Medicare Advantage Plans

BlueCross BlueShield of South Carolina will not offer Medicare BlueSM and Medicare Blue SaverSM plans in 2015. BlueCross will continue to offer MedBlueSM Rx or MedBlueSM Rx Plus prescription drug plans in 2015. 

General Information

2014 Medicare Advantage Office Manual
Medicare Advantage PPO Network Sharing               

Fraud and Compliance Awareness

2015 Provider Compliance Training

Pre-Service Organization Determination

Medicare Advantage organizations (MAOs) do not use the Medicare Advance Beneficiary Notice (ABN). BlueCross Medicare Advantage plans do not accept an ABN of non-coverage for statutorily non-covered services. Providers will initiate a pre-service organization determination for services they perform that are to be non-covered. We require this whether the service is statutorily non-covered by Medicare or the service is non-covered by the Medicare Advantage plan. To initiate the pre-service authorization request in writing, please visit the Forms section.

For additional information on how the pre-service organization determination process works select here.