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Anthem
Blue Cross Freedom Blue PPO
California |
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Oleg Skurskiy an Authorized Independent
Agent for Anthem Blue Cross |
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products on this web site is not connected with
or endorsed by the United States government or the
federal Medicare program |
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Monthly
premium. |
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Freedom
Blue Plan 1 (Regional PPO)
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Formulary-
drugs list 
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Freedom
Blue Plus (Regional PPO) *
Formulary-
drugs list
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Freedom
Blue Classic (Regional
PPO)
** does
NOT cover Medicare Part D prescription
drugs.
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Stand
alone prescription coverageAnthem
Blue Cross Medicare Rx - (PDP) - Plans
2010 |
Do
Freedom Blue plans Cover Medicare Part B
or Part D Drugs?
- * Freedom Blue Plan I (Regional PPO)
and Freedom Blue Plus (Regional PPO) do
cover both Medicare Part B prescription
drugs and Medicare Part D prescription
drugs.
- ** Freedom
Blue Classic (Regional PPO) does cover
Medicare Part B prescription drugs. Freedom
Blue Classic (Regional PPO) does NOT cover
Medicare Part D prescription drugs.
Enrollment
Steps
Step 1: Download
the application for your California state
below, print it and then fill it out.
Freedom
Blue PPO (RPPO) Enrollment Form –
2010
or Click
here to Apply
Online 
Step 2: Mail your enrollment application
to the address below:
Oleg Skurskiy
18375 Ventura Blvd. # 226
Tarzana , CA 91356
Or can fax complete application to Fax:
(818) 776-9865
Also, be sure to complete the Working
Aged Survey and return it along with
your completed enrollment
form.
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Turning
65 ? Looking for reliable Medigap Insurance? or
Looking to get better rates to the plan you have
like plan F or J?
Compare
Medigap insurance online Click Here
Medicare products on this web
site is not connected with or endorsed by the
United States government or the federal Medicare
program
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| Mail
Application to: |
Oleg
Skurskiy
18375 Ventura Blvd. # 226
Tarzana , CA 91356
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also can fax complete application to Fax #
: 1-818-776-9865 |
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| Freedom
Blue Classic (Regional PPO) Summary of Benefits
– SCASB2289BM |
Freedom Blue Plan I (Regional PPO) and Freedom Blue
Plus (Regional PPO)
Summary of Benefits – SCASB2286BM |
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Current members
should contact Customer
Service for process or status questions or to
file a verbal grievance:
Customer Service Hours
for Medicare Advantage plans:
7 days a week, 8
a.m. to 8 p.m.
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Anthem Senior Advantage
Anthem Medicare Preferred
Blue Medicare Access |
1-800-467-1199 |
1-888-853-7754 |
P.O. Box 37180
Louisville, KY
40233-7180 |
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Nevada - Anthem Medicare
Preferred |
1-866-754-3077 |
1-888-877-5378 |
P.O. Box 60007
Los Angeles, CA
90060-0007 |
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Virginia - Anthem Medicare
Preferred |
1-866-827-9866 |
1-800-828-1120 |
P.O. Box 37180
Louisville, KY
40233-7180 |
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Freedom Blue |
1-877-811-3107 |
1-877-247-1657 |
P.O. Box 60007
Los Angeles, CA
90060-0007 |
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Connecticut - MediBlue
HMO |
1-866-673-4157 |
1-800-241-6894 |
P.O. Box 1407 Church Street
Station
New York, NY 10008-1407 |
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Senior Secure |
1-888-230-7338 |
1-877-247-1657 |
P.O. Box 60007
Los Angeles, CA 90060-0007 |
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SmartValue |
1-888-445-8916 |
1-800-425-5705 |
P.O. Box 795180
San Antonio, TX 78279 |
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SureValue |
1-866-408-7086 |
1-877-247-1657 |
P.O. Box 60007
Los Angeles, CA 90060-0007 |
Customer
Service Hours for Medicare Part D plans:
7 days a week, 8 a.m. to 8
p.m.
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California, Colorado, Nevada,
Wisconsin |
1-800-928-6201 |
1-877-247-1657 |
P.O. Box 9282
Oxnard, CA 93031-9282 |
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Connecticut, Indiana, Kentucky,
Maine, Missouri, New Hampshire, Ohio,
Virginia |
1-866-755-2776 |
1-866-798-7026 |
P.O. Box 34160
Louisville, KY 40232-9732 |
Current
members who wish to file written grievances for
any of the plans above*:
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The mailing address and
fax number designated for receiving written
grievances is:
Grievances & Appeals
P.O. Box 1975
Fond du Lac, WI 54936-1975
FAX: (888) 458-1406 |
*Note: For the MediBlue plans offered
in Connecticut, use the following contact information:
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The mailing address and
fax number designated for receiving written
grievances is:
Grievances & Appeals
P.O. Box 1407 Church Street Station
New York, NY 10008-1407
FAX: 888-458-1406 |
Providers
should call
Please call the numbers listed below
for process or status questions as well as Grievance
& Appeals.
Provider Service Hours are
listed below.
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Anthem Senior Advantage
Anthem Medicare Preferred
Blue Medicare Access |
1-888-290-9160
(Monday through Friday 8
a.m. to 8 p.m. ET) |
1-888-853-7754 |
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Nevada - Anthem Medicare
Preferred |
1-866-754-3077
(Monday through Friday 8
a.m. to 8 p.m. ET) |
1-888-877-5378 |
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Freedom Blue |
1-877-811-3107
(Monday through Friday 8
a.m. to 8 p.m. ET) |
1-888-877-5378 |
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MediBlue HMO (Connecticut) |
1-866-673-4157
(Monday through Friday 8
a.m. to 8 p.m. ET) |
1-800-241-6894 |
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Senior Secure |
1-888-230-7338
(Monday through Friday 8
a.m. to 8 p.m. ET) |
1-888-877-5378 |
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SmartValue |
1-866-364-2374
(Monday through Friday 8
a.m. to 8 p.m. ET) |
1-800-425-5705 |
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SureValue |
1-866-408-7086
(Monday through Friday 8
a.m. to 8 p.m. ET) |
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*There may be a late-enrollment
penalty.
Legal Disclaimers for Medicare Advantage Plans
and Medicare Advantage with Prescription Drug
Plans
HMO and PPO Plans:
Blue Cross of California, doing business as
Anthem Blue Cross, is the legal entity that
has contracted with the Centers for Medicare
and Medicaid Services (CMS) to offer the Medicare
Advantage plan noted above or herein. Independent
licensee of the Blue Cross Association. ®
ANTHEM is a registered trademark of Anthem Insurance
Companies, Inc. The Blue Cross name and symbol
are registered marks of the Blue Cross Association.
RPPO plans:
Anthem Blue Cross Life and Health Insurance
Company (Anthem) is the legal entity that has
contracted with the Centers for Medicare and
Medicaid Services (CMS) to offer the Medicare
Advantage Regional PPO plan(s) (MAPD-RPPO) noted.
Anthem is the risk bearing entity licensed under
applicable state law to offer the MAPD-RPPO
plan(s) noted. Anthem has retained the services
of its related companies and the authorized
agents/brokers/producers to provide administrative
services and/or to make the MAPD-RPPO plan(s)
available in this region. Anthem Blue Cross
Life and Health Insurance Company is an independent
licensee of the Blue Cross Association. ®
ANTHEM is a registered trademark of Anthem Insurance
Companies, Inc. The Blue Cross name and symbol
are registered marks of the Blue Cross Association.
PFFS plans:
Blue Cross of California, doing business as
Anthem Blue Cross, is the legal entity that
has contracted with the Centers for Medicare
and Medicaid Services (CMS) to offer the Private
Fee for Service plan(s) (PFFS) noted above or
herein. Anthem is the risk bearing entity licensed
under applicable state law to offer the PFFS
plan(s) noted. Anthem has retained the services
of its related companies and the authorized
agents/brokers/producers to provide administrative
services and/or to make the PFFS plan(s) available
in this region. Independent licensee of the
Blue Cross Association. ® ANTHEM is a registered
trademark of Anthem Insurance Companies, Inc.
The Blue Cross name and symbol are registered
marks of the Blue Cross Association
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®
Anthem is a registered trademark. ® The Blue
Cross name and symbol are registered marks of
the Blue Cross Association © 2007 Anthem
Blue Cross. Serving California. Anthem Blue Cross
is the trade name of Blue Cross of California.
Anthem Blue Cross and Anthem Blue Cross Life and
Health Insurance Company are independent licensees
of the Blue Cross Association |
Please
reference the Evidence of Coverage for information
on premiums, cost-sharing, out-of-network coverage,
rights and responsibilities upon disenrollment,
service areas and any applicable conditions associated
with using the plan benefits.
Material Identification M0013_09_221, CMS Approved
09/25/2009 |
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Copyright © 2005 Oleg Skurskiy Authorized
Independent Agent, CA License 0E50389 |
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