Medicare Health Plans

Welborn Cost 1876 (Plus & Basic) (HMO)


The Cost plan is closed to new members and we cannot accept new applications!

 

PDF DownloadSummary of Benefits - Cost 1876, Plus & Basic (HMO)

PDF DownloadAnnual Notice of Change (ANOC) - Cost 1876, Plus & Basic (HMO)

PDF DownloadEvidence of Coverage (EOC) - Cost 1876, Plus & Basic (HMO)

 

WHP has chosen a group of health care providers to help us meet your needs. These doctors and specialists, hospitals, labs and other health care facilities make up our Provider Network. By using our network of physicians and hospitals*, you are ensured a higher level and preset copays. This means you will not pay more than listed in your Summary of Benefits, unlike other PPO plans or Private Fee For Service (PFFS) plans. By choosing a PCP, all the pre-authorizations and referrals are handled by their office.


If you want to keep seeing your current doctor or check to see which doctors are available close to your home, please search our Provider Directory or call our Medicare Department and they will send a directory to you by mail. Call us if you have any questions or concerns regarding our plans or your coverage.

1-812-426-6600 or 1-800-521-0265

 

PDF DownloadEnding Your Membership - Cost 1876, Plus & Basic (HMO)

 

 

Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B.

Plans may be renewed annually. Limitations, copayments, and restrictions may apply.

Updated 7/2010

H3044_H1558_WHPWeb (10/2009)

Welborn Health Plans
Welborn Health Plans

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