Medical Management Programs and Services
This section provides information about programs and services Blue Medicare HMO and Blue Medicare PPO plans have implemented to maintain the high quality care for its members.
Blue Medicare HMO and Blue Medicare PPO follow review processes for evaluating certain health care services before, during and after those services have been performed.
In certain health situations, members of Blue Medicare HMO and Blue Medicare PPO are eligible to work one-on-one with a case manager. Learn how patients may qualify.
From October through November, while supplies last, members can receive a flu shot at their primary care physician's office or contracting specialist's office, if offered. They can also receive a flu shot at flu clinics sponsored by Blue Medicare HMO and Blue Medicare PPO plans.
Medication therapy management program (MTMP), designed for targeted members to help ensure that covered Part D drugs are appropriately used to optimize therapeutic outcomes by improving medication use and reducing the risk of adverse drug events, including adverse drug interactions.
The Quality Improvement Program for the Blue Medicare HMO and Blue Medicare PPO plans is an important component of the products. Learn more about how the plans we aim to maintain the highest quality.
Blue Cross and Blue Shield of North Carolina is an HMO, PPO, and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability or geographic location within the service area. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area.