July 16, 2024
Blue Cross Medicare AdvantageSM plan and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM providers who choose to opt out of Medicare should immediately notify their Provider Network Consultant at Blue Cross and Blue Shield of Illinois. In compliance with Centers for Medicare & Medicaid Services policy, we’re required to terminate providers from our Medicare Advantage and MMAI networks if they’ve opted out of Medicare.
What It Means To Opt Out
Opting out means that a provider has decided for a two-year period that they won’t participate in Original Medicare or Medicare Advantage Prescription Drug plans. If you opt out, you may not accept federal reimbursement or bill Medicare or Medicare Advantage plans for your services. Your decision to opt out is public on the CMS Opt-Out Dataset.
BCBSIL doesn’t contract with providers who have opted out of Medicare for our Medicare Advantage or MMAI networks. In compliance with CMS policy, we may not pay providers who have opted out of Medicare for Medicare-covered services, except for emergency or urgent care services for our Medicare Advantage and MMAI members who haven’t signed a private contract with you.
See the CMS website for more information.