H3170_W_Jan18WeBCBSN CMS Approved 02082018
© 1998-2018 Blue Cross and Blue Shield of Nebraska.
Blue Cross and Blue Shield of Nebraska is an HMO and HMO-POS plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of Nebraska Medicare Advantage depends on contract renewal.
You must continue to pay your Medicare Part B premium. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or co-payments may change on January 1 of each year. The formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary. All Blue Cross Blue Shield of Nebraska Medicare Advantage individual plans include Part D drug coverage.
Blue Cross and Blue Shield of Nebraska is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield Association licenses Blue Cross and Blue Shield of Nebraska to offer certain products and services under the Blue Cross® and Blue Shield® brand names within the state.