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2017 Annual Notice of Change BlueMedicare HMO LifeTime - Statewide BlueMedicare HMO LifeTime Annual Notice of Change do-not-filter 2017
2017 Annual Notice of Change BlueMedicare HMO LifeTime - MIAMI-DADE BlueMedicare HMO LifeTime , BlueMedicare HMO Annual Notice of Change MIAMI-DADE 2017
2017 Annual Notice of Change BlueMedicare RPPO BlueMedicare Regional PPO Annual Notice of Change do-not-filter 2017
2017 Annual Notice of Change BlueMedicare HMO MyTime - HERNANDO,HILLSBOROUGH,PASCO,POLK BlueMedicare PPO Annual Notice of Change HERNANDO 2017
2017 Annual Notice Of Change - BlueMedicare Preferred HMO - SARASOTA,MANATEE BlueMedicare Preferred HMO Annual Notice of Change MANATEE 2017
2017 Annual Notice Of Change - BlueMedicare Preferred HMO - CLAY,DUVAL BlueMedicare Preferred HMO Annual Notice of Change CLAY 2017
2017 Annual Notice Of Change - BlueMedicare Preferred HMO SNP - MANATEE,SARASOTA BlueMedicare Preferred HMO SNP Annual Notice of Change MANATEE 2017
2017 Annual Notice Of Change - BlueMedicare Rx Option 1 BlueMedicare Rx Option 1 Annual Notice of Change ALACHUA 2017
2017 Annual Notice Of Change - BlueMedicare Rx Option 2 BlueMedicare Rx Option 2 Annual Notice of Change ALACHUA 2017
2017 Annual Notice Of Change - BlueMedicare HMO MyTime - PALM BEACH BlueMedicare HMO MyTime Annual Notice of Change PALM BEACH 2017
2017 Annual Notice Of Change - BlueMedicare HMO LifeTime BlueMedicare HMO LifeTime Annual Notice of Change BAY 2017
2017 Annual Notice Of Change - BlueMedicare HMO LifeTime - PALM BEACH BlueMedicare HMO LifeTime Annual Notice of Change PALM BEACH 2017
2017 Annual Notice Of Change - BlueMedicare PPO BlueMedicare PPO Annual Notice of Change BAY 2017
2017 Annual Notice Of Change - BlueMedicare HMO MyTime - ORANGE,OSCEOLA,SEMINOLE BlueMedicare HMO MyTime Annual Notice of Change ORANGE 2017
2017 Automatic Payment Option (APO)-Electronic Fund Transfer (EFT)-Medicare Advantage and Prescription Drug Plans (PDF) do-not-filter Automatic Payment Option(APO)/Electronic Fund Transfer (EFT) do-not-filter 2017
2017 Automatic Payment Option (APO)-Electronic Fund Transfer (EFT)-Medicare Supplement Plans (PDF) do-not-filter Automatic Payment Option(APO)/Electronic Fund Transfer (EFT) do-not-filter 2017
Blue365 Member Discount Program (PDF) do-not-filter Member Discount Program ALACHUA, BAKER, BAY, BRADFORD, BREVARD, BROWARD, CALHOUN, CHARLOTTE, CITRUS, CLAY, COLLIER, COLUMBIA, DE SOTO, DIXIE, DUVAL, ESCAMBIA, FLAGLER, FRANKLIN, GADSDEN, GILCHRIST, GLADES, GULF, HAMILTON, HARDEE, HENDRY, HERNANDO, HIGHLANDS, HILLSBOROUGH, HOLMES, INDIAN RIVER, JACKSON, JEFFERSON, LAFAYETTE, LAKE, LEE, LEON, LEVY, LIBERTY, MADISON, MANATEE, MARION, MARTIN, MIAMI-DADE, MONROE, NASSAU, OKALOOSA, OKEECHOBEE, ORANGE, OSCEOLA, PALM BEACH, PASCO, PINELLAS, POLK, PUTNAM, SAINT JOHNS, SAINT LUCIE, SANTA ROSA, SARASOTA, SEMINOLE, SUMTER, SUWANNEE, TAYLOR, UNION, VOLUSIA, WAKULLA, WALTON, WASHINGTON 2017
2017 BlueMedicare Preferred HMO Formulary BlueMedicare Preferred HMO Comprehensive Formulary CLAY, DUVAL, MANATEE, PINELLAS, SARASOTA 2017
2017 BlueMedicare Formulary BlueMedicare HMO, BlueMedicare HMO LifeTime , BlueMedicare HMO MyTime, BlueMedicare HMO MyTime , BlueMedicare HMO MyTime Plus, BlueMedicare HMO MyTime Select, BlueMedicare PPO, BlueMedicare Regional PPO, BlueMedicare RX (PDP), BlueMedicare Rx Option 1, BlueMedicare Rx Option 2, BlueMedicare Rx PDP, BlueMedicare RX(PDP), BlueMedicare HMO, BlueMedicare HMO LifeTime , BlueMedicare HMO MyTime , BlueMedicare HMO MyTime Plus, BlueMedicare HMO MyTime Select, BlueMedicare PPO, BlueMedicare Regional PPO, BlueMedicare RX (PDP), BlueMedicare Rx Option 1, BlueMedicare Rx Option 2, BlueMedicare Rx PDP, BlueMedicare RX(PDP) Comprehensive Formulary ALACHUA, BAKER, BAY, BRADFORD, BREVARD, BROWARD, CALHOUN, CHARLOTTE, CITRUS, CLAY, COLLIER, COLUMBIA, DE SOTO, DIXIE, DUVAL, ESCAMBIA, FLAGLER, FRANKLIN, GADSDEN, GILCHRIST, GLADES, GULF, HAMILTON, HARDEE, HENDRY, HERNANDO, HIGHLANDS, HILLSBOROUGH, HOLMES, INDIAN RIVER, JACKSON, JEFFERSON, LAFAYETTE, LAKE, LEE, LEON, LEVY, LIBERTY, MADISON, MANATEE, MARION, MARTIN, MIAMI-DADE, MONROE, NASSAU, OKALOOSA, OKEECHOBEE, ORANGE, OSCEOLA, PALM BEACH, PASCO, PINELLAS, POLK, PUTNAM, SAINT JOHNS, SAINT LUCIE, SANTA ROSA, SARASOTA, SEMINOLE, SUMTER, SUWANNEE, TAYLOR, UNION, VOLUSIA, WAKULLA, WALTON, WASHINGTON 2017
2017 BlueMedicare Enrollment Form PPO and RPPO BlueMedicare PPO, BlueMedicare Regional PPO Enrollment Form do-not-filter 2017
2017 BlueMedicare Enrollment Form Rx (PDP) Option 1 & Option 2 BlueMedicare RX (PDP), BlueMedicare Rx Option 1, BlueMedicare Rx Option 2, BlueMedicare Rx PDP, BlueMedicare RX(PDP) Enrollment Form do-not-filter 2017
2017 BlueMedicare Preferred HMO Enrollment Form BlueMedicare Preferred HMO, BlueMedicare Preferred HMO , BlueMedicare Preferred HMO POS , BlueMedicare Preferred HMO SNP Enrollment Form do-not-filter 2017
2017 BlueMedicare HMO Enrollment Form BlueMedicare HMO Enrollment Form do-not-filter 2017
2017 BlueMedicare Preferred HMO - Dental,Hearing and Vision Benefit Schedule BlueMedicare Preferred HMO , BlueMedicare Preferred HMO Dental/ Vision Benefit Schedule do-not-filter 2017
2017 BlueMedicare Preferred HMO - Hearing Benefit Schedule (PDF) do-not-filter Dental/ Vision Benefit Schedule do-not-filter 2017
2017 BlueMedicare HMO- Dental, Hearing and Vision Benefit Schedule (PDF) do-not-filter Dental/ Vision Benefit Schedule do-not-filter 2017
2017 BlueMedicare PPO-Dental, Hearing and Vision Benefit Schedule (PDF) do-not-filter Dental/ Vision Benefit Schedule do-not-filter 2017
2017 BlueMedicare HMO Plan Rating (PDF) BlueMedicare HMO Plan Rating do-not-filter 2017
2017 BlueMedicare PPO Plan Rating (PDF) BlueMedicare PPO Plan Rating do-not-filter 2017
2017 BlueMedicare RPPO Plan Rating (PDF) BlueMedicare Regional PPO Plan Rating do-not-filter 2017
2017 BlueMedicare Preferred HMO Plan Rating (PDF) BlueMedicare Preferred HMO , BlueMedicare Preferred HMO Plan Rating do-not-filter 2017
2017 BlueMedicare Rx (PDP) Plan Rating (PDF) BlueMedicare RX (PDP), BlueMedicare RX(PDP) Plan Rating do-not-filter 2017
2017 Enrollment Form Instructions do-not-filter Enrollment Form Instructions do-not-filter 2017
BluePrint for Health (PDF) do-not-filter BluePrint for Health ALACHUA 2017
2017 EOC BlueMedicare HMO MyTime Select - POLK BlueMedicare HMO MyTime Select Evidence of Coverage POLK 2017
2017 EOC BlueMedicare Regional PPO BlueMedicare Regional PPO Evidence of Coverage ALACHUA 2017
2017 EOC BlueMedicare Preferred HMO - MANATEE,SARASOTA BlueMedicare Preferred HMO Evidence of Coverage MANATEE, SARASOTA 2017
2017 EOC BlueMedicare HMO LifeTime - MIAMI-DADE BlueMedicare HMO LifeTime Evidence of Coverage MIAMI-DADE 2017
2017 EOC BlueMedicare Rx Option2 BlueMedicare Rx Option 2 Evidence of Coverage ALACHUA 2017
2017 EOC BlueMedicare MyTime Plus - MIAMI-DADE BlueMedicare HMO MyTime Plus Evidence of Coverage MIAMI-DADE 2017
2017 EOC BlueMedicare Preferred HMO POS - PINELLAS BlueMedicare Preferred HMO POS Evidence of Coverage PINELLAS 2017
2017 EOC BlueMedicare Preferred HMO SNP - MANATEE, SARASOTA BlueMedicare Preferred HMO SNP Evidence of Coverage MANATEE, SARASOTA 2017
2017 EOC BlueMedicare Preferred HMO - PINELLAS BlueMedicare Preferred HMO Evidence of Coverage PINELLAS 2017
2017 EOC BlueMedicare Preferred HMO - CLAY,DUVAL BlueMedicare Preferred HMO Evidence of Coverage CLAY, DUVAL 2017
2017 EOC BlueMedicare HMO MyTime Plus - BROWARD BlueMedicare HMO MyTime Plus Evidence of Coverage BROWARD 2017
2017 EOC BlueMedicare HMO MyTime Plus - ORANGE BlueMedicare HMO MyTime Plus Evidence of Coverage ORANGE 2017
2017 EOC BlueMedicare Rx Option1 BlueMedicare Rx Option 1 Evidence of Coverage ALACHUA 2017
2017 EOC BlueMedicare HMO LifeTime - PALM BEACH BlueMedicare HMO LifeTime Evidence of Coverage PALM BEACH 2017
2017 EOC BlueMedicare PPO BlueMedicare PPO Evidence of Coverage BAY 2017
2017 EOC BlueMedicare HMO MyTime - ORANGE,OSCEOLA,SEMINOLE BlueMedicare HMO MyTime Evidence of Coverage ORANGE 2017
2017 EOC BlueMedicare HMO MyTime - HERNANDO,HILLSBOROUGH,PASCO,POLK BlueMedicare HMO MyTime , BlueMedicare HMO Evidence of Coverage HERNANDO 2017
2017 EOC BlueMedicare HMO MyTime - PALM BEACH BlueMedicare HMO MyTime Evidence of Coverage PALM BEACH 2017
2017 EOC BlueMedicare HMO LifeTime - Statewide BlueMedicare HMO LifeTime Evidence of Coverage BAY 2017
2017 EOC BlueMedicare Preferred HMO SNP - CLAY, DUVAL BlueMedicare Preferred HMO SNP Evidence of Coverage CLAY, DUVAL 2017
2017 Medicare Part D Transition Policy do-not-filter General Transition Letter ALACHUA 2017
2017 Low Income Subsidy Premium Summary Table for Those Receiving Extra Help do-not-filter Low Income Subsidy Premium Table for Those Receiving Extra Help ALACHUA 2017
2017 BlueMedicare Preferred HMO Preventive Guidelines BlueMedicare Preferred HMO , BlueMedicare Preferred HMO Preventive Care Guidelines do-not-filter 2017
2017 Preventive Care Guidelines do-not-filter Preventive Care Guidelines do-not-filter 2017
2017 Summary of Benefits - BlueMedicare HMO Lifetime and Mytime Plus - BROWARD BlueMedicare HMO MyTime Plus Summary of Benefits BROWARD 2017
2017 Summary of Benefits - BlueMedicare Rx-Option 1 (PDP) and BlueMedicare Rx-Option 2 (PDP) - Summary of Benefits BlueMedicare Rx PDP Summary of Benefits ALACHUA 2017
2017 Summary of Benefits - BlueMedicare HMO LifeTime - Select Counties BlueMedicare HMO LifeTime Summary of Benefits BAY 2017
2017 Summary of Benefits - BlueMedicare HMO LifeTime (HMO)and BlueMedicare HMO MyTime Plus (HMO) - MIAMI-DADE BlueMedicare HMO MyTime Plus, BlueMedicare HMO LifeTime Summary of Benefits MIAMI-DADE 2017
2017 Summary of Benefits - BlueMedicare Preferred HMO - MANATEE,SARASOTA BlueMedicare Preferred HMO Summary of Benefits MANATEE 2017
2017 Summary of Benefits - BlueMedicare Preferred HMO - CLAY,DUVAL BlueMedicare Preferred HMO Summary of Benefits CLAY 2017
2017 Summary of Benefits - BlueMedicare Preferred HMO and BlueMedicare Preferred HMO POS - PINELLAS BlueMedicare Preferred HMO , BlueMedicare Preferred HMO POS Summary of Benefits PINELLAS 2017
2017 Summary of Benefits - BlueMedicare Preferred HMO SNP - CLAY,DUVAL ,MANATEE,SARASOTA BlueMedicare Preferred HMO SNP Summary of Benefits CLAY 2017
2017 Summary of Benefits - BlueMedicare PPO - Select Counties BlueMedicare PPO Summary of Benefits BAY 2017
2017 Summary of Benefits - BlueMedicare HMO MyTime (HMO) and BlueMedicare HMO MyTime Plus (HMO) - ORANGE,OSCEOLA,SEMINOLE BlueMedicare HMO MyTime Plus, BlueMedicare HMO MyTime Summary of Benefits ORANGE 2017
2017 Summary of Benefits - BlueMedicare HMO MyTime and BlueMedicare HMO MyTime Select - HERNANDO,HILLSBOROUGH,PASCO,POLK BlueMedicare HMO MyTime, BlueMedicare HMO MyTime , BlueMedicare HMO MyTime Select Summary of Benefits HERNANDO 2017
2017 Summary of Benefits - BlueMedicare HMO LifeTime (HMO) and BlueMedicare HMO MyTime (HMO) - PALM BEACH BlueMedicare HMO MyTime , BlueMedicare HMO LifeTime Summary of Benefits PALM BEACH 2017
2017 Summary of Benefits - BlueMedicare Regional PPO BlueMedicare Regional PPO Summary of Benefits ALACHUA 2017
2017 BlueMedicare PPO/ Regional PPO Service Area Map do-not-filter Additional Documents do-not-filter 2017
2017 BlueMedicare Preferred HMO Service Area Map do-not-filter Additional Documents do-not-filter 2017
2017 BlueMedicare PDP Service Area Map do-not-filter Additional Documents do-not-filter 2017
2017 BlueMedicare HMO Plus Service Area Map do-not-filter Additional Documents do-not-filter 2017
2017 BlueMedicare Preferred HMO/ BlueMedicare HMO Plus/BlueMedicare HMO Service Area Map do-not-filter Additional Documents do-not-filter 2017
2017 BlueMedicare HMO Service Area Map do-not-filter Additional Documents do-not-filter 2017
Notice on Nondiscrimination and Foreign Language Assistance (PDF) do-not-filter Additional Documents do-not-filter 2017
2017 BlueMedicare Preferred HMO Over-the-Counter (OTC) Benefit Catalog do-not-filter Additional Documents do-not-filter 2017
Authorization to Share Protected Health Information do-not-filter Additional Documents do-not-filter 2017

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.

For assistance, current members should call our Member Services number at 1-800-926-6565. If you are not a Florida Blue Medicare member, please call 1-855-601-9465. Hours are 8 a.m. - 8 p.m. local time, seven days a week from October 1 to February 14, except for Thanksgiving and Christmas. From February 15th to September 30th, we are open Monday - Friday, 8 a.m. - 8 p.m., local time.

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.

FBM FRM 001  092016

 

 

 


Last Updated: 12.21.2016
Y0011_33313 1016 CMS Approved

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