Skip to Main Content
BCBSAL Mobile Logo - Go to home page
Search

Sales Enhanced Search Bar Portlet

Search

Quick Links

claims

Plan Finder

Documents

Home

Menu Display

  • Our Plans
    • back to Home
    • Medicare Plans
      • back to Medicare Plans
      • Compare Our Plans
      • Medicare Advantage Plan Blue Advantage
      • Medicare Part D Plan BlueRx
    • Medicare Supplement Plan
      • back to Medicare Supplement Plan
      • Medicare Select Plan CPlus
    • Other Health Plans
      • back to Other Health Plans
      • Vision Coverage
      • Travel Coverage
      • Dental Coverage
  • Understanding Medicare
    • back to Home
    • New to Medicare
    • Medicare Basics
    • When am I eligible?
    • Retiring Past 65
    • How Part D Works
    • FAQ
  • Tools & Information
    • back to Home
    • Documents
    • Policies
    • Notices
    • Articles
    • FAQ
  • For Members
    • back to Home
    • Member Resources
      • back to Member Resources
      • myBlueCross Login
      • Fitness Allowance
      • Rewards Program
      • Claims
      • Health & Wellness Benefits
    • Pharmacy Resources
      • back to Pharmacy Resources
      • Pharmacy Benefits with Blue Advantage®
      • Drug Lookup
      • Find a Pharmacy
      • Member Materials
      • Policies
      • Rx Savings Solutions
      • FAQ Videos
      • Blue Advantage Pharmacy Directory
      • BlueRx's Essential Pharmacy Directory
      • BlueRx's Enhanced Plus Pharmacy Directory
      • Medicare Prescription Payment Plan
  • Enroll Now
Contact Us

Menu Display

  • Alabama Blue
  • Individual
  • Employer
  • Provider
  • Medicare
Age: County: Change | Text Size: A A A

Medicare

myBlueCross Member Login Contact Us: 1-888-543-9212 (TTY:711)
myBlueCross Member Login Call 1-888-543-9212 TTY 711

Menu Display

  • Our Plans
    • Medicare Plans

      • Compare Our Plans
      • Medicare Advantage Plan Blue Advantage
      • Medicare Part D Plan BlueRx
    • Medicare Supplement Plan

      • Medicare Select Plan CPlus
    • Other Health Plans

      • Vision Coverage
      • Travel Coverage
      • Dental Coverage
    • women viewing ipad

      Need some help deciding which plan is right for you?

      Start here >
  • Understanding Medicare
    • New to Medicare
    • Medicare Basics
    • When am I eligible?
    • Retiring Past 65
    • How Part D Works
    • FAQ
    • Women giving granddaughter a piggy back ride

      Explore our enrollment timeline to plan for Medicare.

      Start Now >
  • Tools & Information
    • Documents
    • Policies
    • Notices
    • Articles
    • FAQ
    • Blue Cross and Blue Shield of Alabama enrollment kit

      Everything you need to enroll in a Blue Cross plan

      Get a Kit >
  • For Members
    • Member Resources

      • myBlueCross Login
      • Fitness Allowance
      • Rewards Program
      • Claims
      • Health & Wellness Benefits
    • Pharmacy Resources

      • Pharmacy Benefits with Blue Advantage®
      • Drug Lookup
      • Find a Pharmacy
      • Member Materials
      • Policies
      • Rx Savings Solutions
      • FAQ Videos
      • Blue Advantage Pharmacy Directory
      • BlueRx's Essential Pharmacy Directory
      • BlueRx's Enhanced Plus Pharmacy Directory
      • Medicare Prescription Payment Plan
    • doctor holding a pill bottle

      Search your prescriptions to see which plan meets your needs

      Start here >
  • Enroll Now
About Us
Contact Us

Sales Enhanced Search Bar Portlet

Search

Quick Links

claims

Plan Finder

Documents

C Plus Review and Appeal - Medicare

Breadcrumb

  1. Tools & Information
  2. C Plus Review and Appeal

CPlus Content Logo

CPlus, A Medicare Select Plan

CPlus - RAAP

Review and Appeal, Arbitration Procedures

 

If we accept your application for C Plus Select Plan B or Plan F, you will have the right to seek and obtain full and fair review by us of any determination we make under your C Plus contract. The following is a summary of the review and appeal procedures you must use to do this. More detailed information about these procedures is included in the C Plus contract.

 

Requesting a Review

If you believe that we incorrectly denied all or part of your benefits or made an incorrect decision relating to anything else under your C Plus contract, and you want us to review our determination, you should submit to us a written request for review at the address set forth in your C Plus contract. Your written request must state your full name and subscriber identification number. If your request relates to a claim, you must state the number of the claim that you want reviewed and include a copy of the C Plus Claim Report. Your envelope should be marked "C Plus Request for Review." We will send you a copy of our determination upon review with the reason for it.

 

Dispute Resolution Procedures:

If you have a complaint or dispute that has not been adequately addressed under the review procedures just described, you may submit an appeal to us at the address set forth in your C Plus contract. Your appeal must be submitted to us in writing within 30 days. Your envelope should be marked C Plus Dispute Resolution. Upon receipt of your appeal, we will examine the facts fully and fairly. You will receive a written decision from us within 30 days.

 

Arbitration

In consideration of coverage under the contract and payment of the premiums, you (and we) agree to binding arbitration. This means that any and all claims whether in contract, tort, or otherwise, whether arising before, on, or after the date of your contract, and including without limitation any statutory, common law, intentional tort, or equitable claims will be settled by arbitration - not a court. The arbitrator's decision is final and binding and cannot be reviewed by a court.

As outlined more fully in the contract, the arbitration will be conducted in accordance with the American Arbitration Association's dispute resolution procedures for insurance claims (a copy of which may be obtained by written request to us), except as modified in the contract. The claimant is responsible for starting the arbitration proceedings. We will bear all costs of arbitration other than your costs of representation. If you initiate arbitration, and if the arbitrator finds that the dispute is without substantial justification, the arbitrator has the authority to order that the cost of the arbitration proceedings be borne by you.

The arbitration will be conducted before a single arbitrator in the county in which you reside unless you and we agree to conduct the arbitration in some other county. Prior to the arbitration, if all parties consent to mediate the claim, the arbitrator will refer the claim to a separate mediator, but arbitration will follow if no settlement is reached. A claimant's claim(s) must be arbitrated separately from the claims of others, and may not be consolidated with the claims of others or arbitrated on a class-wide basis.

Medicare Site Stock ID

Blue Advantage is a PPO with a Medicare contract. Enrollment in Blue Advantage (PPO) depends on contract renewal. Blue Rx is PDP with a Medicare contract. Enrollment in BlueRx (PDP) depends on contract renewal. C Plus℠ is a Medicare Select Plan and is a private insurance plan regulated by the Alabama Department of Insurance. It is not connected with or endorsed by the U.S. government or the federal Medicare program.

Last Updated: 09/30/2024 20:57

Menu Display

Facebook Twitter Linkedin YouTube Pinterest Instagram

Menu Display

Company
  • Contact Us
  • Contact Medicare
Other Websites
  • Alabama Blue
  • Individual
  • GroupAccess
  • Providers
Support
  • Information in Other Languages
  • Accessibility Information
  • Plan Policies for Catastrophic Events
  • Learn About Different Parts of Medicare
Legal
  • Fraud & Abuse
  • HIPAA Privacy Notice
  • Privacy Statement
  • Legal Disclaimer
  • Notice of Nondiscrimination
Y0106_MKT5WEB

© 2025 BlueCross BlueShield of Alabama is an independent licensee of the BlueCross BlueShield Association.

Third Party Website Disclaimer

You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Prime is our business associate and is an independent company that provides pharmacy benefit management services to Blue Cross health plans. Prime has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information.

To continue to the Prime website, click "Accept." If you want to stay on the Blue Cross website, click "Cancel."

Third Party Website Disclaimer

This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by BCBSAL.

To continue, click "Accept". If you want to stay on the Blue Cross website, click "Cancel".

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to learn more about our Dental Plans. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue to our Commercial website, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel".

Third Party Website Disclaimer

This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by BCBSAL.

To continue, click "Accept". If you want to stay on the Blue Cross website, click "Cancel".

Third Party Website Disclaimer

You are about to leave Blue Cross and Blue Shield of Alabama Medicare website to visit the UTIC Insurance Company website. The site is operated by UTIC Insurance Company and all of UTIC Insurance Company's privacy and security policies regarding the confidentiality and protection of your personal health information apply.

To continue, click "Accept." If you want to stay on the Blue Cross and Blue Shield of Alabama Medicare website, click "Cancel."

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to visit one of our social media sites. Although content of our social media sites is maintained by Blue Cross, Blue Cross does not control the security and/or privacy practices of these external social media sites. Therefore, Blue Cross advises users of these sites against sharing any personal health information or any other information the user would otherwise not feel comfortable being made public. Blue Cross shall not be liable for privacy breaches, security incidents or similar events due to the use of social media sites.

To continue, click "Accept." If you want to stay on the Blue Cross and Blue Shield of Alabama Medicare website, click "Cancel."

Third Party Website Disclaimer

This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible of the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by BCBSAL.

To continue, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel."

Third Party Website Disclaimer

You are leaving the Blue Cross and Blue Shield of Alabama Medicare products website to log into myBlueCross, Blue Cross and Blue Shield of Alabama's member website. myBlueCross is operated by Blue Cross and all privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel."

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website and go to AlabamaBlue.com. AlabamaBlue.com is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel."

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to learn more about vision plans. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue to our Commercial website, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel".

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website and be taken to another website. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue, click "Accept." If you want to stay on the Blue Cross' website, click "Cancel".


© 2025, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.

C Plus Plan F Disclaimer

Per Federal Guidelines, you are eligible for Plan F only if you became eligible for Medicare prior to January 1, 2020.

By clicking "Accept", you are acknowledging that you are eligible for C Plus Plan F and would like to continue with the enrollment process. If you would like to go back to the C Plus Compare and Enroll page, click "Cancel".

Third Party Website Disclaimer

As a Patrius representative, I agree to the payment terms and conditions of Patrius Health and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance.

To continue , please click "Accept."

Get Your Personalized Information Now!

Am I Eligible?

You may be eligible if you are:

  • A resident of Alabama
  • Eligible for Medicare
County
*
Age