Access to Doctors and Hospitals
If you choose Medicare HMO Blue PlusRx, you'll pick a primary care provider from our Medicare HMO Blue network. Your primary care provider will coordinate your care and refer you to any in-network specialists you may need. Our list of network providers shows you the number and type of providers in our network.
You must use in-network providers except in the following circumstances:
- Emergency Services
- Urgently needed care from out-of network providers when network providers are temporarily unavailable or inaccessible
- Kidney dialysis Services that you get at a medicare-certified dialysis facility when you are temporarily outside the plan's service area.
Services received from out-of-network providers and hospitals may not be covered/paid for by Blue Cross Blue Shield of Massachusetts.
For more information, please refer to the plan Evidence of Coverage (EOC).
Is my doctor in the network?
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 or call Member Service at 1-800-200-4255 (TTY: 711), 8:00 a.m. to 8:00 p.m. ET.
- October 1- March 31: 7 days a week
- April 1 - September 30: Monday through Friday
- If you would like a Provider Directory mailed to you, you can call Member Service at the number above.
Looking for a new doctor?
You can choose a doctor from our list of participating providers. Our network of doctors is subject to change, but you can keep up-to-date with the most complete list of current network doctors by:
- Using our Find a Doctor tool
- Calling Member Service at 1-800-200-4255 (TTY: 711) from April 1 through September 30, 8:00 a.m. to 8:00 p.m. ET, Monday through Friday, or October 1 through March 31, 8:00 a.m. to 8:00 p.m. ET, seven days a week. You may also request to have the Provider Directory mailed to you.
- Your monthly premium will be different if you qualify for Extra Help from Medicare.
This information is not a complete description of benefits. Call 1-800-200-4255 (TTY: 711) for more information.
Every year, Medicare evaluates plans based on a 5-star rating system.