Web Content Viewer - Fixed Context

  1. You are here
  2. CAPM
  3. Home
  4. Enroll
  5. 2026 Benefit Information

Web Content Viewer - Fixed Context

2026 Benefit Information for Members

View and download information for your 2026 plan through December 31, 2026.

Capital Blue Cross Medicare HMO

All 21 Counties

001 - Centre, Dauphin, Juniata, Mifflin, Perry Counties

002 - Columbia, Montour, Northumberland, Snyder, Union Counties

003 - Berks, Lehigh, Northampton, Schuylkill Counties

004 - Cumberland, Fulton, Lancaster, Lebanon Counties

005 - Adams, Franklin, York Counties

Representation Forms

Appoint a Representative to Discuss Your Options with us

Print, complete and send back this form to allow a family member or friend to communicate with us on your behalf. You can also call the Member Services number on your ID card and request a copy be mailed to you.

National and Local Medicare Coverage Information

The Centers for Medicare and Medicaid Services (CMS) works to expand and improve coverage for Medicare participants. There are National Coverage Determinations (NCD’s) and Local Coverage Determinations (LCD’s) issued throughout the year that expand health care coverage for various services. Listed below are some of those new coverage determinations.

Quality Improvement Organization

You should contact the Quality Improvement Organization if you have a complaint about the quality of care you have received. For example, you can contact the Quality Improvement Organization if you were given the wrong medication or if you were given medications that interact in a negative way.

Livanta (Pennsylvania’s Quality Improvement Organization)

Contact

Phone: 888.396.4646 (TTY: 888.985.2660)

Fax: 1.833.868.4057

Visit the Livanta website.

Write by mail:

Livanta BFCC-QIO Program

10820 Guilford Road, Suite 202 
Annapolis Junction, MD 20701

Prescription Drug Information

Compare the cost of your drugs at participating pharmacies.

To access pricing, login to your secure member account.

Search the Ideal Formulary for drugs included on the Capital Blue Cross Ideal formulary. This formulary applies to the following plans: Capital Blue Cross Basic, Complete, Enhanced, Select, Value PPO and Capital Blue Cross HMO Essential. 

Search the Classic Formulary for drugs included in the Capital Blue Cross Classic formulary. This formulary applies to the following plans: Capital Blue Cross Classic and Prime PPO and Capital Blue Cross Premier and Value HMO, as well as our Capital Blue Cross PPO and HMO Group benefit plans. 

Drug Comparison Tool

Add your prescriptions to see how much you will pay each month and save by either switching to a pharmacy that has lower prescription cost or finding a lower cost alternative.

Web Content Viewer - Fixed Context

Medicare Prescription Payment Plan

Eligible members with Medicare Advantage plans that cover prescription drugs or a stand-alone Part D drug plan can use the Medicare Prescription Payment Plan to spread out the out-of-pocket costs of their covered Part D drugs into monthly payments.

You can enroll in the Medicare Prescription Payment Plan now for a January 1, 2026, start date, or at any time throughout the year. There are three easy ways to sign up:

Option 1:  Register for a secure account, choose Medicare Prescription Payment Plan, and follow the steps.

Already have a secure account? Sign in, choose Medicare Prescription Payment Plan, and follow the steps.

Option 2: Call  833-247-0639 (TTY: 711),

  • October 1 through December 7, seven days a week from 8:00 AM to 1:00 AM ET.
  • December 8 through March 31, seven days a week from 8:00 AM to 11:00 PM ET.
  • April 1 through September 30, Monday through Friday from 8:00 AM to 11:00 PM ET.

Option 3: Sign up by mail or fax. Download the enrollment form and mail or fax to:

Mail: Mailstop: 1001MPPP Election Dept.13900 N. Harvey AveEdmond, OK 73013

Fax: 440.557.6525

Capital Blue Cross is working with SimplicityRx1 for Medicare Prescription Payment Plan services. Most calls about the Medicare Prescription Payment Plan will be handled by this vendor on behalf of Capital Blue Cross. If you choose to receive email notifications, they will come from from SimplicityRx using this email address: noreplyrx@rxpayments.com.

Questions?

Check out the Medicare Prescription Payment Plan website or call 833-247-0639 (TTY: 711),

  • October 1 through December 7, seven days a week from 8:00 AM to 1:00 AM ET.
  • December 8 through March 31, seven days a week from 8:00 AM to 11:00 PM ET.
  • April 1 through September 30, Monday through Friday from 8:00 AM to 11:00 PM ET.

Web Content Viewer - Fixed Context

Get the most out of your coverage today.

Coverage in a Disaster

Coverage in a Disaster

Get the most out of your Rx benefits.

Dental, Vision and Hearing

Checkups and knowledge for life.

Updated

Y20170719