You may have a concern you’d like to tell us about or disagree with a decision we’ve made about your coverage.
Waxaad samayn kartaa cabasho ama aad xaraysan kartaa rafcaan si aad caawimo ugu hesho xaaladdaada. Waa muhiim inaad raacdo habka saxda ah ee dhibaatada ku haysata. Dukumeentiyada qorshahaaga ayaa si faahfaahsan u sharaxaya habsocod kasta.
Haddii aad u baahan tahay in lagaa caawiyo si aad cabasho u samayso, codso dib u eegis ama xerayso rafcaan, wac lambarka ku yaal dhabarka dambe ee kaarka aqoonsiga xubinimadaada.
Halkee laga heli karaa macluumaadka kujira agabyada xubintaada
Heshiiskaaga xubin, Caddaynta Caymiska, Soo koobida Caymiska iyo Shaac ka qaadista ama Buug-gacmeedka Xubinta wuxuu sharraxaya faafaahinta sida loo sameeyo cabasho ama loo soo gudbiyo racfaan. You can log in or create your Member Account to get access to materials specific to your plan.
Faahfaahinada
Waxa aad samayn lahayd haddii ay dhibaato ama walaac ku qabsato
Waxaa jira laba nooc oo habraac ah oo lagu xallinayo dhibaatooyinka iyo walaacaaha. Qandaranska xubintada,Caddaynta caymiska, Buug-gacmeedka Xubinta ama Caymiska Kooban iyo shaac ka qaadista waxaa ku macluumaad faafaahsan ee ku saabsan hanan walba. The process you use depends on the kind of problem you are having.
Appeals process
Isticmaal habkan haddii dhibaatadu ku saabsan tahay caymis ama lacag bixinta adeegyada caafimaadka ama daawooyinka dhakhtar qoray.
If we have told you we will not cover or pay for a medical service in the way you want: We will review the decision and let you know if we will change it or not. Refer to your plan documents for more information or contact the phone number on the back of your ID card.
If we say no to all or part of your appeal, you can choose to take your appeal further: There are up to five levels of appeal. Ka eeg dukumeentiyada qorshahaaga wixi macluumaad dheeraad ah.
Habka Cabashada
Isticmaal habkan haddii dhibaatadu aysan la xiriirin faa'iidooyinka ama caymiska.
Waxaad samayn kartaa cabasho ku saabsan tayada daryeelka aad hesho, wakhtiyada sugitaanka, adeegga macaamiisha iyo walaacyada kale. Samaynta cabashada waxa kale oo loo yaqaan "xeraynta cabashada."
Wac lambarka adeegga macaamiisha ee ku yaal dhabarka dambe ee kaarkaaga aqoonsiga. We will inform you if you need to take additional steps.
Haddi aad door bidayso, waxaad ku sharaxi kartaa dhibka asgoo qoraal ah oo aad waxad na waydiin kartaa inaan xalino. Ka eeg dukumeentiyada qorshahaaga wixi macluumaad dheeraad ah.
Macluumaadka xiriirka
Halkee nagala soo xiriiri kartaa cabashooyinka iyo rafcaannada caafimaadka?
For Medicare Advantage, Platinum BlueSM and Medicare Supplement plan members
Ciwaanka boostada:
Blue Cross iyo Blue Shield ee Minnesota
P.O. Box 982800
El Paso, TX 79998-2800
Lambarada adeegga macmiilka:
Qorshayaasha Advantage (PPO) ee Medicare: 1-800-711-9865, TTY 711
Qorshayaasha (Kharash) ee Platinum Blue: 1-866-340-8654, TTY 711
Qorshayaasha Dheeraadka ah ee Medicare: 1-800-531-6686, TTY 711
Nambarada faakiska:
Qorshayaasha Advantage ee Medicare:6516629517
Qorshayaasha Platinum Blue }6516629517
Qorshayaasha kaabida Medicare: (651) 662-9517
Wixii ah xubnaha Blue Plus / SecureBlueSM
Ciwaanka boostada:
Blue Plus / SecureBlue
Xarunta Helida Blue Pus
P.O. Box 982816
El Paso, TX 79998-2816
Lambarka adeegga macmiilka: 1-888-740-6013 (TTY 711)
Lambarka faksiga: (651) 662-6287
Halkee nagala soo xiriiri kartaa cabashooyinka daawada dhakhtar qoray & racfaan
Ciwaanka boostada:
Diginiin: Waaxda Murugada Medicare
P.O. Box 64813
St. Paul, MN 55164-0813
Wixii ah MedicareBlueSM qorshayaasha Rx :
MedicareBlue Rx
Xarunta Helida Cabashada iyo Murugada
P.O. Box 22348
Tampa, FL 33631
Lambarada adeegga macmiilka:
Platinum Blue oo leh qorshayaasha Rx: 1-800-489-7336, TTY 711
Qorshayaasha Faa'iidooyinka warqada dawada ee dhakhtar qoray (MAPD) ee Medicare Advantage: 1-800-490-1251, TTY 711
MedicareBlueSM Rx qorshayaasha: 1-888-832-0075, TTY 711
Nambarada faakiska:
warqada dawada dhakhtar qoray ee Medicare Advantage (MAPD) iyo Platinum Blue ee leh qorshayaasha Rx: 1-888-285-2242
MedicareBlueSM qorshayaasha Rx: 1-855-874-4705
Haddii aad rabto macluumaad ku saabsan sida loo helo lambarada wadarta ee murugada, racfaanad, iyo ka reebanaanta lagu buuxiyey qorshaha, waxaad wici kartaa adeegga macmiilka. Waxa kale oo aad wax ka weydiin kartaa qiimaynta waxqabadka qorshaha oo ay ku jirto sida ay u qiimeeyeen xubnaha qorshaha iyo sida uu ula barbar dhigay qorshayaasha kale ee caafimaadka ee Medicare.
To request this information, please call the customer service phone number on the back of your member ID card, 8 a.m. to 8 p.m., daily.
Blue Cross waxay bixisaa qorshayaasha PPO, Qiimaha iyo PDP ee qandaraasyada Medicare. Ku-biiritaanka qorsha-yaashaan waxay ku xiran tahay cusboonaysiinta qandaraaska. SecureBlueSM waa qorshe HMO SNP ah oo leh heshiis Medicare ah iyo qandaraas lala galayo barnaamijka Medical Assistance ee Minnesota. Iska diiwaangelinta SecureBlueSM waxay ku xiran tahay cusboonaysiinta qandaraaska.
S5743_090926_P01_M
Y0138_090926_P01_M