Home
Medicare Plans

Medicare Part D Abridged Formulary
Medicare Part D Comprehensive Formulary
2010 Medicare Pharmacy Policies
Appeals and Grievances
Contact Us

Health Alliance

Notice of Privacy Practices
Privacy Policy Legal Disclaimer




Take a look at our members' cute grandkids

CMS Best Available Evidence
 
  Health Alliance Medicare is a health plan with a Medicare contract.

Health Alliance offers a variety of Medicare plans for practically every need and budget:

2010 Medicare Advantage


Medicare HMO 20 (HMO)—Your costs for covered medical services are capped at $1,500 each year. You choose among the doctors and hospitals in our broad network for routine care. Available to all beneficiaries in a 10-county area of east central Illinois. Basic or comprehensive Part D pharmacy coverage can be added to Medicare HMO 20 (HMO).

Medicare PPO 30 (PPO)—With Medicare PPO 30 (PPO), you have the flexibility of visiting any provider, but your coverage will be greater when you see in-network providers. You also enjoy a $3,000 out-of-pocket maximum for in-network medical services and lower monthly premiums. In exchange, the copayments for services received may be slightly higher than those for other Health Alliance Medicare plans. Available to all beneficiaries in a 40-county area of central Illinois. Basic or comprehensive Part D pharmacy coverage can be added to Medicare PPO 30 (PPO).

Medicare PPO 10 (PPO)—For a moderate monthly premium, you get comprehensive medical coverage, and your costs for covered in-network medical services are capped at $1,500 each year. With PPO 10 (PPO), you can choose to use non-plan providers to get covered services; however, if you do so, it may cost you more to use them. Available to all beneficiaries in a 40-county area of central Illinois. Basic or comprehensive Part D pharmacy coverage can be added to Medicare PPO 10 (PPO).


___________________________________________________


Medicare Supplement—Our supplement plans—Plan A, Plan C and Plan F—offer three coverage levels to suit your individual needs and no restrictions on which doctors and hospitals you use. Available to beneficiaries throughout Illinois.

___________________________________________________


Most Recent HEDIS® Results

All information on this website is available in alternative formats. For more information, please contact Health Alliance Medicare Services.

___________________________________________________


  • If you decide to have your premium withheld from your Social Security Check or if you are currently having your premium withheld from your Social Security Check and you wish to change to paying your premium directly to Health Alliance Medicare, it may take up to three months for it to take effect and you will be ultimately held responsible for the bill.
  • You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help call:
    • 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week);
    • The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or
    • Your State Medicaid office
  • You must be entitled to Medicare Part A and enrolled in Part B and you must continue to pay you Medicare Part B premium to remain eligible, unless under Medicaid or paid for by a third party.
  • Individuals with End State Renal Disease are generally not eligible to enroll in Health Alliance Medicare unless they are members of our organization and have been since dialysis began.
  • You must live in the Health Alliance Medicare service area.



  • For HMO Plans Only
  • If you join an HMO plan and obtain care from an out-of-network plan provider, neither Medicare nor Health Alliance Medicare will be responsible for the costs.
  • You must use plan providers except in emergent or urgent care situations or for out of area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Health Alliance Medicare will be responsible for the costs.



  • For PPO Plans Only
  • If you join a PPO plan and use a non-plan or non-preferred provider, with the exception of emergency or urgent care, you will pay more for services.
  • If you are enrolled in a PPO plan and get health care service from a plan provider, this is known as an "in-network" service. A health care service you get from a non-plan provider is known as "out-of-network" service.
  •  
       
     

    H1463_07_06_09
    H1417_07_06_09

    Approved February 8, 2010