This link will take you to a new site not affiliated with BCBSTX. It will open in a new window. To return to our website, simply close the new window. Refer to important information for our linking policy.
After receiving your completed enrollment form, Blue Cross MedicareRx will send you:
The Evidence of Coverage (EOC) is a detailed document that explains the plan rules associated with Blue Cross MedicareRx. This document, together with your enrollment form, riders, coverage and the amendments that we may send to you, is our contract with you.
The EOC explains:
Evidence of Coverage - Basic Plan
Evidence of Coverage - Value Plan
Evidence of Coverage - Plus Plan
Evidence of Coverage: Basic Plan en Español
Evidence of Coverage: Value Plan en Español
Evidence of Coverage: Plus Plan en Español
Blue Cross MedicareRx agrees to stay in the program for a full year at a time. Each year, the plan decides whether or not to continue offering prescription drug coverage for the following year. Should we decide not to continue offering Blue Cross MedicareRx, we will send you a letter explaining your options for Medicare prescription drug coverage in your area. Your Medicare coverage is not affected.
As for claims, if Blue Cross MedicareRx ever denies your prescription drug benefits, we will explain our decision to you. You always have the right to appeal and ask us to review the claim that was denied. In addition, if your physician prescribes a drug that is not on our formulary, is not a preferred drug, or is subject to additional utilization rules, you may ask us to make a coverage exception.
Disenrollment from Blue Cross MedicareRx means ending your membership. Disenrollment can be voluntary or involuntary. We are not allowed to ask you to leave the Plan because of your health.
You can leave the Plan and join another Medicare prescription drug plan, Medicare Cost Plan, or Advantage Plan available in your area. It will take some time for your prescription drug coverage to end and your new prescription drug coverage to begin.
To voluntarily disenroll:
HCSC Insurance Services Company (HISC) must disenroll an individual from Blue Cross MedicareRx in the following cases: