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PROVIDER/PHARMACY DIRECTORY

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H3351_4955_NM IPA-628Y17-09 /10799-16MedM

Medicare Blue Choice Optimum (HMO-POS) PlanMedicare Blue Choice Select (HMO-POS) Plan Medicare Blue Choice Value (HMO) PlanMedicare Blue Choice Value Plus (HMO) Plan Medicare Blue Choice Group (HMO-POS) PlanThis directory provides a list of Excellus BlueCross BlueShields network providers and pharmacies.

This directory is for Livingston, Monroe, Ontario, Seneca, Wayne and Yates counties.

This directory is current as of 7/28/2017. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Excellus BlueCross BlueShields network providers in your area, you can visit ExcellusMedicare.com/Providers or call our Customer Care Service Department at 1-877-883-9577, Monday Friday, 8:00 a.m. 8:00 p.m. If you are calling from October 1 February 14, representatives are available to assist you seven days a week from 8:00 a.m. 8:00 p.m. TTY/TDD users should call 1-800-421-1220.

This pharmacy directory was updated on 8/8/2017. For more recent information or other questions, please contact Excellus BlueCross BlueShield at 1-877-883-9577 or, for TTY users, 1-800-421-1220, Monday Friday, 8:00 a.m. 8:00 p.m. From October 1 to February 14, representatives are available to assist you seven days a week from 8:00 a.m. 8:00 p.m., or visit ExcellusMedicare.com/Pharmacy.

Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at ExcellusMedicare.com/Pharmacy. You may also call Customer Care for updated Provider information.

This document may be available in an alternative format. Please call our Customer Care Service Department at 1-877-883-9577, Monday Friday, 8:00 a.m. 8:00 p.m. If you are calling from October 1 February 14, representatives are available to assist you seven days a week from 8:00 a.m. 8:00 p.m. TTY/TDD users should call 1-800-421-1220.

2017PROVIDER/PHARMACY DIRECTORY

Table of Contents Section 1 - Introduction ........................................................................................................................... i

What is the service area for Excellus BlueCross BlueShield? ... ............................................................. iii

How do you find Excellus BlueCross BlueShield providers in your area? ............................................... iii

Section 2 - List of Network Providers ..................................................................................................... 1

Primary Care Physicians .................................................................................................................... 1

Specialists .......................................................................................................................................... 70

Hospitals .......................................................................................................................................... 355

Skilled Nursing Facilities (SNF) ........................................................................................................... 363

Outpatient Mental Health Providers ................................................................................................... 358

Pharmacies ...................................................................................................................................... 373

IPA-628Y17-09 (Rev. 9/2017)

Section 1 IntroductionThis directory booklet provides a list of Excellus BlueCross BlueShields network providers and pharmacies. To get detailed information about your health care coverage and/or a complete description of your prescription coverage, including how to fill your prescriptions, please see/review your Evidence of Coverage and Medicare Blue Choice Optimum (HMO-POS)s, Medicare Blue Choice Select (HMO-POS)s, Medicare Blue Choice Value (HMO)s, Medicare Blue Choice Value Plus (HMO)s or Medicare Blue Choice Group (HMO-POS)s formulary.

About Our Providers Network providers are the doctors and other healthcare professionals, medical groups, hospitals and other healthcare facilities that have an agreement with us to provide covered services to members in our plans. Use this directory to find network providers available in your area and surrounding areas. The network providers are listed alphabetically by specialty under the county in which they are located.

The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers.

You will have to choose one of our network providers who are listed in this Directory to be your Primary Care Physician (PCP). The term PCP will be used throughout this directory. Generally, you must get your health care services from your PCP. Look in the Primary Care Physician section of this directory to find the PCPs in your area. Women may also select a provider specializing in obstetrics/gynecology as well as a PCP.

Your PCP will coordinate the rest of the covered services you need as well. This includes X-rays, laboratory tests, therapies, specialists, hospital admissions and follow-up care. Your PCP also contacts other plan providers for updates about your care and/or treatment. In most cases, you must see your PCP to get a referral before you see a specialist or any other health care provider. A referral is not needed to see an OB/GYN doctor. You may change your PCP for any reason, at any time. To change your PCP, call Customer Care.

There are only a few types of covered services you can get on your own, without seeing your PCP first. When your PCP thinks you need specialized treatment, he or she will give you a referral (approval ahead of time) to see a plan specialist. A specialist is a doctor who provides health care services for a specific disease or part of the body. Some examples of specialists are cardiologists who treat heart conditions; gastroenterologists who treat digestive disorders and orthopedists who treat certain bone, joint or muscle conditions. Your PCP can request an open-ended referral, meaning the referral does not need to be renewed from year to year. Always ask your doctor to refer you to an in-network specialist to make sure the service will be covered under the plan. Before some types of services are provided, your physician may have to request approval in advance from Excellus BlueCross BlueShield. This is called prior authorization. For details on the covered services that need prior authorization, please see your Evidence of Coverage. If you receive services without a prior authorization, you may be responsible for the cost.

Some of our HMO plans include a Point-of Service (POS) benefit. If your plan has a Point of Service (POS) benefit, this benefit gives you the extra flexibility to receive some services from doctors, hospitals or other healthcare providers that are not in our provider network without having to pay the entire cost yourself. You will pay more when you use your POS benefit, except in limited cases such as out-of-network dialysis, emergency care or urgently needed care, or services when our network is not available. The POS benefit has a coverage limit per calendar year. Once your costs go above this limit, you will be responsible for 100% of the remaining costs for the out-of-network services. For more information, call Customer Care.

i

About Our Pharmacies We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under our plan only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your Evidence of Coverage.

All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This list is current as of 8/8/2017. For the most current list, please contact us. Our contact information appears on the front and back cover pages.

You can get prescription drugs shipped to your home through our network mail order delivery program. For more information, please contact us or see the mail order section of this pharmacy directory.

If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact us.

Out-of-Network Provider Claims In cases where non-contracting providers submit a bill directly to you, you should not pay the bill. Make a copy of the bill for your records and send the original to us for processing and determination of your responsibility for costs, if any.

Send the bill to:Excellus BlueCross BlueShieldAttn: Medicare DepartmentPO Box 22999Rochester, NY 14692

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