Medicare Health Plans >> Platinum Select Rx (HMO-POS) Plan

Medicare Health Plans

Platinum Select Rx (HMO-POS)

 

Summary of Benefits - Platinum Select Rx (HMO-POS)

Evidence of Coverage (EOC) - Platinum Select Rx (HMO-POS)

 

Welborn Health Plans (WHP) has a contract with the Centers for Medicare and Medicaid Services (CMS) to meet the health care needs of people in Medicare and who want to be part of a managed care plan. The service area for our plans includes: Gibson, Knox, Perry, Pike, Posey, Spencer, Vanderburgh and Warrick counties in southern Indiana. You must live in one of these counties to join our Medicare plans.

WHP has contracts with pharmacies that equals or exceeds CMS requirements for pharmacy access in your area. Enjoy the freedom of 101 local Tri-State pharmacy locations.

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

 

Ending Your Membership - Platinum Select Rx (HMO-POS)

 

 

A Federally-Qualified HMO with a Medicare contract.

Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B premium even if the plan premium is $0. Members may enroll in the plan only during specific times of the year. Contact Welborn Health Plans for more information.

Beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances, and quantity limitations and restrictions may apply. HMO members must receive all routine care from plan providers. Plans may be renewed annually. Limitations, copayments, and restrictions may apply.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for up to one hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

This information may be available in a different format, including large print. Please call Customer Service at the 1-800-521-0265 or TTY 1-800-743-3333, 7 days a week 8 a.m. to 8 p.m.

Updated 7/2010

H3044_H1558_WHPWeb (10/2009)