Group Medicare Advantage (PPO) 2021 Provider Directory
This directory is current as of .
This directory provides a list of Group Medicare Advantage’s network providers.
This directory is for Anoka, Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carver, Cass, Chippewa, Chisago, Clay, Clearwater, Cottonwood, Crow Wing, Dakota, Dodge, Douglas, Faribault, Fillmore, Freeborn, Grant, Hennepin, Houston, Hubbard, Isanti, Jackson, Kandiyohi, Kittson, Lac Qui Parle, Lake Of Woods, Lincoln, Lyon, Mahnomen, Marshall, Martin, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Polk, Pope, Ramsey, Red Lake, Redwood, Renville, Roseau, Scott, Sherburne, Stearns, Steele, Swift, Todd, Wabasha, Wadena, Waseca, Washington, Watonwan, Wilkin, Winona, and Wright counties in Minnesota and the bordering counties of Iowa, North Dakota, South Dakota and Wisconsin.
To access Group Medicare Advantage’s online provider directory, you can visit bluecrossmn.com.
For any questions about the information contained in this directory, please call our Customer Service department at 1-800-711-9865, 8 a.m. to 8 p.m. Central Time. TTY users should call 711. We are available seven days a week October 1 through March 31 and available Monday through Friday the rest of the year.
Group Medicare Advantage is a PPO plan with a Medicare contract. Enrollment in Group Medicare Advantage depends on contract renewal.
If you have special needs, alternative formats are available. Please call Customer Service at the number above.
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Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association. Introduction
This directory provides a list of Group Medicare Advantage’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).
The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers. Other physicians/providers are available in our network.
Out-of-network providers are under no obligation to treat Group Medicare Advantage enrollees, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Customer Service Department at 1-800-711-9865, daily, 8:00 a.m. to 8:00 p.m. CT. TTY users should call 711. You may also refer to your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.
While you don’t need to get a referral when you receive care from in-network or out-of-network providers, prior authorization may be required for some services. For details on covered services that need prior authorization, please see your Evidence of Coverage. If you receive these services without prior authorization, you may be responsible for the costs. If you have any questions about whether we will pay for any medical service or care that you are considering, you have the right to ask us whether we will cover it before you get the service or care.
The Group Medicare Advantage plan will cover services from either in-network or out-of- network providers, as long as the services are covered benefits and medically necessary. However, if you use an out-of-network provider, your share of the costs for your covered services may be higher.
The Group Medicare Advantage plan offers as a supplemental benefit a visitor/traveler program for the United States and its territories (outside the state of Minnesota and contiguous counties), which will allow you to obtain eligible covered services at an in-network cost share when traveling for up to 9 continuous months. Prior notification is required. Please contact Customer Service for more information.
You may get covered emergency medical care whenever you need it, anywhere worldwide. Group Medicare Advantage covers ambulance services in situations where getting to the emergency room in any other way could endanger your health. If you have an emergency, we will talk with the doctors who are giving you emergency care to help manage and follow up on your care. The doctors who are giving you emergency care will decide when your condition is stable, and the medical emergency is over. After the emergency is over you are entitled to follow-up care to be sure your condition continues to be stable. Your follow-up care will be covered by Group Medicare Advantage.
If your emergency care is provided by non-network providers, we will try to arrange for network providers to take over your care as soon as your medical condition and the circumstances allow. Coverage outside of the United States is limited to emergency medical care.
Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area you should use network providers for urgent care. In most situations, if you are in the plan’s service area and you use an out-of-network provider, you will pay a higher share of the costs for your care. When you are outside the service area and cannot get care from a network provider, our plan will cover urgently needed services that you get from any provider at the lower in-network cost sharing amount. In addition, when out of the service area you can obtain dialysis treatment from any qualified dialysis provider. If you obtain routine care from out-of-network providers, you will pay the higher out-of-network cost-sharing.
We feature a large network of health care providers. Each provider is an independent contractor and is not our agent.
What is the service area for Group Medicare Advantage?
Anoka, Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carver, Cass, Chippewa, Chisago, Clay, Clearwater, Cottonwood, Crow Wing, Dakota, Dodge, Douglas, Faribault, Fillmore, Freeborn, Grant, Hennepin, Houston, Hubbard, Isanti, Jackson, Kandiyohi, Kittson, Lac Qui Parle, Lake Of Woods, Lincoln, Lyon, Mahnomen, Marshall, Martin, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Polk, Pope, Ramsey, Red Lake, Redwood, Renville, Roseau, Scott, Sherburne, Stearns, Steele, Swift, Todd, Wabasha, Wadena, Waseca, Washington, Watonwan, Wilkin, Winona, and Wright.
How do you find Group Medicare Advantage providers that serve your area?
Providers in the Group Medicare Advantage network are listed in this directory in sections by type of provider: Primary Care Providers, Hospitals, Home Health Care Centers, Skilled Nursing Facilities, Outpatient Rehabilitation Centers, Ambulatory Surgical Centers, Urgent Care Centers and Specialists. TruHearing* is a hearing aid benefit for Group Medicare Advantage members. Please reference the Hearing Aids/Routine Hearing Exams (TruHearing) section for a list of providers. NOTE: To access this benefit you must call TruHearing directly at 1-855-205-5137 to schedule an appointment.
To locate a provider, look in the section that contains the type of provider that you are seeking and then find your county, then city (or city nearest you). If you cannot find a provider using the directory, our Customer Service department will help you to locate one.
If you have questions about Group Medicare Advantage, please call our Customer Service department at 1-800-711-9865, 8 a.m. to 8 p.m. Central Time. TTY users should call 711. We are available seven days a week October 1 through March 31 and available Monday through Friday the rest of the year. You can also visit bluecrossmn.com.
*TruHearing® is a registered trademark of TruHearing, Inc., an independent company who works with health plans to offer low out-of-pocket costs on hearing aids. NOTICE OF NONDISCRIMINATION PRACTICES Effective July 18, 2016
Blue Cross and Blue Shield of Minnesota and Blue Plus (Blue Cross) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or gender. Blue Cross does not exclude people or treat them differently because of race, color, national origin, age, disability, or gender.
Blue Cross provides resources to access information in alternative formats and languages: Auxiliary aids and services, such as qualified interpreters and written information available in other formats, are available free of charge to people with disabilities to assist in communicating with us. Language services, such as qualified interpreters and information written in other languages, are available free of charge to people whose primary language is not English. If you need these services, contact us at 1-800-382-2000 or by using the telephone number on the back of your member identification card. TTY users call 711.
If you believe that Blue Cross has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or gender, you can file a grievance with the Nondiscrimination Civil Rights Coordinator by email at: [email protected] by mail at: Nondiscrimination Civil Rights Coordinator Blue Cross and Blue Shield of Minnesota and Blue Plus M495 PO Box 64560 Eagan, MN 55164-0560 or by phone at: 1-800-509-5312 Grievance forms are available by contacting us at the contacts listed above, by calling 1-800-382-2000 or by using the telephone number on the back of your member identification card. TTY users call 711. If you need help filing a grievance, assistance is available by contacting us at the numbers listed above.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf by phone at: 1-800-368-1019 or 1-800-537-7697 (TDD) or by mail at: U.S. Department of Health and Human Services 200 Independence Avenue SW Room 509F HHH Building Washington, DC 20201 Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
image_0006_NDL_Portrait (09/16)
Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
F10773R01 (1/17) This information is available in other languages. Free language assistance services are available by calling the toll free number below. For TTY, call 711.
Si habla español, tiene a su disposición servicios gratuitos de asistencia con el idioma. Llame al 1-855-903-2583. Para TTY, llame al 711.
Yog tias koj hais lus Hmoob, muaj kev pab txhais lus pub dawb rau koj. Hu rau 1-800-793-6931. Rau TTY, hu rau 711.
Haddii aad ku hadasho Soomaali, adigu waxaad heli kartaa caawimo luqad lacag la'aan ah. Wac 1-866-251-6736. Markay tahay dad maqalku ku adag yahay (TTY), wac 711. erh>uwdRunDusdm'D;<