Health Insurance Is What We Do
At Network Health, we do whats right, even when it isnt easy. Were honest and hardworking, just like you, Wisconsin. Plus, were co-owned by two of Wisconsins high-quality health systems, Froedtert Health and Ascension Wisconsin. All this means we take extra steps to make health insurance affordable and understandable, so you can make the most of your coverage.
We do whats right because its who we are. Health insurance is what we do.
Protecting Your Vision For The Future
An annual eye exam helps to ensure your health and well-being by spotting early warning signs for a variety of health conditions like diabetes and blood pressure. Most Network Health Medicare Advantage Plans cover an annual routine eye exam, at a local EyeMed provider.
Refer to your plan specific Evidence of Coverage for more details. You can contact EyeMed at 833-279-4359 , MondaySaturday from 6:30 a.m. to 10 p.m. and Sunday from 10 a.m. to 7 p.m.
Visit EyeMed’s website to Find a Vision Provider.
Network PlatinumSelect, Network PlatinumChoice, Network PlatinumPlus, Network PlatinumPlus Pharmacy, Network PlatinumPremier, Network PlatinumPremier Pharmacy, Network Health Medicare Go, Network Health Medicare Anywhere
Routine Eye Exam
Network Health Medicare Explore
Routine Eye Exam
NetworkPrime
Vision services are billed at the Medicare-approved amount until you meet your $5,100 deductible. Once you’ve met your deductible, you pay nothing for Medicare-covered services.
The Most Commonly Offered Benefit In 2022 Is Telehealth Services
Medicare Advantage supplemental benefits fall into one of two categories: enhanced coverage of a Medicare-covered service, such as a lower deductible or copay, or a non-Medicare covered benefit, such as dental or vision coverage. In 2022, the most widely offered extra benefits in Medicare Advantage Plans according to KFF analysis are:
- Telehealth, offered by 95% of plans
- Fitness, offered by 97% of plans
- Dental, offered by 94% of plans
- Eye exams and glasses, offered by 98% of plans
- Hearing aids, offered by 95% of plans
Other common benefits in 2022 include over-the-counter items in 81% of plans, meal benefits in 67% of plans and transportation benefits in 38% of plans. Only 8% of plans offer bathroom safety and 10 % in-home support benefits, according to KFF analysis.
Another exciting addition to Medicare Advantage plans in 2022 is the ability of individuals with End-Stage Renal Disease to enroll in Medicare Advantage Plans as of January 1, 2021, says Cynthia Pruemm, investment advisor and founder and CEO of SIS Financial Group in Hoffman Estates, Illinois.
The expanded telehealth benefits can allow seniors who cant get to a doctors office to meet via video conference, which can be safer and more convenient, Pruemm says.
Plan providers may also restrict who has access to these extra benefits, such as by restricting benefits for beneficiaries with certain conditions. So the same provider may offer different benefits to different enrollees.
Also Check: What Is Social Security Retirement Benefits
Fitness For A Healthy Life
A SilverSneakers nationwide gym membership is included with most Network Health Medicare Advantage Plans. Refer to your plan specific Evidence of Coverage for more details.
Dont worry if youre new to fitnessnearly half of SilverSneakers members have never been to a gym before joining SilverSneakers. No matter what your fitness level and ability, you will find the support you need.
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Ready to socialize? Join a group class like yoga or SilverSneakers Classic.
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Rather exercise on your own? Youll have full access to all facility fitness equipment.
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Prefer to get wet? Hit the facility fitness pool.
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Looking for something different? Discover FLEX® classes, taking workouts beyond the gym.
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Enjoy the pool at one location and the stability class at another? Your membership grants you access to multiple facilities, so you can participate in both classes.
Network Healths Silver Sneakers membership provides unlimited access to over 16,000 nationwide locations, so if youre traveling its easy to find a convenient location near you. Visit SilverSneakers.com today for more information.
In addition to your SilverSneakers fitness benefit, Network Health is partnering with the Greater Green Bay YMCA and the Kettle Moraine YMCA to give you access to their facilities. Simply show your Network Health member ID card and discover what the facilities have to offer.
Network PlatinumSelect, NetworkPrime
Medicare Advantage Plans Cover All Medicare Services
Medicare Advantage Plans provide all of your Part A and Part B benefits, excluding clinical trials, hospice services, and, for a temporary time, some new benefits that come from legislation or national coverage determinations. Plans must cover all emergency and urgent care and almost all medically necessary services Original Medicare covers. If youre in a Medicare Advantage Plan, Original Medicare will still help cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies.
The plan can choose not to cover the costs of services that aren’t
under Medicare. If you’re not sure whether a service is covered, check with your provider before you get the service.
With a Medicare Advantage Plan, you may have coverage for things Original Medicare doesn’t cover, like fitness programs and some vision, hearing, and dental services . Plans can also cover even more benefits. For example, some plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs that Part D doesnt cover, and services that promote your health and wellness. Check with the plan before you enroll to see what benefits it offers, if you might qualify, and if there are any limitations.
Most plans include
. In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.
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Get The Latest Medicare Advantage Plan Benefits At Medicaregov Or Through A Local Insurance Agent
Nearly all Medicare beneficiaries have access to at least one Medicare Advantage Plan with extra benefits not available through Original Medicare, KFF reports. Around 99% of beneficiaries can also access telehealth and over-the-counter items, 98% can get a meal benefit and 95% of beneficiaries can get transportation assistance.
To learn about the latest benefits being offered by Medicare Advantage plans, you can go to Medicare.gov. On Medicares website, you can enter in your zip code, county, doctors names and medication and youll be matched up with the best plan options in your area, Pruemm says. Each Medicare Advantage plan has a summary of benefits that will explain what you will pay for each procedure and what your copays will be when picking up your medication.
For individuals that would like more personalized information from a licensed and certified professional, there are agencies in your area that specialize in these types of plans, she says.
If you choose to work with a professional, Jensen says its important to use a local agent because plans are county-specific. A national representative may not be as familiar with all the plans offered in your area.
If you do work with an independent broker, be sure to do your due diligence. Look for an active broker who works with all of the plans so they wont have an incentive to put you into one plan over another.
What should I consider when looking for a Medicare Advantage Plan?
How Do Medicare Advantage Plans Work
Medicare pays private insurance companies to administer the benefits of Medicare Advantage plans they sell. These plans then function the same way Original Medicare does, with the addition of benefits the private insurance provider elects to include in a given plan.
Depending on the provider and plan you choose, Medicare Advantage coverage works similarly to employer-sponsored health insurance with which you may be familiar. For a monthly premium in addition to the Medicare Part B premium, an MA plan provides set copays, coinsurance rates and deductibles for various components of care, as well as additional coverage benefits and perks.
Read Also: Spouse’s Social Security Benefits
Florida Blue Medicare Hmo Plans
Looking for a Medicare plan that saves you money? If you prefer having one doctor to coordinate your care with specialists and other healthcare providers, one of our Medicare Advantage HMO plans could be a great choice for you.
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You choose a trusted primary care physician to coordinate your medical needs.
- With most plans, you must use in-network doctors, specialists or hospitals, with a few exceptions, like medical emergencies.
- You can benefit from our rewards programs.
Our HMO D-SNP plan provides Dual Eligible Special Needs coverage to people who have both Medicare and Medicaid.
Cigna Dental Care Plan
Your plan may include a range of preventive dental services, such as oral exams and cleanings. Some plans may include comprehensive dental coverage, such as fillings, extractions, root canals, dentures, and other services.
How do I find an in-network Cigna Dental dentist?
- Or, call Cigna Dental Customer Service at
8 am – 8 pm, 7 days a week
8 am – 8 pm, Monday Friday
A messaging service is used on weekends, after hours, and on federal holidays.
A Cigna Dental Information Guide is included in your Welcome Kit or end-of-the-year renewal mailing. Review this information to know what services are covered under your plan. After youve selected a Cigna Dental network dentist, call them directly to schedule an appointment.
Read Also: At What Age Can I Retire With Full Benefits
Benefits Of Medicare Advantage Plans
Medicare Advantage Plans:
- Facilitate a more coordinated approach to your care
- May provide affordable costs for doctor visits
- May include affordable prescription drug coverage
- Are required to limit your annual out-of-pocket costs, unlike Original Medicare
- Offer preventive services, including annual physicals, and may offer more comprehensive coverage including, X-ray and lab services, routine dental and vision care
- May result in better health outcomes for patients
- Offer the same peace of mind when traveling as Original Medicarewith urgent and emergency coverage access nationwide
This is not a complete description of benefits.
Medicare Advantage patients:
- Are more likely to receive preventive care
- Are half as likely to go to the emergency room
- Are less likely to be admitted to the hospital
- Go home from the hospital one day earlier
- Are less likely to be readmitted to hospital after discharge*
*Source: Based on Sutter Health 2019 managed care datawhen compared to people on fee-for-service Medicare.
What Types Of Medicare Advantage Plans Are There
Coordinated Care Plans
Most Medicare Advantage plans are coordinated care plans. Coordinated care plans have a network of doctors and providers. If you use the plan’s network doctors and providers, you generally pay less out-of-pocket for care.
Health Maintenance Organization plans
HMO plans use a network primary care provider to help coordinate care. HMO plans usually only pay for doctors and providers in the plan network.
Point of Service plans
POS plans have the benefits of an HMO, but with more flexible doctor/provider choice. Costs are generally lower for using in-network doctors/providers.
Preferred Provider Organization plans
PPO plans cover doctors and providers both in and out of network. These plans pay a portion of the cost for using an out-of-network doctor or provider.
Special Needs Plans
Special Needs Plans have benefits that cover special health care or financial needs. All SNPs include prescription drug coverage.
- Dual-Eligible Special Needs Plans for people who have both Medicare and Medicaid
- Chronic Special Needs Plans for people living with severe or disabling chronic conditions
- Institutional Special Needs Plans for people who live in a skilled nursing facility
- Institutional-Equivalent Special Needs Plans for people who live in a contracted assisted living facility and need the same kind of care as those who live in a skilled nursing facility
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Other Types Of Medicare Advantage Plans
If you want more freedom in health care providers or payment options, there are two other types of Medicare Advantage plans to consider.
Private Fee-For-Service plans
PFFS plans may or may not have a doctor/provider network, but cover any doctor or provider who accepts Medicare. If the plan doesn’t include prescription drug coverage, you can also enroll in a stand-alone Part D plan separately.
Medical Savings Account plans
MSA plans combine a high-deductible health plan with a special savings account. Medicare deposits funds that are withdrawn tax free to pay for qualified health care services. You can see any doctor or provider you choose. MSA plans don’t cover prescription drugs, but you can enroll in a stand-alone Part D plan separately.
Not all plans are available in all areas.
Premiums Starting At Zero Dollars
Depending on where you fall in Network Healths service area, there are several plans available for you to choose from. They offer plans for nearly every budget.
Whether you are looking to pay a predictable monthly payment in exchange for low deductibles and copays, or if you would like to pay no premium and instead only be charged per service, Network Health has an option to fit your needs.
Recommended Reading: Social Security Benefit At Age 62
Types Of Medicare Advantage Plans
There are four common types of Medicare Advantage plans to compare when making your selection.
Health Maintenance Organization
- Must receive your care from providers in your plans network except in the case of emergency care or out-of-area dialysis
- Requires choosing a primary care provider
- Typically covers prescription drugs
- Doesnt require you to select a primary care provider
Special Needs Plans
- Benefits, drug coverage and provider choices are tailored to best meet the needs of the groups served by the plan.
- Membership is limited to people with specific chronic diseases or conditions that are disabling, those who require institutional or nursing home care and people who have both Medicare and Medicaid coverage.
Its easy to switch Medicare Advantage plans if youre already using a Medicare Advantage plan. Enroll in a new plan during one of the open enrollment periods, and your old plan will disenroll you once your new coverage begins. If you receive medical insurance through an employer or elsewhere, speak with your provider to understand how you and your familys coverage may change while under Medicare Advantage before deciding to make the switch.
Lets Find The Right Medicare Advantage Plan For You
HealthPartners® Journey Medicare Advantage plans are a great way to get more from Medicare. These plans bring medical and prescription drug coverage together, making it easier to use your benefits. Youll also get extra perks and coverage that go beyond whats offered through Original Medicare alone.
Even better, all of our Journey plans received overall Medicare Star Ratings of 5 out of 5 for 2023 the highest score possible. It all comes back to our commitment to great customer service and helping members reach their best health.
Need coverage for the rest of 2022? Explore 2022 plans instead.
Your Medicare plan should help you live healthier, and thats why with our plans, your needs always come first:
Our Medicare network includes access to major care systems across the Twin Cities metro, central Minnesota and greater Minnesota. So you can see the doctors you know and trust and start making new connections, too.
Youll never pay an in-network primary care copay, and you can also choose a plan where monthly premiums are $0. Plus, no matter which plan you pick, an out-of-pocket maximum ensures your spending never goes over a certain amount each year.
All plans feature an annual maximum dental benefit amount for common preventive dental care, like checkups and cleaning. You can add on comprehensive dental coverage if you need more coverage or even pick a plan where its already included.
Also Check: How Long Does It Take To Get Social Security Benefits
Your Original Medicare Costs May Include:
- Deductible – The amount you pay before Florida Blue Medicare begins to pay its share of the cost. Some MA plans have a separate drug deductible before they start to pay for your prescriptions.
- Copay – A flat dollar amount you pay each time you receive care or fill a drug.
- Coinsurance – A percentage you pay for your care or drugs after you meet your deductible.
- Premium – A fixed, monthly amount you pay for your MA plan coverage. Many Florida Blue Part C plans have a $0 premium.
- Out-of-pocket maximum – The most you pay for covered health care services during your plans calendar year. All of your Medicare-covered expenses go toward this maximum.
Supplemental Benefits Are Not The Only Thing To Consider When Choosing A Medicare Advantage Plan
Medicare Advantage Plan supplemental benefits can be an important factor when choosing between plan providers as the benefits and degree of coverage offered by each plan will vary. Its important that you understand the pros and cons of the Medicare Advantage plan you are considering since you can only enroll and disenroll during the annual enrollment period.
That said, the extra benefits are not the only things to consider. When looking for Medicare Advantage Plans there are several things to keep in mind. First, make sure the plan offers coverage for the medications you use and contracts with your doctor, Jensen says.
You should also keep in mind that while the majority of Medicare Advantage Plans are HMOs, some plans are available as PPOs or HMO-POS, Jensen says. HMOs typically have a network of doctors and medical facilities that are covered under the plan. To get insurance coverage, you generally must use one of these in-network providers. With an HMO-POS, you have the option of paying more for an out-of-network provider.
PPOs give more flexibility in seeing specialists and out-of-network doctors, but they often have higher premiums than either HMO or HMO-POS plans. Jensen doesnt normally recommend PPOs because of their higher out-of-pocket costs.
If somebody wants to consider a PPO Medicare Advantage Plan, they should really be looking at Medicare Supplement plans as well, she says. A Medicare Supplement plan can offer flexibility and is worth a comparison.
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Set Up Your Network Health Mdlive Account In One Of Four Ways
MDLIVE can assist with these conditions and many more.
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