Effective 2009, government rule changes enable health plans to enroll and cover some retiree group members in Medicare Advantage (MA) HMO or PPO products, even in areas where a formal provider network is not available. We do not maintain a provider network for Medicare Advantage at this time; although, our providers may be asked to service a MA member while they are in our service area. MA members who are enrolled in areas without a provider network (in this case, Louisiana), are “non-network members,” and may receive care from any Medicare eligible provider, including all Medicare participating providers.
Key Information
- You are encouraged but not required to render services to non-network MA members
- Pays the “Medicare allowed amount” based on where the services were rendered and under the member's out-of-network benefits
- Non-network members may receive care from any Medicare eligible provider, including all Medicare participating providers
- Claims are submitted directly to us
Servicing Steps
- Verify eligibility and bill for services for any out-of-state Blue Plan member you agree to treat
- Verify benefits by referring to the number on the member’s ID card
- Complete a Member Servicing Confirmation Form. (By completing this form, you are agreeing to provide services to a particular member for the period of time indicated on the form at the Medicare allowed amount.)
- Submit form to us at network.administration@bcbsla.com or fax to us at 225.297.2750
View Medicare Advantage Frequently Asked Questions
Contact:
Provider Services 800.922.8866 Option 3
