Member Resources
For more information about who to call for your CareFirst BlueCross BlueShield Advantage DualPrime (HMO-SNP) plan or claims information, please review the tabs below.
Who to Call
Medical and Hospital Services
- Member Services and Prior Authorizations:
410-779-9932 or toll-free at 1-844-386-6762; TTY: 711
October 1 - March 31 | 8 am - 8 pm EST | 7 days a week
April 1 - September 30 | 8 am - 8 pm EST | Monday – Friday - Behavioral Health (Carelon Behavioral Health):
1-844-470-6334; TTY: 711
24 hours a day, 7 days a week - Vision:
410-779-9932
or toll-free at 1-844-475-6334; TTY: 711
8am-8pm EST, Monday through Friday - Dental (DentaQuest):
1-844-386-6762; TTY: 711
8am-8pm EST, Monday through Friday - Routine Transportation:
1-844-476-6334; TTY: 711
8am-8pm EST, 7 days a week, October 1 through March 31 and Monday through Friday, April 1 through September 30 - Over-The-Counter Rx and Products:
1-844-479-6334; TTY: 711 8am-9pm EST, Monday-Friday - Routine Hearing Exams and Hearing Aids:
1-877-246-1666; TTY: 711
8 AM to 8 PM, EST, Monday-Friday - Porter:
1-800-558-9922
8AM to 8 PM EST, Monday-Friday - All Plan Members: Please call CareFirst BlueCross BlueShield Medicare Advantage prior to all non-emergency inpatient admissions
Prescription Drug Services
- Pharmacy Member Services:
1-844-786-6762; TTY: 711 - Requests for Prior Authorizations and Exceptions:
1-855-344-0930; TTY: 711
Where to Write:
Member Services
PO Box 915
Owings Mills, MD 21117
Where to Send Premium Billing Forms:
Social Security Administration/Railroad Retirement Board Deduction Forms:
Attention: Enrollment Department
CareFirst BlueCross BlueShield Medicare Advantage
PO Box 915
Owings Mills, MD 21117
Where to Submit Claims:
Medical and Hospital Claims
Providers can obtain additional information about submitting claims through Availity by calling 800-282-4548 or visiting the website at https://www.availity.com/essentials/. Any paper claims should be submitted to:
CareFirst BlueCross BlueShield Medicare Advantage
PO Box 14361
Lexington, KY 40512
Members: Please submit your claims for reimbursement to:
CareFirst BlueCross BlueShield Medicare Advantage
Claims Reimbursement
PO Box 915
Owings Mills, MD 21117
Behavioral Health Claims
CareFirst BlueCross BlueShield Medicare Advantage
c/o Carelon Behavioral Health
P.O. Box 1850
Hicksville, NY 11802-1850
Part D Drug Claims
CareFirst BlueCross BlueShield Medicare Advantage
c/o CVS Caremark
P.O. Box 52066
Phoenix, AZ 85072-2066
Where to Submit Appeals and Grievances
Grievances:
Grievances for Medical Care:
CALL:
410-779-9932 or toll-free 1-844-386-6762 (TTY users: 711)
8 AM to 8 PM, 7 days a week from October 1 to March 31.
8 AM to 8 PM, Monday – Friday from April 1 to September 30
Voice mail is available after business hours to leave messages
FAX:
1-844-405-2158
WRITE:
CareFirst BlueCross BlueShield Medicare Advantage
Attention: Appeals & Grievances Department
P.O. Box 915
Owings Mills, MD 21117
Grievances for Part D Prescription Drugs:
CALL:
1-844-786-6762 (TTY users: 711)
FAX:
1-855-633-7673 (TTY users: 711)
WRITE:
Grievance Department
P.O. Box 30016
Pittsburgh, PA 15222-0330
Appeals:
Important Note: Requests for “Expedited” or “Fast” Appeals may be made verbally; however, all Standard Appeals must be made in writing.
Appeals for Medical Care:
CALL:
410-779-9932 or toll-free 1-844-386-6762 (TTY users: 711)
8 AM to 8 PM, 7 days a week from October 1 to March 31
8 AM to 8 PM, Monday – Friday from April 1 to September 30
Voice mail is available after business hours to leave message
FAX:
1-844-405-2158
WRITE:
CareFirst BlueCross BlueShield Medicare Advantage
Attention: Appeals & Grievances Department
P.O. Box 915
Owings Mills, MD 21117
Appeals for Part D Prescription Drugs:
CALL:
1-844-786-6762 (TTY users: 711)
FAX:
1-855-633-7673
WRITE:
CVS Caremark Coverage Determinations/Exceptions
P.O. Box 52000
Phoenix, AZ 85072-2000