Member Annual Notice of Changes

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-1 (previously enrolled in H5576-020-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-1 (previously enrolled in H6453-005)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-1 (previously enrolled in H6453-006)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-2 (previously enrolled in H5576-020-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-2 (previously enrolled in H5576-020-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-2 (previously enrolled in H6453-005)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-2 (previously enrolled in H6453-006)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-3 (previously enrolled in H5576-020-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-3 (previously enrolled in H5576-020-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-3 (previously enrolled in H6453-010-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-3 (previously enrolled in H6453-010-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-4 (previously enrolled in H5576-020-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-4 (previously enrolled in H5576-020-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-4 (previously enrolled in H6453-007-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-4 (previously enrolled in H6453-007-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-4 (previously enrolled in H6453-008-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-4 (previously enrolled in H6453-008-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-5 (previously enrolled in H5576-020-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-5 (previously enrolled in H5576-020-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-5 (previously enrolled in H6453-009-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Classic (HMO-POS) H6453-013-5 (previously enrolled in H6453-009-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Reliance (HMO-POS) H6453-017-1 (previously enrolled in H5576-017-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Reliance (HMO-POS) H6453-017-2 (previously enrolled in H5576-017-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Reliance (HMO-POS) H6453-017-2 (previously enrolled in H5576-017-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Platinum (HMO-POS) H6453-018-1 (previously enrolled in H5576-018-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Platinum (HMO-POS) H6453-018-1 (previously enrolled in H5576-022)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Platinum (HMO-POS) H6453-018-2 (previously enrolled in H5576-018-001)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Platinum (HMO-POS) H6453-018-2 (previously enrolled in H5576-018-002)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Platinum (HMO-POS) H6453-018-2 (previously enrolled in H5576-022)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Dual Plus (HMO-POS D-SNP) H6453-019 (previously enrolled in H5576-019)

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Premier (PPO) H1248-004

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Liberty (PPO) H1248-007

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Giveback (HMO-POS) H6453-011

  Last Updated 11/03/2023

• 2024 Annual Notice of Changes - Blue adVantage Giveback (HMO-POS) H6453-011 (previously enrolled in H5576-023)

  Last Updated 10/01/2023

Member Evidence of Coverage

• 2024 Evidence of Coverage - Blue adVantage Classic (HMO-POS) H6453-013-1

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Classic (HMO-POS) H6453-013-2

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Classic (HMO-POS) H6453-013-3

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Classic (HMO-POS) H6453-013-4

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Classic (HMO-POS) H6453-013-5

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Reliance (HMO-POS) H6453-017-1

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Reliance (HMO-POS) H6453-017-2

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Platinum (HMO-POS) H6453-018-1

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Platinum (HMO-POS) H6453-018-2

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Premier (PPO) H1248-004

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Liberty (PPO) H1248-007

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Giveback (HMO-POS) H6453-011

  Last Updated 10/12/2023

• 2024 Evidence of Coverage - Blue adVantage Dual Plus (HMO-POS D-SNP) H6453-019

  Last Updated 11/03/2023

Member Summary of Benefits

• 2024 Summary of Benefits - Blue adVantage Classic (HMO-POS) H6453-013-1

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Classic (HMO-POS) H6453-013-2

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Classic (HMO-POS) H6453-013-3

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Classic (HMO-POS) H6453-013-4

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Classic (HMO-POS) H6453-013-5

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Reliance (HMO-POS) H6453-017-1

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Reliance (HMO-POS) H6453-017-2

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Platinum (HMO-POS) H6453-018-1

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Platinum (HMO-POS) H6453-018-2

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Premier (PPO) H1248-004

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Liberty (PPO) H1248-007

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Giveback (HMO-POS) H6453-011

  Last Updated 10/01/2023

• 2024 Summary of Benefits - Blue adVantage Dual Plus (HMO-POS D-SNP) H6453-019

  Last Updated 10/01/2023

Member Provider Directory

• 2024 Provider and Pharmacy Directory 

  Last Updated 12/01/2024

Member Formulary

• 2024 Formulary

  Last Updated 12/01/2024

• 2024 Formulary - DSNP

  Last Updated 12/01/2024