Using Your Medicare Plan | Blue Cross and Blue Shield of Illinois

Using Your Medicare Plan

Blue Cross and Blue Shield of Illinois wants you to get the most from your plan. Understanding how it works and having the right resources can help. In this section you can find out what's covered, how to file an appeal or grievance, download the formulary, search for a pharmacy, and more.

Is It Covered

It's easy to ask questions or voice concerns about your coverage. If you have questions about what your plan covers, you can:

  • Look at your Evidence of Coverage. This important notice is in the Welcome Kit you received in the mail shortly after you enrolled. It details what the plan covers, how much you pay, and more. You can also find it on the Plan Documents page.
  • Call customer service at the number on the back of your member ID card. The Customer Service representative can help you understand your benefits.

Medicare Coverage Determination, Appeals and Grievances

Medicare Coverage Determination, Appeals and Grievances

Blue Cross MedicareRx Plans have processes in place to address Medicare coverage issues, complaints and problems.  If you have issues, complaints or problems with your Medicare plan or the care you receive, you have the right to make a complaint.  You can find more information on the Drug Coverage, Appeals and Grievances page.

Drug Information

Drugs covered by Blue Cross MedicareRx are listed in formularies (or drug lists). Each plan has its own drug list. The drug lists include generic and brand name drugs. They also have information about drug copays and limitations such as prior authorization, quantity limits and step therapy.

Drug lists can change. Most of the changes in the Drug List are new for the beginning of each year. However, during the year, we might make other changes that are allowed by Medicare rules. We will provide you with advance notice of these changes.

Use the Drug Finder tool to find the most up-to-date list of medicines covered by each plan.

Download your formulary on our Forms & Documents page.

If you need help with additional plan documents, please contact us.

Prior Authorization/Utilization Management

Drug Plan Transition

Pharmacy Information

Medication Therapy Management

If you would like to submit feedback directly to Medicare, please use the Medicare Complaint Form or contact the Office of the Medicare Ombudsman.

Help Me Choose a Plan

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Now that you’ve picked a plan, it’s time to enroll.

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