23.03.2013 Views

Name of Manual - Blue Cross and Blue Shield of Minnesota

Name of Manual - Blue Cross and Blue Shield of Minnesota

Name of Manual - Blue Cross and Blue Shield of Minnesota

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

Medicare Advantage Claims through <strong>Blue</strong>Card<br />

Overview “Medicare Advantage” (MA) is the program alternative to<br />

st<strong>and</strong>ard Medicare Part A <strong>and</strong> Part B fee-for-service coverage;<br />

generally referred to as “traditional Medicare.”<br />

<strong>Blue</strong>Card®<br />

MA <strong>of</strong>fers Medicare beneficiaries several product options (similar<br />

to those available in the commercial market), including health<br />

maintenance organization (HMO), preferred provider organization<br />

(PPO), point-<strong>of</strong>-service (POS) <strong>and</strong> private fee-for-service (PFFS)<br />

plans.<br />

All Medicare Advantage plans must <strong>of</strong>fer beneficiaries at least the<br />

st<strong>and</strong>ard Medicare Part A <strong>and</strong> B benefits, but many <strong>of</strong>fer<br />

additional covered services as well (for example, enhanced vision<br />

<strong>and</strong> dental benefits).<br />

In addition to these products, Medicare Advantage organizations<br />

may also <strong>of</strong>fer a Special Needs Plan (SNP), which can limit<br />

enrollment to subgroups <strong>of</strong> the Medicare population in order to<br />

focus on ensuring that their special needs are met as effectively as<br />

possible.<br />

<strong>Blue</strong> <strong>Cross</strong> <strong>and</strong> <strong>Blue</strong> <strong>Shield</strong> <strong>of</strong> <strong>Minnesota</strong> Provider Policy <strong>and</strong> Procedure <strong>Manual</strong> (12/30/10) 7-23

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!