We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
What does this disclaimer mean?
This is required to be posted on all communication by medicare – it basically means that as we communicate medicare options to you we have to let you know that we are not able to offer every single medicare plan in your area because that would be pretty close to impossible. It is a disclaimer that we are required to share so you are aware that when we comparison shop we are only comparing the plans we have access to, rather than comparing every single plan. However, we can check medicare.gov and compare what we have vs what plans show up on medicare.gov to give you the best options. We will always recommend the best plan for you even if its not though us as your agent of records.
If your plan has a network
You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Humana will be responsible for the costs.
For PPO plans
With the exception of emergency or urgent care, it will cost more to get care from out-of-network providers. Additionally, accessing services from in-network providers can cost less than using services of out-of-network providers.
If benefits for which the coinsurance percentage is the same both in and out of network, member responsibility will be greater out of network when the out-of-network coinsurance is based on the Medicare allowed amount and the contracted amount is lower.
The plan provides reimbursement for all covered benefits regardless of whether they are received in network, as long as they are medically necessary.
Legal information for Medicare Supplement plans
Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and in some states to those under age 65 eligible for Medicare due to disability or End Stage Renal disease.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.
It should be noted that Medicare Supplement plans are not managed care
Legal information for Medicare Advantage plans
For some MA and MA-PD plans, you must receive all routine care from plan providers. You must use plan providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers neither Medicare nor your health plan will be responsible for the costs. For PPO, RPPO, and POS plans, it may cost more to get care from out-of-network providers, except in an emergency or for urgent care.
A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. For certain Medicare Advantage Private-Fee-for-Service plans, your provider is not required to agree to accept the plan’s terms and conditions, and thus may choose not to treat you, with the exception of emergencies. If your provider does not agree to accept the plan’s payment terms and conditions of payment, they may choose not to provide health care services to you, except in emergencies.
If this happens, you will need to find another provider that will accept the plan’s payment terms and conditions. Providers can find the plan’s terms and conditions on each plan’s website. For other types of Medicare Advantage Private-Fee-For-Service plans, some plans have network providers (that is, providers who have signed contracts with our plan) for all services covered under Original Medicare and some plans have network providers for only certain services covered under Original Medicare.
These providers have already agreed to see members of the plan. If your provider is not one of the network providers for a specific plan, then the provider is not required to agree to accept the plan’s terms and conditions, and thus may choose not to treat you, with the exception of emergencies. If your provider does not agree to accept the plan’s payment terms and conditions, they may choose not to provide health care services to you, except in emergencies. If this happens, you will need to find another provider that will accept the plans payment terms and conditions. Providers can find the plan’s terms and conditions on each plan’s website.
Benefit information is available in alternate formats or languages from the health plan or insurance company offering the plan. For some plans, Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.