Medicare Medicare

2016 Medicare Resource Center

 

 

 

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EVIDENCE OF COVERAGE

The Evidence of Coverage booklet tells members how to get their Medicare medical care and prescription drugs (if applicable) through our plan, a Medicare Advantage Plan. The Evidence of Coverage booklet explains member’s rights and responsibilities, what is covered, and what you will pay as a member of the plan. .

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SUMMARY OF BENEFITS/ STAR RATINGS

Compare our Medicare Advantage plans and the Original Medicare Plan using the Summary of Benefits.  For each benefit, you can see what our plan covers and what the Original Medicare Plan covers.   View the Star Ratings for our Medicare Advantage plans to compare our plans’ performance to other plans.

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ENROLLMENT AND HIPAA FORMS

View and download important Medicare and HIPAA forms.

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HEALTH AND WELLNESS

We are committed to helping our members take an active role in their good health.  Through our Health and Wellness programs and benefits, you can enjoy the advantages of learning from healthcare professionals throughout the area and exclusive member discounts

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EXCEPTIONS AND APPEALS

Understand the process for coverage decisions, how to request an appeal, and who to contact with questions related to benefits and coverage for medical services and prescription drugs.

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PRESCRIPTION DRUG INFORMATION

Our Medicare Advantage plans are offered with or without a prescription drug benefit.  View the Medicare Formulary or search for a network pharmacy.  Review the Transition, Prior Authorization, Quantity Limits, Step Therapy, and Medication Therapy Management guidelines.  Also, see if you qualify for help with your prescription drug costs and more.

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This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change January 1 of each year.  The Formulary, pharmacy network, and/or provider network may change at any time.  You will receive notice when necessary. You must continue to pay your Medicare Part B Premium.

 

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

 

HealthNow New York Inc.  is a Medicare Advantage and stand-alone PDP plan with a Medicare contract. Enrollment in HealthNow New York Inc. depends on contract renewal. 

 

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Content Last Updated January 19, 2016