Before You Enroll

What is

Medicare Advantage?

Medicare Advantage Plans, or Part C plans, are plans from private companies, like Health Alliance, that take the place of your Part A and Part B Original Medicare and also offer extras over and above Original Medicare.

Medicare Advantage, or Part C, is Part A, Part B, Part D and additional services.

Still exploring your options? Watch this video to learn more in-depth info about choosing Medicare Advantage over Original Medicare and Medicare Supplement.

We've also created an online seminar to help you understand Medicare.

We've also created an online seminar to help you understand Medicare.

We've also created an online seminar to help you understand Medicare.

  View Health Alliance Medicare Advantage Plans

Most Medicare Advantage plans cover:

  • Hospital stays, care in skilled nursing facilities, hospice care and home health care
  • Visits to doctors and specialists
  • Outpatient surgery and rehabilitation services
  • Yearly physicals and eye exams
  • Preventive services like shots and screenings

Health Alliance Medicare
Advantage also gives you:

  • Low copayments and coinsurance
  • Thousands of doctors and hospitals
  • Personal customer service
  • SilverSneakers® fitness program
  • Assist America help for travelers
  • Be Well solutions for your health when you're healthy or if you get sick
  • Yearly Dental Cleaning *Copay may apply for other dental services

For a summary of what our plans cover, see their Summary of Benefits.

Learn more about plan benefits on our Additional Services page.

Should I add a prescription plan?

Before you start shopping, these three tips can help you decide what you need in a prescription plan.

Check that your medicines are covered.

A formulary is a list of covered drugs. The formulary will also tell you what tier (cost group) your drugs belong to and how much you’ll pay. Check our formulary.

Understand the Coverage Gap

It’s important you understand the coverage gap (sometimes called the donut hole) because with most Medicare plans you pay most of your drug costs during this time.

Infographic explaining the Coverage Gap

Look for programs to help you save.

Some plans offer special pharmacy programs that help you manage your meds and save money. Take a look at ours.

$0 Drugs at Walmart and Sam’s Club

Sound too good to be true? It’s not. Members with prescription drug coverage get Tier 1 prescription drugs at Walmart and Sam’s Club for $0. Tier 1 drugs feature the most-used drugs on our formulary.

You pay low copayments when you go to other in-network pharmacies.

Also at Walmart and Sam’s Club, you can use Choice 90Rx.
* Get three months of your meds for two copays. *90-day supplies available at other pharmacies for a low copay.

Medication Therapy Management

If you have a chronic condition and take several meds, we have personalized help to answer your questions and make sure you take your medications just as your doctor prescribed. Learn more here or call us at 1-866-218-6646, Monday through Friday, 10 a.m.–8 p.m. (Eastern Time). TTY/TDD users call 1-800-367-8939.

Extra Help

You may also qualify for extra help from the federal government.

Check the Low Income Subsidy RatesLow Income Subsidy RatesLow Income Subsidy Rates. For more information and to see if you’re eligible, contact your local Social Security office, visit ssa.gov/prescriptionhelp or call 1-800-MEDICARE (1-800-633-4227).

What doctors and hospitals can I visit?

When you choose a Medicare Advantage plan, you get a group of doctors and hospitals (called a provider network) with it.

With some plans, you can use any doctor or hospital—but you will pay less if you use those in your provider network.

Click Find A Doctor to see all the doctors and hospitals in the Health Alliance Medicare network.

What You Pay

For a Medicare Advantage Plan, you pay:

  • A set amount per month (called a premium) for your health care coverage
  • Your monthly Part B premium
  • A percentage of the cost (called coinsurance) or a set fee (called a copayment) each time you use medical services—for example, each time you visit the doctor. With some plans though, you might pay nothing for certain services
  • Once you hit your yearly spending limit, we pay for everything else for the rest of the year

View Our Plans

For a Medicare Supplement Plan, you pay:

  • A set amount per month (called a premium) for your Medicare Supplement health care coverage. This rate will go up as you get older.
  • Your monthly Part B premium
  • A copayment or coinsurance for services based on your plan
  • If you want pharmacy coverage, you have buy a Part D plan separately

See our Medicare Supplement plans

 

For a Stand-Alone Prescription Drug Plan, you pay:

  • A set amount per month (called a premium) for your Prescription Drug Plan
  • Your monthly Part B premium
  • Any other Medicare premiums you pay, like for Supplement Plans

See our Standalone Prescription Drug plans

Advantage over Supplement

Health Alliance offers both Medicare Advantage plans and Medicare Supplement plans. Medicare Advantage plans are Part C plans, and they take the place of Original Medicare (Part A and Part B).

Medicare Supplement plans are not Part C plans. They are plans that help you pay for more of your Original Medicare costs.

Choose Medicare Advantage

To get more out of your insurance, choose a Medicare Advantage plan. Our plans are easy to use. And they offer so much more than Medicare Supplement.

 

Medicare Advantage
from Health Alliance Medicare

  1. Your hospital, medical and pharmacy coverage in one tidy package.
  2. You pay your plan premium to one company — less paperwork for you!*
  3. Less expensive than Medicare Supplement.
  4. Extras, like dental and vision coverage, travel assistance, a free gym membership, our Anytime Nurse Line and an online wellness tool.
  5. Helpful customer service reps based right in your state. They really know their stuff!
  6. With a PPO plan, you can see any doctor who accepts Medicare.

*You must continue to pay your Part B premium.

 

Medicare Supplement
 

  1. Does not include pharmacy coverage. You have to buy it on your own. That means more paperwork and another place for customer service.
  2. You purchase this because Original Medicare isn't enough, but you'll get paperwork from both Original Medicare and your Medicare Supplement plan. Plus, you'll have two customer service areas to deal with.
  3. More expensive, especially as you get older.
  4. Does not include extra benefits beyond what Original Medicare covers.

What to Ask

Think through these important topics when deciding between plans. Although answering the questions might not lead you to an exact plan, you’ll know what to ask yourself.

Doctor and Hospital Choice

Do you want to choose your doctors and hospitals from a network to help keep costs down?

? If yes, you should choose an HMO plan. You can check the doctors and hospitals in the plan’s provider directory.


Choice

Do you move somewhere else each winter?

Then you should choose a PPO plan. With a PPO, you can go to any doctor and hospital, but you will pay less if you go to the in-network doctors and hospitals listed in the plan’s provider directory.


Coverage

Does the plan cover the services you need?

If you have other types of health or prescription drug coverage, how do they work with Medicare?

Prescription Drugs

Do you need to join a Medicare Prescription Drug Plan?

You can get prescription drug coverage with most Medicare Advantage plans.


Cost

What will your prescription drugs cost under each plan? Does the plan’s formulary cover your drugs? Are there any rules that apply to your prescriptions? Is the pharmacy you use in the plan's network? Can you use the free Medication Therapy Management (MTM) program?

Quality of Care

Are you happy with your health care? How have the Centers for Medicare & Medicaid (CMS) and other people with Medicare rated your health and drug plan’s care and services?

These are Health Alliance’s ratings.


Convenience

Where are the doctor’s offices? What are their hours? Which pharmacies can you use? Can you get your prescriptions by mail?


Travel

Will the plan cover you if you travel to another state or outside the U.S.?

An HMO requires you stay in-network unless it’s an emergency or urgent care, but a PPO gives you the freedom to go out-of-network. Assist America can also help you get emergency care while traveling.

When To Enroll


Initial Enrollment Period (IEP): Turning 65 years old

If you’re about to become eligible for Medicare, you can sign up for plans three months before you turn 65, the month of your birthday, and during the three months after you turn 65. This is your Initial Enrollment Period.

If you sign up before the start of your birthday month, your coverage begins the first day of your birthday month. If you sign up anytime after the start of your birthday month, your coverage begins the first day of the next month.

Annual Enrollment Period (AEP): October 15 – December 7

After your IEP, you can enroll in Original Medicare, a Medicare Advantage plan, a stand-alone Prescription Drug Plan, or you can switch plans from October 15-December 7, during the Annual Enrollment Period.

If you enroll during this time, your coverage begins on January 1.

Medicare Advantage Disenrollment Period: January 1 – February 14

During this period, you can switch from a Medicare Advantage plan back to Original Medicare. You cannot switch to a different Medicare Advantage plan. You cannot add a new Medicare Advantage plan.

Special Enrollment Period (SEP): February 15 – October 14

You can’t change your coverage after the annual enrollment period. Special circumstances include:

  • Losing your coverage through no fault of your own
  • Changing jobs
  • Moving out of your service area
  • Being institutionalized
  • Your current plan violating its contract or having enrollment errors
  • Your current plan losing its Medicare contract
  • Having Medicare eligibility issues
  • Becoming eligible for Extra Help, Medicaid or a Medicare Savings Program
  • Becoming eligible or losing eligibility for a Special Needs Plan (SNP)
  • Enrolling or disenrolling from PACE (Program of All-inclusive Care for the Elderly)

More detail about special circumstances can be found at the Medicare.gov site.

Enroll in Medicare Advantage

Medicare Supplement

You can enroll in a Medicare Supplement plan at any time.

*Disabled beneficiaries under the age of 65 can only enroll at certain times of the year. You can find more info at Medicare.gov.

How to Enroll


By Phone

Call us toll-free 1-888-382-9771, 8 a.m. to 8 p.m. daily, October 1 to February 1 and 8 a.m. to 8 p.m. weekdays the rest of year. TTY/TDD 711.

By Mail

Download and complete the PPO and HMO Enrollment Form

Simply fill out the form and mail it to:
Health Alliance Medicare
Application Processing Center
301 S. Vine St.
Urbana, IL 61801