Liberty Dental

Blue Cross^® and Blue Shield^® of North Carolina (Blue Cross NC) is working with Liberty Dental Plan and their large network of providers to provide dental benefits as part of your Blue Medicare Advantage plan.  Members will have access to this new network of providers effective January 1, 2022. Members will receive a separate Member ID card and will have access to the Liberty Dental member portal to view claims, benefits, and the Find a Participating Provider tool. The dental benefits are included in the medical plan. Members cannot add or remove these benefits. 

Two benefit designs:

Plans with preventive coverage only (HMO Essential, HMO Choice) 

Covered services include:  

• Preventive dental services
  
• Oral exams  
• Cleanings  
• Dental x-rays  

Plans with preventive and comprehensive coverage (HMO Medical Only, HMO Essential Plus, HMO Enhanced, PPO Enhanced) 

Covered services include:  

• A combined allowance per year for preventive and  comprehensive dental services  
  
• Preventive services (oral exams, cleanings, dental x-rays)  
• Restorative services  
• Endodontics  
• Periodontics  
• Extractions  
• Prosthodontics and maxillofacial services  

Please note: Members must use a provider that is contracted with our dental vendor to receive these services under the plan.  

Service area expansion 

The Medicare Advantage Service Area is expanding to include the following counties:  

HMO:   Graham 

PPO: Alleghany, Ashe, Avery, Burke, Davie, Graham, Granville, Greene, Halifax, Hyde, Jackson, Lenoir, Lincoln, Macon, Montgomery, Northampton, Pamlico, Pender, Rutherford, Stanly, Swain, Tyrrell, Union, Vance, Yadkin 

New plan offering for FEP: Blue Medicare Freedom+  

Blue Cross NC is excited to offer a Medicare Advantage plan for Federal Employee Plan (FEP) members, however, any Medicare-eligible beneficiary can purchase this plan. In addition to the Blue Medicare Freedom+ plan, FEP retirees are also eligible to purchase any Medicare Advantage plan. See below for additional details on the Blue Medicare Freedom+ plan: 

• Freedom+ is a $0 individual medical only PPO plan (drug and dental coverage will be provided through FEP)  
• Freedom+ is primary and FEP is secondary for retirees 
• Freedom+ is secondary and FEP is primary for active FEP employees 
• Supplemental benefits include: 
  • Part B Premium Reduction 
  • Meals  
  • Over-the-counter (OTC) allowance  
  • Fitness benefit  

New preferred mail order providers

• Currently, Blue Cross NC utilizes AllianceRx Walgreens Prime and Express Scripts as our preferred mail order providers for MA PPO and HMO. Effective January 1, 2022, Blue Cross NC will be adding Kroger Postal Prescription Services to our preferred mail order provider list, for a total of three preferred providers.  
  
• We will also be adding Costco mail as a non-preferred mail order provider.