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HealthPlus MedicarePlus Advantage HMO

HealthPlus offers a MedicarePlus Advantage HMO/POS product, that will support a suscriber’s healthcare needs, regardless of where they live, work or travel.

Benefit packages cover:

  • Medicare Part A (hospital)
  • Medicare Part B (medical/outpatient hospital and additional preventive care)
  • Medicare Part D (outpatient prescription drugs)
  • Access to a limited out of network benefit (Point of Service plans, only)

*Enhanced HMO plans provide additional supplemental benefits, such as limited hearing aids and preventative dental.

The MedicarePlus Advantage HMO Benefit Level Summary outlines benefits and member co-pay amounts.

All MedicarePlus Advantage HMO/POS members are issued a HealthPlus MedicarePlus AdvantageHMO/POS Member Identification Card .

MedicarePlus Advantage (also referred to as Part C) HMO/POS offers members:

  • A primary care physician (PCP) who will coordinate all health care needs
  • Coverage for preventive and routine medical
  • Speciality care (referrals may be required) 
  • Lab services ( JVHL  or Quest Diagnostics  laboratories).
  • Dental (not covered by all plans)
  • Vision (not covered by all plans)
  • Hearing  coverage (available for Option 1 and Option 2 plans, only) 

Ask for 90 Rx allows a 90 day supply, to save time and money on maintenance prescription drugs.

Referrals  

If specialty care is needed, the PCP will refer the member to the appropriate in-plan physician or appropriate medical professional. Referrals  are not necessary for routine gynecological and obstetric care.

Copays and Coinsurance  

Copays and coinsurance may apply and are dependent upon the benefit plan selected by the member. A copay is a fixed dollar amount that a member must pay for certain covered services at the time of visit. Coinsurance is a percentage of the cost of covered services that a member will pay after a deductible, if any, has been met.

For questions related to a MedicarePlus Advantage HMO/POS member, please contact HealthPlus Customer Service at (800) 332-9161 and ask to speak with MedicarePlus Advantage Services.