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For more information about our plans or to determine if you’re eligible
Visit bluecrossma.com/medicare or call 1-800-678-2265 (TTY: 711). February 15 through
September 30, 8:00 a.m. to 8:00 p.m. ET, Monday through Friday. October 1 through February 14,
8:00 a.m. to 8:00 p.m. ET, seven days a week.

We are pleased to offer you highly rated and affordable options to help ensure your health
and well-being. We look forward to hearing from you.
Sincerely,

Larry Croes
Vice President of Sales

Enclosures

Blue Cross Blue Shield of Massachusetts is a HMO and PPO Plan with a Medicare contract.
Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information.
Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/
co-insurance may change on January 1 of each year. You must continue to pay your Medicare
Part B premium. The formulary, pharmacy network, and/or provider network may change
at any time. You will receive notice when necessary.

Blue Cross Blue Shield of Massachusetts complies with applicable Federal civil rights laws
and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual
orientation or gender identity.

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.
Llame al 1-800-200-4255 (TTY: 711).

ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis.
Ligue para 1-800-200-4255 (TTY: 711).

1. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year
and may change from one year to the next. Star Ratings can be found at medicare.gov.

® Registered Marks of the Blue Cross and Blue Shield Association.
© 2016 Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.

163128 55-0619-17V2 (10/16) Y0014_16193 Accepted 10232016