospitals, skilled nursing facilities, ancillary providers, and other health care providers through which members obtain covered services.




Participating physicians, professional providers, and facility providers must submit claims to Blue Cross Medicare Advantage within 180 days of the date of service, using the standard CMS-1500 or UB-04 claim form, or electronically. Services billed beyond 180 days from the date of service are not eligible for reimbursement.


To join our Blue Cross Medicare Advantage network, follow the process for Network Participation.


All providers who contract with BCBSNM to provide Medicare Advantage services are expected to abide by the Centers for Medicare & Medicaid Services (CMS) rules for marketing when it involves BCBSNM or Blue Cross Medicare Advantage products or benefits.


View the guidelines that are applicable to providers in the Provider Medicare Marketing Guidelines Excerpt 


  • Blue Cross Medicare Advantage section  of the Blues Provider Reference Manual.
  • Pharmacy — view Medicare newsletters, drug lists and forms.
  • Provider Finder ® — search for doctors, hospitals, and other health care providers in the Blue Cross Medicare Advantage network.
  • Sample ID Card  — See Section 2 of the Blue Cross Medicare Advantage section of the Blues Provider Reference Manual.

 

To view the following forms, go to the Attachments section of the Blue Cross Medicare Advantage section of the Blues Provider Reference Manual .

  • New Mexico Optional Advance Health Care Directive Form
  • Notice of Medicare Non-Coverage

Blue Cross Medicare Advantage and Blue Cross Medicare Advantage Dual Care plans are HMO, HMO-POS, PPO, and HMO Special Needs Plans provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract and a contract with the New Mexico Medicaid program. Enrollment in HCSC's plans depends on contract renewal.