Tips to understand Medicare and prepare for enrollment
Medicare coverage is made up of several “parts” – Original Medicare (Parts A and B), Medicare Advantage (Part C) and Medicare prescription drug plans (Part D) – designed to fit specific needs. We’ll help you understand how Medicare works, avoid potential penalties and compare plans.
Why choose HAP?
We’ve enhanced our Medicare Advantage benefits for 2019. With HAP you get more choice, easy-to-use and easy-to-understand plans, great preventive benefits and extras that you don’t pay for.
Medicare Part A helps cover hospital inpatient care. If you’ve been employed and paid Medicare taxes, you likely won’t have to pay a premium for Part A coverage.
Part B
Medicare Part B helps cover things such as doctor visits, outpatient services and preventive care. You’ll pay a monthly premium if you want Part B coverage.
Medicare Part C also is known as Medicare Advantage. These plans are offered by private companies such as HAP. They provide all the coverage available in Medicare Part A and Part B and may include additional benefits as well. They also can include Medicare Part D prescription drug coverage.
We offer a variety of Part C plans (available with and without Part D prescription drug coverage) to make sure you get the coverage that’s right for your lifestyle and budget.
Medicare Part D is prescription drug coverage available only through private companies such as HAP. It helps lower prescription drug costs and protects against higher costs in the future. Our Medicare Advantage health plans offer prescription coverage.
Benefits of a HAP Medicare supplement plan:
Competitive monthly premiums
Freedom to choose any doctor or hospital that accepts Medicare
No referrals needed to see a specialist
$0 copays on Medicare-approved preventive services
Now that you know more about Medicare parts, it’s important to understand the different types of plans we offer. We have four different types of Medicare plans.
HAP Senior Plus (HMO), HAP Senior Plus (HMO-POS), HAP Senior Plus (PPO) serves members with Medicare who reside in our 30-county service area:
Arenac
Bay
Clare
Clinton
Eaton
Genesee
Gladwin
Gratiot
Hillsdale
Huron
Ingham
Ionia
Iosco
Isabella
Jackson
Lapeer
Lenawee
Livingston
Macomb
Midland
Monroe
Montcalm
Oakland
Saginaw
Sanilac
Shiawassee
St. Clair
Tuscola
Washtenaw
Wayne
HAP Primary Choice Medicare (HMO) and HAP Senior Plus Henry Ford Tiered Access (HMO) serve members with Medicare who reside in Wayne, Oakland and Macomb counties.
Alliance Medicare Supplement plans serve Michigan residents with Original Medicare.
HMOs are typically more affordable than PPOs. HMO members get their care through their primary care physician, or PCP. If you need to see a specialist, all you have to do is make an appointment. Your doctor will handle the rest.
HAP Senior Plus (HMO) offers Medicare Advantage plans with and without drug coverage. These plans offer members lower premiums and out-of-pocket medical and drug costs. All of your health care services will be coordinated between you and your designated primary care physician from a network of local healthcare providers who refer you when necessary to in-network specialists or hospitals. This network is made up of 30 counties (highlighted in orange²)
HAP Primary Choice Medicare (HMO)
HAP Primary Choice Medicare (HMO) and HAP Senior Plus Henry Ford Tiered Access (HMO) are available to residents of Oakland, Macomb and Wayne counties.
HAP Primary Choice Medicare (HMO) and HAP Senior Plus Henry Ford Tiered Access (HMO) are available to residents of Oakland, Macomb and Wayne counties.
Our Primary Choice Medicare plan gives Medicare Advantage members who reside in Wayne, Oakland and Macomb counties access to an integrated network of nearly 400 primary care physicians, along with open access to specialists.
HAP Senior Plus Henry Ford Tiered Access (HMO)
Our Henry Ford Tiered Access plan offers Medicare Advantage members who reside in Wayne, Oakland and Macomb counties the reassurance of seeing a Henry Ford Health System doctor or specialist, as well as the flexibility of seeing network doctors and specialists in our entire 30-county HMO service network.²
The “tiered access” refers to the costs associated with the doctors or specialists you see.
“Tier 1 providers” are network providers who you will access at the highest benefit level or least amount of patient cost share.
"Tier 2 providers” are the network doctors and other health care professionals, medical groups, hospitals, and other health care facilities who you will access at the lowest in network benefit level or highest patient cost share.
Very similar to the HMO above with the added flexibility to see doctors outside your network, if needed. This type of plan is good for members who want extra coverage when traveling outside the HAP network. Members still get lower premiums and regularly managed care through their PCP. 1
PPOs offer more flexibility than HMOs but you’ll pay a little more for care. You don’t need to have a PCP (but you should pick one), and you can seek care in, or outside of, the network. 1
Medigap plans, also known as Medicare supplement plans, are offered by private companies such as Alliance Health and Life Insurance Company® as a a way to help pay some of the health care costs Original Medicare doesn’t cover like copays, coinsurance and deductibles. It only supplements your Original Medicare benefits. You’ll still need to have Medicare Parts A and B.
HAP offers Alliance Medicare Supplement Plans A, C, F, G and N.
When weighing health plan costs, you need to look beyond your premium. As a health plan member, you’ll need to pay your part of the costs associated with your care through:
Copays
Coinsurance
Deductibles
Copay
This is a set amount you pay each time you visit your doctor, get health care services, medications or health care supplies. The amount depends on the type of covered service. Often, copays don’t count toward your deductible. You’ll still pay copays after you’ve met your deductible, until you reach your out-of-pocket limit. In some cases, your deductible must be met before copays start.
Deductible
The amount you owe for covered health care or prescription drugs before your plan starts to pay for them. There are individual deductible amounts and family deductible amounts. If you go out-of-network for care, your deductible will be much higher. Your deductible resets each benefit period, which is most often a calendar year.
Coinsurance
The percentage of charges for certain covered health care that you pay after your deductible has been met.
Out-of-pocket limit
The most you’ll have to pay out-of-pocket during your benefit period, which is usually a calendar year.
Still have questions?
Send us an email, or give us a call and speak with a licensed HAP Medicare sales representative.
You can join us at one of our free Medicare seminars to get the latest information and answers to your questions. Find a Medicare seminar.
1HAP Senior Plus (HMO), HAP Senior Plus (HMO-POS), and HAP Senior Plus (PPO)is a health plan with a Medicare contract. Enrollment in the plan depends on contract renewal. HAP Senior Plus (HMO) serves members with Medicare who reside in Arenac, Bay, Clare, Genesee, Gladwin, Gratiot, Hillsdale, Huron, Ingham, Iosco, Jackson, Lapeer, Livingston, Macomb, Midland, Monroe, Oakland, Saginaw, Sanilac, Shiawassee, St. Clair, Tuscola, Washtenaw or Wayne counties.
2 HAP Senior Plus Henry Ford Tiered Access (HMO) is available only to residents of Macomb, Oakland, or Wayne counties. HAP Senior Plus Henry Ford Tiered Access (HMO) Tier 1 providers are Henry Ford Health System doctors and providers located in Macomb, Oakland, and Wayne counties. HAP Senior Plus Henry Ford Tiered Access (HMO) Tier 2 providers are within HAP’s 30-county HMO service network which include Arenac, Bay, Clare, Genesee, Gladwin, Gratiot, Hillsdale, Huron, Ingham, Iosco, Jackson, Lapeer, Livingston, Macomb, Midland, Monroe, Oakland, Saginaw, Sanilac, Shiawassee, St. Clair, Tuscola, Washtenaw or Wayne counties.
Alliance Medicare Supplement and Alliance Medicare PPO are products of Alliance Health and Life Insurance Company, a wholly owned subsidiary of HAP.
Neither Alliance Medicare Supplement nor its agents are connected with Medicare and are not connected with or endorsed by the United States government or the federal Medicare program
This is a solicitation of Alliance Medicare Supplement insurance and you may be contacted by a licensed, authorized HAP Medicare Sales Person.
The provider network may change at any time. You will receive notice when necessary.
HAP Senior Plus (HMO)/(HMO-POS)/(PPO) and HAP Primary Choice Medicare (HMO) are health plans with Medicare contracts. HAP Empowered Duals (HMO SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment in the plans depends on contract renewals. HAP Senior Plus (PPO) is a product of Alliance Health and Life Insurance company, a wholly owned subsidiary of HAP.
This information is not a complete description of benefits. For more information call Medicare Michigan customer service at (800) 868-9885 (TTY: 711) 8 a.m. to 8 p.m., seven days a week (Oct. 1 – March 31) / 8 a.m. to 8 p.m., Monday through Friday (April 1 - Sept. 30).
