Medicare Advantage: What You Need to Know

If you participate in our BlueDental Choice Copayment (PPO) Network, you are considered an in-network provider for Florida Blue’s Medicare Advantage members. These members have a Medicare HMO or PPO medical plan, with an embedded dental PPO. Reimbursement is paid according to the BlueDental Choice Copayment PPO schedule of allowances, located on our website on the Fee Schedules page.

Members will present to your office with a Florida Blue BlueMedicare HMO or PPO Medicare Advantage ID card. You can verify benefits using the online tool, My Patients Benefits, or by calling Customer Service at 866-445-5148. To view samples of benefit plans and member ID cards, visit the Plans, Manuals & CDT Guides page of our website.

If a service is not covered by a member’s Medicare Advantage benefit plan, you are required by law to inform members in writing and in advance of treatment, outlining their financial responsibility.

If you opted-out of participation with Medicare, you are prohibited from providing services to Medicare members. If you provide services, you will not be reimbursed by Florida Combined Life (FCL). You are also required by law to inform members in writing and in advance of treatment that you do not participate and that they will be responsible for all charges.