​​​​New Medicare Advantage Plus PPO Plan - Effective April 1, 2022

December 30, 2021

This article was updated on December 30, 2021, to update the plan's effective date.

Effective April 1, 2022, Anthem City of New York Medicare retirees are moving to a new Medicare Advantage PPO plan called NYC Medicare Advantage Plus.

NYC Medicare Advantage Plus is a Medicare Advantage PPO group retiree plan offered through the Retiree Health Alliance, an alliance between Empire BlueCross® BlueShield® and Emblem Health.

We are informing you of upcoming changes for these members because you may have provided care to some of them in the past.

Key messages

You may receive calls from City of New York retirees inquiring if you are participating or if you accept NYC Medicare Advantage Plus. Some retirees may also refer to the new plan as Medicare Advantage Plus or The Alliance.

  • NYC Medicare Advantage Plus members have access to BCBS Medicare Advantage Network Sharing
  • MA PPO participating providers will be paid per their local Blue Plan contract
  • NYC Medicare Advantage Plus has out-of-network benefits and members can see any Medicare health care provider
  • Non-participating providers will be reimbursed per the Medicare fee schedule

Claims submissions

City of New York retirees currently have traditional Medicare whereby providers submit claims directly to CMS for processing.

Once effective, providers will submit all claims for NYC Medicare Advantage Plus members to your local Blue Plan for processing. Please include the new prefix, N6Y, when you submit claims for these members. You can submit claims electronically or by paper submission.

Questions

For additional information, review the NYC Medicare Advantage website​