Get answers to your questions about True Blue Special Needs Plan (HMO SNP)
Ready to enroll in True Blue SNP?
Click the Enroll Now link below to go to the online enrollment, or call 888-495-2583 or TTY 800-377-1363. Our trained customer service representatives are available from 8 a.m. to 8 p.m., seven days a week, or fill out this contact request form to have Customer Service call you.
Search for medical and dental providers, pharmacies and other True Blue network providers.
Choosing a healthcare provider is one of the most important decisions in your life. We want to make it easy for you to decide on the True Blue Special Needs Plan.
Click the links below to get answers to your questions. If you need help, call us at 888-495-2583 or TTY 800-377-1363, between the hours of 8 a.m. to 8 p.m. seven days a week.
Questions and Answers
Blue Cross of Idaho is proud to offer the True Blue health Plan. True Blue provides coverage for Medicare A, B and D. Medicaid services such as long term services and supports (A and D waiver services) were added to the plan on July 1, 2014. We designed True Blue to address members' specific needs, and to provide members their own Care Manager to serve as a central point of contact.
True Blue is available in Ada, Bannock, Bingham, Boise, Bonner, Bonneville, Boundary, Canyon, Cassia, Clark, Elmore, Fremont, Gem, Jefferson, Kootenai, Madison, Minidoka, Nez Perce, Owyhee, Payette, Power, and Twin Falls counties. You must live in one of these areas to join the Plan.
True Blue covers all medically-necessary and preventive services covered under Medicare Part A and Part B and prescription drug coverage under Part D as well as additional services covered by Medicaid. True Blue also covers additional services over and above original Medicare/Medicaid, such as:
- Care Coordination
- Call-in 24 Hour Nurseline
- Fitness Benefit
Full Benefit Dual Eligible beneficiaries who are enrolled in Medicare Parts A, B, D and Idaho Medicaid services. Beneficiaries must also be at least 21 years of age and enrolled in the State of Idaho Medicaid program. The enrollee must also be eligible for Medicare Part A, enrolled in Medicare Part B, and reside in the service area (see Do I need to live in a certain part of the state? above).
Blue Cross of Idaho knows how important it is to see your doctor. That's why True Blue formed a State-wide network of doctors, dentists, specialists, and hospitals. For provider information, or to help locate your doctor or specialist, call Blue Cross of Idaho Customer service number at 1-888-495-2583. You can also use our website www.bcidaho.com/FindAProvider to locate your doctor.
Members can work with their Care Managers to find a provider within the True Blue network and develop a transition plan. Most providers are in Blue Cross of Idaho's True Blue Network. If you choose to go to a doctor outside of the network without a transition plan, you must pay for these services yourself.
There is no cost to join. Network provided services and coverage are also provided at no cost to you. Members must maintain their eligibility for Medicaid in the State of Idaho, be entitled to Medicare Part A, and enrolled in Medicare Part B.
(Note: The fitness benefit requires a yearly cost-share of $50)
A Care Manager serves as the member’s central point of contact. Care Managers ensure a member receives the right care and information, while working directly with the member's family and healthcare provider. Care Managers are an essential part of the member's Care Team, a small group made up of the member, a designated family member, and physician.
Care Managers work with you, your family and physician to ensure your healthcare needs are met in a timely, professional manner. Care Managers can also link you to community-based services, find specialists, and provide information on chronic health concerns, preventing illnesses and accidents, and trips to the doctor.
Being a member of the True Blue plan is entirely voluntary. You can ask to leave True Blue at any time for any reason. To request True Blue disenrollment, call customer service at 1-888-495-2583 or TTY 1-800-377-1363. We are available from 8 a.m. to 8 p.m., seven days a week. You can also contact Medicare, at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week, and ask to be disenrolled. TTY users should call 1-877-486-2048.
If you decide to change to a new plan, you can choose any of the following types of Medicare plans:
- Another Medicare Advantage health plan. (You can choose a plan that covers prescription drugs or one that does not cover prescription drugs.)
- Original Medicare with a separate Medicare prescription drug plan. If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you have opted out of automatic enrollment.
Until your membership ends, you are still a member of our plan
- You should continue to use our network pharmacies to get your prescriptions filled until your membership in our plan ends.
- If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged.
- If you disenroll from True Blue, your True Blue coverage ends on the last day of the month that you disenrolled. All Medicaid services will go back to Fee for Service. Any new Medicare plan you enroll in begins on the first day of the next month.
You will have to leave True Blue if:
- You do not stay continuously enrolled in Medicare Part A and Part B.
- You are no longer eligible for Medicaid.
- You move out of our service area.
- You go to prison.
- You lie about or withhold information about other insurance you have that provides prescription drug coverage.
- You gave True Blue false information when you signed up, we may ask Medicare for permission to have you leave the plan.
- You let someone else use your membership card to get medical care, we may ask Medicare for permission to have you leave the plan. If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.
- You are supposed to pay the extra Part D prescription drug amount because of your income and you do not pay it, Medicare will disenroll you from our plan.
True Blue provides interpreter services for those enrollees who do not speak English.
True Blue covers a full range of Part D Prescription medications as well as the full array of medications covered by Medicaid including over the counter drugs. Complete coverage information can be found by calling the Blue Cross of Idaho Customer service number or on the Blue Cross of Idaho website.
More True Blue information can be obtained from the Blue Cross of Idaho website bcidaho.com/medicare. Interested parties may also call and speak to a Blue Cross Customer Representative a 1-888-495-2583.
2017 & 2018 Tools, Resources & Other Information
- True Blue RX & SNP Formulary (Printable Drug List)
- Find a Pharmacy
- True Blue Rx & SNP Formulary Step Therapy Drugs
- True Blue Rx & SNP Formulary Prior Authorization Drugs
- How to use a Drug List (formulary)
- Notice of Drug List (formulary) Changes
- Prescription Drug Utilization
- Coverage Limits and Additional Requirements
- Medication Therapy Management Program (MTMP)
- What is Part D transition and how does it affect you?
- Member Submitted Part D Claim Form
- How to request an exception if your drug is not on our list
- How to request a Part D Drug Appeal
- Rights and Responsibilities
- How to ask for an organizational determination (coverage decision)
- Grievances or Complaints
- Civil Rights Complaint Form
- How to make a Medicare appeal based on a coverage decision
- How to appeal the state (Medicaid) based on a medical decision
- How to Name a Representative to Help with an Appeal
- Naming a Representative Form
- Customer Service
- When can you join a Medicare Advantage health plan
- Ending Your Membership
Centers for Medicare and Medicaid Services (CMS) occasionally makes a change or revision in Medicare coverage. We are required to notify you in our member newsletter when a National Coverage Determination (NCD) occurs.
You can review decisions using Medicare's Coverage Database. Visit www.cms.gov/medicare-coverage-database to get started.
Medicare beneficiaries may enroll in Blue Cross of Idaho Medicare Advantage plans through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
Last updated 10-01-2017