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2020 Benefit Information
For BlueJourney HMO and PPO Members
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You can view and download information for your 2020 Medicare benefits through the links below.
This information will be posted through December 31, 2020.
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Benefit Information
BlueJourney HMO
- Evidence of Coverage
- Summary of Benefits
- Annual Notice of Changes — Premier Plan
- Annual Notice of Changes — Value Plan
- Annual Notice of Changes — Essential Plan
- Out of Network Coverage Rules
BlueJourney PPO
- Evidence of Coverage
- Summary of Benefits
- Annual Notice of Changes — Prime Plan
- Annual Notice of Changes — Classic Plan
- Out of Network Coverage Rules
BlueJourney Alliance (HMO C-SNP)
- Evidence of Coverage
- Summary of Benefits
- Annual Notice of Changes - Heart and Diabetes Care
- Annual Notice of Changes - Lung Care
- Out of Network Coverage Rules
BlueJourney Alliance (HMO I-SNP)
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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 in the BlueJourney PPO, BlueJourney HMO and BlueJourney Alliance HMO (SNP) individual benefit plans.
- Download a Ideal Formulary listing. (updated 10/2020)
- Ideal Formulary Prior Authorization Criteria
- Ideal Formulary Step Therapy Criteria
Search the Value Formulary for drugs included in the BlueJourney PPO and BlueJourney HMO group benefit plans.
- Download a Value Formulary listing. (updated 10/2020)
- Value Formulary Prior Authorization Criteria
- Value Formulary Step Therapy Criteria
- Help with Drug Costs - See if you qualify for help paying for your prescription drugs.
- Out of Network Pharmacy Information - How to get reimbursed for prescriptions filled at an out-of-network pharmacy.
- General Transition Notice - Explanation of the transition process of your current drugs when you switch to a different health plan.
- Medication Therapy Management - A free educational program to help control long-term conditions for members who have multiple chronic diseases.
- Drug Utilization Management - If required, this process will ensure you are getting the proper drugs for your diagnosed condition.
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Provider Directories
2020 BlueJourney HMO Provider and Pharmacy Directory
- Table of Contents, Introduction, Language Index
- PCPs, OBGYNs, and Behavioral Health
- Specialists
- Hospitals, BH Facilities, SNFs, Ancillaries, Labs, and Pharmacies
- Dental, Vision, and Fitness Directory
2020 BlueJourney PPO Provider and Pharmacy Directory
- Table of Contents, Introduction, and Language Index
- PCPs, OBGYNs, and Behavioral Health
- Specialists (A-N)
- Specialists (O-Z)
- Hospitals, BH Facilities, SNFs, Ancillaries, Labs, and Pharmacies
- Dental, Vision, and Fitness Provider Directory
2020 BlueJourney Alliance Heart and Diabetes Care, BlueJourney Alliance Lung Care
Provider and Pharmacy Directory
- Table of Contents, Introduction, and Language Index
- PCP, OBGYN and Behavioral Health
- Specialists
- Hospitals, Facilities, and Pharmacies
- Dental, Vision and Fitness Directory
2020 BlueJourney Alliance Assisted Care
Provider and Pharmacy Directory
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If you are looking to join a Medicare Advantage HMO or PPO plan for the remainder of 2020, you can view your options and how to enroll.
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Updated October 1, 2020
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