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for BlueJourney PPO and BlueJourney HMO
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Telephone Services

October 1 - February 14, 
7 days a week, 
8:00am – 8:00pm

February 15 - September 30, 
Monday through Friday
8:00 am - 8:00 pm 

BlueJourney PPO
866.987.4213

BlueJourney HMO
800.779.6962

or TTY: 711

Write Us

Customer Service
P.O. Box 779519
Harrisburg, PA 17177-9519

Fax Us

717.541.6915

Walk-In Services

Harrisburg Office

2500 Elmerton Avenue
Harrisburg, PA 17177-9799
Monday through Friday
8:30am – 4:30pm

Allentown Office

1221 W. Hamilton Street
Allentown, PA 18102-4304
Monday through Friday
8:30am – 4:30pm


Capital Blue

2845 Center Valley Parkway
Suite 404/409
Center Valley, PA 18034
Monday through Friday
8:00am – 8:00pm
Saturday
8:00am - 4:00pm

4500 Marketplace Way
Enola, PA 17025
Monday through Friday
8:00am – 8:00pm
Saturday
8:00am - 4:00pm
Multi-language Interpreter Services
BlueJourney HMO
BlueJourney PPO
Telephone Services

October 1 - February 14, 
7 days a week, 
8:00am – 8:00pm

February 15 - September 30, Monday through Friday
8:00 am - 8:00 pm 

800.990.4201

or TTY: 711

Write Us

Customer Service
P.O. Box 779519
Harrisburg, PA 17177-9519

Fax Us

(717) 541.6915

Walk-In Services

Harrisburg Office

2500 Elmerton Avenue
Harrisburg, PA 17177-9799
Monday through Friday
8:30am – 4:30pm

Allentown Office

1221 W. Hamilton Street
Allentown, PA 18102-4304
Monday through Friday
8:30am – 4:30pm


Capital Blue

2845 Center Valley Parkway
Suite 404/409
Center Valley, PA 18034
Monday through Friday
8:00am – 8:00pm
Saturday
8:00am - 4:00pm

4500 Marketplace Way
Enola, PA 17025
Monday through Friday
8:00am – 8:00pm
Saturday
8:00am - 4:00pm
Multi-language Interpreter Services
BlueJourney HMO
BlueJourney PPO
Check It Out
An automated payment option that will deduct your premium directly from your bank account. To learn more about this program, download a Check It Out Enrollment / Change Form.
Monthly Paper Billing

Receive a paper bill the first of each month for the following month. Pay directly by check or money order. Refer to the BlueJourney PPO Evidence of Coverage or the BlueJourney HMO Evidence of Coverage for more information.

Pay through your monthly social security check

Automatically have your Plan premium deducted from your monthly Social Security check. Contact Customer Service for more information. 

Credit/debit card or electronic check

Log in to your account to enjoy the convenience and timeliness of paying your premium online. 

Pay My Premium

Capital Blue, a first-of-its kind health and wellness store, is more than a store, it’s a one-of-a-kind experience! Offering so much more than health insurance, Capital Blue’s mission is to empower you – whether you are a Capital BlueCross member or not – to live healthy.

CapitalBlue

As a member, you are entitled to file a grievance if you are dissatisfied with our service, plan, or providers. You are also entitled to appeal a denial of payment, eligibility or other decision. The following links provide the information needed to complete and file grievances and appeals, prescription drug coverage determination request or representative forms:

Appointing a Representative

If you want a friend, relative, your doctor or other provider, or other person to be your representative, you will need to complete the Appointment of Representative form. This will give that person the ability to act on your behalf. The form must be signed by you and by the person who you would like to act on your behalf. You must give us a copy of the signed form.

Obtaining a Coverage Decision

Members of BlueJourney PPO and BlueJourney HMO may ask us to make a coverage decision about a service or drug. To request an expedited coverage decision about your medical care, please contact BlueJourney HMO at 866.779.6962 or BlueJourney PPO at 866.987.4213  (TTY: 711). To request an expedited coverage decision for a Part D drug, please contact CVS/caremark - BlueJourney HMO at 800.844.0719 or BlueJourney PPO at 800.861.1737 (TTY: 711).

Standard coverage decisions must be in writing. Please send these requests to:

BlueJourney HMO Organizational Determinations  (or) 
BlueJourney PPO Organizational Determinations
PO Box 773733
Harrisburg PA 17177-3733

CVS/caremark
PO box 52000, MC109
Phoenix, AX 85072-2000
Attention: PA Department

Obtaining Data on Exceptions, Appeals and Grievances

Members of BlueJourney PPO and BlueJourney HMO receive a description of the plans’ total number of exceptions, appeals and grievances received and how these cases were resolved. Contact BlueJourney PPO and BlueJourney HMO by phone or in writing.

There is a Quality Improvement Organization for each state. The organization is paid by Medicare to check on and help improve the quality of care for people with Medicare. This is an independent organization. It is not connected with your plan.

You should contact this organization in any of these situations:

  • You have a complaint about the quality of care you have received
  • You think coverage for your hospital stay is ending too soon
  • You think coverage for your home health care, skilled nursing facility care, or Comprehensive Outpatient Rehabilitation Facility (CORF) services are ending soon.

The name, address, and phone number of the quality improvement organization is:

Livanta
BFCC-QIO Program
9090 Junction Drive, Suite 10
Annapolis Junction, MD 20701

Phone: 866.815.5440
TTY: 711
Fax (Appeals): 855.236.2423
Fax (All other reviews): 844.420.6671
Website: www.BFCCQIOAREA1.com

Disenrollment is the process by which your membership in our Plan ends. This may be done voluntarily by you, or you may be involuntarily disenrolled for certain reasons (listed below).
Voluntary Disenrollment
  • If you change plans during the annual enrollment period (October 7 – December 15, with a January 1 effective date).
  • If you qualify for special enrollment periods. Call Medicare at 800.MEDICARE (800.633.4227), 24 hours a day, 7 days a week. TTY: 711.

If you leave our Plan, it may take time before your membership ends and your new Medicare coverage goes into effect. During that time, you must continue to get your medical care and prescription drugs through our Plan.

Involuntary Disenrollment

We may end your coverage for any of the following reasons:

  • If you do not stay continuously enrolled in Medicare Part A and Part B.
  • If you are enrolled in BlueJourney HMO and move out of our service area for more than six months or at any time when you confirm a permanent out-of-area address.
  • If you are enrolled in BlueJourney PPO and move out of our service area for more than six months or at any time you confirm a permanent out-of-area address. BlueJourney PPO offers a supplemental visitor/traveler program that allows you to remain enrolled in our plan when you are outside of our service area for less than twelve months. See the BlueJourney PPO Evidence of Coverage for more information.
  • If you become incarcerated (go to prison).
  • If you intentionally give us incorrect information when you are enrolling in our Plan and that information affects your eligibility for our Plan; We cannot make you leave our Plan for this reason unless we get permission from Medicare first.
  • If you continuously behave in a way that is disruptive and makes it difficult for us to provide medical care to you and other Members in our Plan. We cannot make you leave our Plan for this reason unless we get permission from Medicare first.
  • If you let someone else use your membership card to get medical care; We cannot make you leave our Plan for this reason unless we get permission from Medicare first.
  • If you do not pay the Plan premiums for two calendar months.
  • If you are required to pay the extra Part D amount because of your income and you do not pay it, Medicare will disenroll you from our Plan and you will lose prescription drug coverage.

For more information on disenrollment and all of your rights and responsibilities, please review the BlueJourney PPO Evidence of Coverage or the BlueJourney HMO Evidence of Coverage.

Updated March 3, 2017
Y0016_17_400 Approved 10052016