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Medicare beneficiaries may also enroll in BlueMedicare HMO, BlueMedicare Preferred HMO, BlueMedicare PPO, BlueMedicare Regional PPO and Blue Medicare Rx (PDP) through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Florida Blue is a PPO, RPPO and Rx (PDP) Plan with a Medicare contract. Florida Blue HMO and Florida Blue Preferred HMO are HMO Plans with a Medicare contract. Enrollment in Florida Blue, Florida Blue HMO or Florida Blue Preferred HMO depends on contract renewal.

You must continue to pay your Medicare Part B premium.This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.

Florida Blue Medicare Supplement Insurance policies are not connected with or endorsed by the U.S. Government or the Federal Medicare Program. These policies have limitations and exclusions. The amount of benefits provided depends on the plan selected and the premium may vary with the amount of benefits selected. While medical cost increases and inflation could increase our premiums, your premium will always remain the lowest we offer, according to your age at enrollment. Medical Underwriting will apply to all BlueMedicare Supplement and BlueMedicare Supplement Select products unless the applicant is eligible for guaranteed issue. Networks are comprised of independent contracting healthcare providers.

Policy Numbers: BlueMedicare Supplement Plan K - 30154-1014 SU | BlueMedicare Supplement - Plan L - 30155-1014 SU | BlueMedicare Supplement Plan A -  30147-1014 SU | BlueMedicare Supplement Select Plan B - 30166-1014 SU | BlueMedicare Supplement Select Plan M - 30159-1014 SU | BlueMedicare Supplement Select Plan D - 30168-1014 SU | BlueMedicare Supplement Plan N - 30157-1014 SU | BlueMedicare Supplement Plan M - 30156-1014 SU | BlueMedicare Supplement Plan B - 30148-1014 SU | BlueMedicare Supplement Select Plan C - 30167-1014 SU | BlueMedicare Supplement Plan D - 30150- 1014 SU | BlueMedicare Supplement Plan G - 30152-1014 SU | BlueMedicare Supplement Plan C - 30149-1014 SU | BlueMedicare Supplement Plan F - 30151-1014 SU

If this policy is replacing current health insurance coverage that has been in effect for at least three months, there is no waiting period required for pre-existing conditions. However, if this policy does not replace current health insurance coverage, a condition treated three months before the effective date may not be covered until three months after the effective date of this policy. Additionally, coverage for this condition may not begin for patients in a hospital or skilled nursing facility the day before the effective date until they have been released, or six months passed the effective date of the policy. For special circumstances or questions, please call 1-855-601-9465 or TTY 800-955-8770. BlueMedicare Supplement and BlueMedicare Supplement Select Plans are guaranteed renewable. Florida Blue will only terminate your coverage for nonpayment of premiums or material misrepresentation.

Florida Blue is a trade name of Blue Cross and Blue Shield of Florida, Inc., an Independent Licensee of the Blue Cross and Blue Shield Association.

David McBride
State License Number: P027737

FBM CART 001 092016


Last Updated: 12.21.2016
Y0011_33313 1016 CMS Approved

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