Got questions? We have answers. Remember, you can also call a licensed benefits advisor to answer your questions. Note: he following answers apply to Health Partners Medicare 2020 plans. 2019 plan benefits may vary.
Health Partners Medicare currently offers Medicare Advantage plans that include prescription drug coverage, also known as Part D. We do not currently offer Medicare Supplement Insurance (Medigap). Our Simple (HMO-POS) plan provides limited coverage with no monthly premium while our Prime (HMO-POS) plan provides enhanced benefits with a $35.60 monthly premium. Medicare participants with full Medicaid coverage may select our Special (HMO SNP) plan.
Medicare has four parts: Parts A and B (also known as Original Medicare) and Part D, which provides prescription coverage. Medicare Advantage plans (sometimes referred to as Part C) are offered through private companies like Health Partners Medicare. They combine all the services of Parts A and B, and can include extra benefits not covered by Original Medicare. Some, including those offered by Health Partners Medicare, have prescription drug coverage (Part D).
See our benefits page to learn more about everything you can get with Health Partners Medicare. Benefits vary by plan.
All Prime and Simple plans have no deductible for medical services (Special members without Extra Help may be responsible for a deductible). Prime and Simple members will be responsible for a prescription deductible for some drug tiers.
All plans offered have an annual maximum out-of-pocket limit for medical services (see plans for more information). Out-of- pocket limits do not apply to prescriptions or out-of-network care.
Our 2020 plans all provide access to specialists with no referral.
Enrollment in a Medicare Advantage plan can take place only during election periods. All Medicare beneficiaries may enroll during the Annual Election Period (October 15-December 7). Those already enrolled in a Medicare Advantage plan may switch plans or switch back to Original Medicare during the Open Enrollment Period (January 1-March 31). Those new to Medicare may enroll during their Initial Coverage Election period. Some Medicare beneficiaries are eligible for a Special Election Period.
If you already have Medicare coverage benefits, you can enroll or change your plan during the Annual Election Period from October 15 through December 7. Any changes that you make will take effect on January 1.
From January 1 to March 31, a one-time change is permitted for Medicare Advantage plan enrollees. You may do the following:
If you are newly eligible for Medicare, you can enroll in a Medicare Advantage plan during an Initial Coverage Election Period. This period begins three months before the month you turn 65 and lasts through the three months after you turn 65.
You may have an opportunity to participate in a Special Election Period if you have Medicaid, are eligible for Extra Help or if certain events happen in your life. You also may be eligible if you permanently move outside of your current Medicare plan's service area or if you lose other insurance coverage.
Contact a licensed, professional benefits advisor at 1-866-599-5306 (TTY 1-877-454-8477). Calls are answered between 8 a.m. and 8 p.m., seven days a week, October 1 through March 31 (Monday through Friday rest of the year).
Health Partners Medicare is available in the following counties: Berks, Bucks, Carbon, Chester, Dauphin, Delaware, Lancaster, Lebanon, Lehigh, Northampton, Perry, and Philadelphia. Health Partners Medicare is an HMO plan with Medicare and Pennsylvania State Medicaid program contracts. Enrollment in Health Partners Medicare depends on contract renewal. Health Partners Medicare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
H9207_HPM-220S05-1148_M Last updated 10/1/2019