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When It Comes to Coverage, You Have Options

Medicare is a federal health insurance program that is available to people 65 and older, people under 65 with certain disabilities and people with end-stage renal disease. When you are ready to decide on a plan, take the time to understand how the plans work. That way, you can make an informed decision and choose the plan that is right for you. 

You have the choice of your Medicare coverage. There are two primary options, Original Medicare and Medicare Advantage (also known as Part C).

What are the parts of Medicare?

Original Medicare is a fee-for-service health plan managed by the federal government that has two parts: Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). For drug coverage, you can join a separate Medicare drug plan (Part D).

Learn more about the individual parts of Medicare:

Part A - Hospital Coverage
Helps cover:

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care

Part B - Medical Coverage
Helps cover:

  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment (like wheelchairs, walkers, hospital beds and other equipment)
  • Many preventive services (like screenings, shots/vaccines and yearly "Wellness" visits)

Medicare Advantage (also known as Part C)

  • An "all in one" alternative to Original Medicare that includes Part A, Part B and, usually, Part D.
  • Plans may have lower out-of-pocket costs than Original Medicare.
  • Most plans offer extra benefits that Original Medicare doesn't cover such as vision, hearing, dental and more.

Part D - Prescription Drug Coverage
Helps cover:

  • Cost of prescription drugs (including many recommended shots and vaccines)

Part D plans are run by private insurance companies that follow rules set by Medicare.

What are Medicare Advantage plans?

A Medicare Advantage Plan is another way to get your Medicare Part A (hospital insurance) and Part B (Medicare insurance) coverage. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies that are approved by Medicare.

If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A and Part B coverage, excluding hospice care. Most plans also include drug coverage (Part D). Medicare Advantage plans often offer coverage for things Original Medicare doesn't cover, such as vision, hearing, dental, and fitness programs (like gym memberships or discounts).

There are different types of Medicare Advantage plans. The most common types of plans include:

  • Health Maintenance Organization (HMO) Plans
  • Preferred Provider Organization (PPO) Plans (PDF)
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNPs)

Find a Medicare Advantage plan that may be right for you. 

Napateg nga Impormasion

Naisingsingayan a Kasapulan

Nadisenio ti Wellcare Special Needs Plans (SNPs) tapno matungpal dagiti kasapulan ti tattao a:

  • Maikari para ti Medicare
  • Agbibiag babaen ti limitado a sapul
  • Maikari para ti Medicaid

No makualipika ka ti SNP, mabalin nga iraman ti planom ti:

  • Ospital, doktor ken masakupan ti naireseta nga agas
  • Dagiti serbisio iti panangimaton ti panangtaripato
  • Masakupan ti rutina a panagkita ken panangtaming ti ngipen
  • Tulong tapno mabayadan dagiti bambanag a kas dagiti bitamina, dagiti first aid a suplay ken dagiti produkto para ti ngipen
  • Tulong mapan ti ken gapu kadagiti medikal nga apoyntmentmo

Mabalin nga addaan ti Wellcare ti SNP a makatungpal kadagiti kasapulam. Nakadepende daytoy iti lebelmo ti Medicaid. Kontakennakami tapno maammoan ti ad-adu maipapan kadagiti SNP.

Dagiti Mailibak

Ti Wellcare ket Medicare brand para ti Centene Corporation, maysa plano nga HMO, PPO, PFFS, PDP nga addaan iti kontrata ti Medicare ken maysa nga naaprobaran nga Isponsor ti Part D. Dagiti plano mi nga D-SNP ket addaan iti kontrata kadua iti programa ti estado nga Medicaid. Ti panagpalista kadagiti plano mi ket nakadepende ayan ti pannakapabaro ti kontrata.

‘Ohana Health Plan, maysa a plano nga idiaya ti WellCare Health Insurance of Arizona, Inc.

Dagiti residente ti Texas: Iraman ti Wellcare (HMO ken HMO SNP) dagiti produkto a nakasurat iti WellCare of Texas, Inc., WellCare National Health Insurance Company, ken SelectCare of Texas, Inc.

Kadagiti residente ti Washington: Ti “Wellcare" ket idiaya ti WellCare Health Insurance Company of Washington, Inc.

Dagiti Miembro ti Wellcare Dual Liberty (HMO D-SNP): Ti Wellcare Dual Liberty (HMO D-SNP) ket maysa a Fully Integrated Dual Eligible Special Needs Plan nga addaan ti kontrata iti Medicare ken addaan ti kontrata ti programa iti New Jersey Medicaid. Ti panagpalista iti Wellcare Dual Liberty ket nakadepende ayan ti pannakapabaro ti kontrata. Daytoy nga impormasion ket saan a kompleto a panangiladawan dagiti benepisio. Kontaken ti plano para ti ad-adu nga impormasion. Dagiti limitasion ken restriksion ket mabalin a maiyaplikar. Dagiti benepisio ket mabalin nga agbaliw inton Enero 1 ti kada tawen. Nasakup ti Medicaid ti premium-mo ti Paset B. Sidadaan daytoy a plano kadagiti addaan iti agpada a Medicare ken dagiti pakabuklan a benepisio ti Medicaid. Mangus-usar ti Wellcare ti pormulario. Maidawat a kontaken ti Wellcare para kadagiti detalye.

Kada tawen, kedkedngan ti Medicare dagiti plano base ti sistema ti 5-star a rating.

Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please contact us.

Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please contact us.

Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any benefits above and beyond traditional Medicare benefits are applicable to Wellcare Medicare Advantage only and do not indicate increased Medicaid benefits.

Dagiti tagaipaay iti ruar ti network/saan a nakontrata ket awanan ti obligasion nga agasan dagiti miembro ti Plano, malaksid kadagiti emerhensia a kasasaad. Maidawat nga awagan ti numero ti serbisio iti kostumer wenno kitaen ti Ebidensia ti Masakupan para ad-adu nga impormasion, agraman ti cost-sharing a maiyaplikar para kadagiti serbisyio a maala iti ruar ti network.

Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Georgia, Hawaii, Missouri, and Nebraska. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-866-892-8340 (TTY: 711) for Wellcare No Premium (HMO) in GA or consult the online pharmacy directory at www.wellcare.com/medicare; 1-877-457-7621 (TTY: 711) for Wellcare ‘Ohana No Premium (HMO) and Wellcare ‘Ohana Low Premium Open (PPO) in HI or consult the online pharmacy directory at www.wellcare.com/ohana; 1-833-444-9088 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare Assist (HMO) in MO or consult the online pharmacy directory at www.wellcare.com/medicare; and 1-800-977-7522 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), Wellcare No Premium Open (PPO), and Wellcare Assist Open (PPO) in NE or consult the online pharmacy directory at www.wellcarene.com.

Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

Maidawat a kontaken ti planom para kadagiti detalye.

Kasano nga ma-access ti pannakasakup nu mapasamak ti didigra wenno lokal nga emergency.

No mapasamak ti emerhensia wenno natural a didigra, ti WellCare ket dedikado a tumulong kaniam nga agtultuloy a nalaka a ma-access ti panangtaripatom. No tiempo iti krisis, dakami ket:

  • Palubusan nga dagiti benepisyo ti Part A ken Part B ken ti supplemental Part C a plano nga maited ayan dagiti ispesipiko nga madi-nakakontrata nga pasilidad (laglagipen nga dagiti benepisyo ti Part A ken Part B ket kasapulan, ka ibaga ti 42 CFR §422.204(b)(3), nga maited ayan dagiti sertipikado ti Medicare nga pasilidad)
  • Waive in full, requirements for gatekeeper referrals where applicable
  • Temporaryo nga pabassiten ti inaprobaran ti plano nga madi-kadua-ti-plano nga cost-sharing paapan iti gatad ti cost sharing para iti kadua-ti-network
  • I-waive iti kasapulan nga 30-aldaw nga pakaammoa para kadagiti agpalpalista basta amin dagiti panagbaliw (kas iti panagbassit iti cost-sharing ken ti panag-waive iti otorisasyon) ket agbenepisyo ti agpalpalista
  • Palubusan daka nga pakargaan dagiti agas mo it nasapsapa ngem kadawyan tapno maisigurado nga addaan ka nju anya iti kasapulam bayat ti emergencey 

Dagitoy nga aksyon ket umepekto babaen iti teimpot iti emergency declaration. Dagiti Didigra/Emergency ket mabalin nga maideklara babaen ti Gobyerno ti U.S., ti Federal Emergency Management Agency (FEMA), wenno ti Governador iti anyaman nga estado.

Kadawyanna, ti source nga nangideklara iti didigra ket ilawlawag na nu kaano nga malpas iti didigra wenno emergency. Ngem, nu ti tiempo ti didigra wenno emergency ket madi nga malpas iti 30 nga aldaw manipod iti umuna nga panagipalawag, ken nu ti Centers for Medicare & Medicaid Services (CMS) ket madi nga nangidikta iti petsa nga malpasan ti didigra wenno emergency, irugi mi ulit ti normal nga operasyon 30 nga aldaw manipod iti umuna nga deklarasyon.

  • Naisingsingayan a Kasapulan

    Naisingsingayan a Kasapulan

    Nadisenio ti Wellcare Special Needs Plans (SNPs) tapno matungpal dagiti kasapulan ti tattao a:

    • Maikari para ti Medicare
    • Agbibiag babaen ti limitado a sapul
    • Maikari para ti Medicaid

    No makualipika ka ti SNP, mabalin nga iraman ti planom ti:

    • Ospital, doktor ken masakupan ti naireseta nga agas
    • Dagiti serbisio iti panangimaton ti panangtaripato
    • Masakupan ti rutina a panagkita ken panangtaming ti ngipen
    • Tulong tapno mabayadan dagiti bambanag a kas dagiti bitamina, dagiti first aid a suplay ken dagiti produkto para ti ngipen
    • Tulong mapan ti ken gapu kadagiti medikal nga apoyntmentmo

    Mabalin nga addaan ti Wellcare ti SNP a makatungpal kadagiti kasapulam. Nakadepende daytoy iti lebelmo ti Medicaid. Kontakennakami tapno maammoan ti ad-adu maipapan kadagiti SNP.

  • Dagiti Mailibak

    Dagiti Mailibak

    Ti Wellcare ket Medicare brand para ti Centene Corporation, maysa plano nga HMO, PPO, PFFS, PDP nga addaan iti kontrata ti Medicare ken maysa nga naaprobaran nga Isponsor ti Part D. Dagiti plano mi nga D-SNP ket addaan iti kontrata kadua iti programa ti estado nga Medicaid. Ti panagpalista kadagiti plano mi ket nakadepende ayan ti pannakapabaro ti kontrata.

    ‘Ohana Health Plan, maysa a plano nga idiaya ti WellCare Health Insurance of Arizona, Inc.

    Dagiti residente ti Texas: Iraman ti Wellcare (HMO ken HMO SNP) dagiti produkto a nakasurat iti WellCare of Texas, Inc., WellCare National Health Insurance Company, ken SelectCare of Texas, Inc.

    Kadagiti residente ti Washington: Ti “Wellcare" ket idiaya ti WellCare Health Insurance Company of Washington, Inc.

    Dagiti Miembro ti Wellcare Dual Liberty (HMO D-SNP): Ti Wellcare Dual Liberty (HMO D-SNP) ket maysa a Fully Integrated Dual Eligible Special Needs Plan nga addaan ti kontrata iti Medicare ken addaan ti kontrata ti programa iti New Jersey Medicaid. Ti panagpalista iti Wellcare Dual Liberty ket nakadepende ayan ti pannakapabaro ti kontrata. Daytoy nga impormasion ket saan a kompleto a panangiladawan dagiti benepisio. Kontaken ti plano para ti ad-adu nga impormasion. Dagiti limitasion ken restriksion ket mabalin a maiyaplikar. Dagiti benepisio ket mabalin nga agbaliw inton Enero 1 ti kada tawen. Nasakup ti Medicaid ti premium-mo ti Paset B. Sidadaan daytoy a plano kadagiti addaan iti agpada a Medicare ken dagiti pakabuklan a benepisio ti Medicaid. Mangus-usar ti Wellcare ti pormulario. Maidawat a kontaken ti Wellcare para kadagiti detalye.

    Kada tawen, kedkedngan ti Medicare dagiti plano base ti sistema ti 5-star a rating.

    Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please contact us.

    Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please contact us.

    Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any benefits above and beyond traditional Medicare benefits are applicable to Wellcare Medicare Advantage only and do not indicate increased Medicaid benefits.

    Dagiti tagaipaay iti ruar ti network/saan a nakontrata ket awanan ti obligasion nga agasan dagiti miembro ti Plano, malaksid kadagiti emerhensia a kasasaad. Maidawat nga awagan ti numero ti serbisio iti kostumer wenno kitaen ti Ebidensia ti Masakupan para ad-adu nga impormasion, agraman ti cost-sharing a maiyaplikar para kadagiti serbisyio a maala iti ruar ti network.

    Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Georgia, Hawaii, Missouri, and Nebraska. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-866-892-8340 (TTY: 711) for Wellcare No Premium (HMO) in GA or consult the online pharmacy directory at www.wellcare.com/medicare; 1-877-457-7621 (TTY: 711) for Wellcare ‘Ohana No Premium (HMO) and Wellcare ‘Ohana Low Premium Open (PPO) in HI or consult the online pharmacy directory at www.wellcare.com/ohana; 1-833-444-9088 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare Assist (HMO) in MO or consult the online pharmacy directory at www.wellcare.com/medicare; and 1-800-977-7522 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), Wellcare No Premium Open (PPO), and Wellcare Assist Open (PPO) in NE or consult the online pharmacy directory at www.wellcarene.com.

    Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

    Maidawat a kontaken ti planom para kadagiti detalye.

  • Kasano a ma-access ti masakupan nu mapasamak ti didigra wenno lokal nga emergency.

    Kasano nga ma-access ti pannakasakup nu mapasamak ti didigra wenno lokal nga emergency.

    No mapasamak ti emerhensia wenno natural a didigra, ti WellCare ket dedikado a tumulong kaniam nga agtultuloy a nalaka a ma-access ti panangtaripatom. No tiempo iti krisis, dakami ket:

    • Palubusan nga dagiti benepisyo ti Part A ken Part B ken ti supplemental Part C a plano nga maited ayan dagiti ispesipiko nga madi-nakakontrata nga pasilidad (laglagipen nga dagiti benepisyo ti Part A ken Part B ket kasapulan, ka ibaga ti 42 CFR §422.204(b)(3), nga maited ayan dagiti sertipikado ti Medicare nga pasilidad)
    • Waive in full, requirements for gatekeeper referrals where applicable
    • Temporaryo nga pabassiten ti inaprobaran ti plano nga madi-kadua-ti-plano nga cost-sharing paapan iti gatad ti cost sharing para iti kadua-ti-network
    • I-waive iti kasapulan nga 30-aldaw nga pakaammoa para kadagiti agpalpalista basta amin dagiti panagbaliw (kas iti panagbassit iti cost-sharing ken ti panag-waive iti otorisasyon) ket agbenepisyo ti agpalpalista
    • Palubusan daka nga pakargaan dagiti agas mo it nasapsapa ngem kadawyan tapno maisigurado nga addaan ka nju anya iti kasapulam bayat ti emergencey 

    Dagitoy nga aksyon ket umepekto babaen iti teimpot iti emergency declaration. Dagiti Didigra/Emergency ket mabalin nga maideklara babaen ti Gobyerno ti U.S., ti Federal Emergency Management Agency (FEMA), wenno ti Governador iti anyaman nga estado.

    Kadawyanna, ti source nga nangideklara iti didigra ket ilawlawag na nu kaano nga malpas iti didigra wenno emergency. Ngem, nu ti tiempo ti didigra wenno emergency ket madi nga malpas iti 30 nga aldaw manipod iti umuna nga panagipalawag, ken nu ti Centers for Medicare & Medicaid Services (CMS) ket madi nga nangidikta iti petsa nga malpasan ti didigra wenno emergency, irugi mi ulit ti normal nga operasyon 30 nga aldaw manipod iti umuna nga deklarasyon.

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Y0020_WCM_134133E_M Last Updated On: 10/1/2023