Blue Cross Medicare Advantage Provider Portal

The Blue Cross Medicare Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.

Your digital resource for all news and announcements related to policy updates, digital tools, reimbursement and prior authorization changes, educational opportunities, and more.

At Availity, you can:

Request authorizations

Submit claims

Access reports

The Blue Medicare Advantage (BMA) local PPO plan is a managed care plan in which members pay less out-of-pocket costs when they use providers who are part of the Blue Medicare Advantage PPO network. Local PPOs are available in select counties within a state. CMS allows the Medicare Advantage plan to select the counties they want to participate in.

BMA has a contract with the federal government that allows BMA to administer all Medicare benefits. Medicare Advantage PPO members are strongly encouraged, but not required, to select a PCP. MA PPO members are also not required to obtain a referralfor specialty care but should coordinate with their PCP. Blue Medicare Advantage PPO members can use providers both in and out of the network. Prior Authorization is required for some services.

To Redeem in Store.

1. Let the cashier know you’re using your OTC benefit. Then show your Member ID card before the cashier begins to scan products. Your Member ID is used to verify eligibility, not as a form of payment.

2. Give this QR Code to the cashier to finish the transaction

Is the cashier having trouble? Give them these instructions:

1. Scan QR Code.

2. You will be automatically redirected to the OTCHS App on the POS terminal.

3. Ask the member for their plan ID Card.

4. Select the member’s plan.

5. Enter the Member ID or the member’s first and last name.

6. Scan eligible products and follow instructions on the POS system to complete the transaction.

7. If you’re having trouble locating the member or processing the transaction, please call the dedicated OTCHS Store Support line for assistance.

Pennsylvania logo

How to identify eligible items in store

Online

Order online 24/7 at bcbstmedicare.com/OTC. Online orders must be submitted by 11:59 PM ET to be processed the same day.

1. You’ll need to create an account if it’s your first time placing an order online

– Then, choose the “Create Account” button and follow the instructions.

– You will need your Member ID, date of birth, ZIP code and current email address. Each member registering needs to have a separate email address. If a member shares an email address with a spouse or caregiver who also has an OTC account, they will only be able to register one account.

– You will also need to create a password.

• If you need help locating your Member ID, select “Get help locating your Member ID.”

• Remember to save your password for future orders. You will need your Member ID or email address along with your password to sign in again.

• If you forget your password, choose the “Forgot Password?” button to create a new one.

Phone

1. Orders can be placed by calling 1-888-628-2770, TTY 711. You can speak to a live agent Monday to Friday, from 9 AM to 8 PM ET. Please have your ID and order ready when placing your order by phone. You can always use the automated Interactive Voice Response (IVR) system24/7 to:

• Place an order

• Track an order

• Cancel an order

• Hear benefit information

• Order a catalog

2. When your account is located, you will be asked to input your date of birth in MMDD format.

3. The account authentication process will start and the system will verify the name and address on the account.

4. Please enter the numerical portion of the item code.

• Example: If you would like to order item “B33 unscented wipes,” you will select “33” and wait for the prompt to confirm the item. Once the system locates the item, it will read back the product name and quantity and ask if the selection is correct. Please allow the system to complete the statement before making your selection.

• If yes, the system will add the item to your cart.

• If no, the system will provide an option to edit the product or the quantity.

5. Once the order is completed, you will have the choice to review the items in the cart or submit the order

.• If you submit the order without review, the system will provide a confirmation number and the call will be disconnected.

• If you want to review your order, the system will allow you to edit the items, start over, submit the order or speak with a representative. Note: Should you choose to speak to a representative, your items will not be saved and you will have to restart your order

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