Member Resources
For more information about who to call for your CareFirst BlueCross BlueShield DualPrime plan or claims information, please review the tabs below.
Who to Call
Medical and Hospital Services
- Part C 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 Health:
1-800-558-9922
8AM to 8 PM EST, Monday-Friday - All Plan Members: Please call CareFirst Medicare Advantage prior to all non-emergency inpatient admissions
Prescription Drug Services
- Part D Member Services:
1-844-786-6762; TTY: 711 - Member Services:
PO Box 915
Owings Mills, MD 21117 - Requests for Prior Authorizations and Exceptions:
1-855-344-0930; TTY: 711 - Pharmacy Help Desk (For Pharmacy Use Only):
1-866-693-4620
Where to Write:
Member Services
PO Box 915
Owings Mills, MD 21117
Where to Send Premium Billing Forms:
Electronic Fund Transfer (EFT) Forms:
Attention Premium Billing
CareFirst BlueCross BlueShield Medicare Advantage
PO Box 915
Owings Mills, MD 21117
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