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Medicare 101

What you need to know:

When Can I Enroll?

Being new to Medicare means you have a lot of important decisions to make about your health care. Chances are you’re like many people—in the dark about your options for health care coverage under Medicare.

If you’re new to Medicare, now is the time to take advantage of early Medicare enrollment with Integra Managed Care.

So call us at 1-877-388-5195 or TTY - 711 and speak with a plan representative who can answer all your questions – about Medicare, how to sign up for Medicare, and how to make the most of your Medicare coverage.

As a new beneficiary to Medicare, your complete understanding of your Medicare options is beneficial to your getting the most from your benefits. Medicare offers you different ways to get your Medicare benefits as well as providing tools to help you make the best choice.

Medicare consists of four distinct programs that include:

Medicare Part A

Hospital Insurance which helps cover the following: Inpatient care in hospitals; Inpatient stays in a skilled nursing facility; Hospice care services; Home health care services and Inpatient care in a Religious Nonmedical Health Care Institution.

Medicare Part B

Medical Insurance which helps cover medically necessary services like doctors’ services and tests, outpatient care, and other medical services. Part B also covers some preventive services.

Medicare Part C

Which is commonly known as a Medicare Advantage plan, permits Medicare beneficiaries to receive their medical care and usually other benefits that Medicare doesn’t cover, from a number of delivery options which includes Integra Managed Care HMO plans.

Medicare Part D

Which covers prescription medications can be purchased separately as a Prescription Drug Plan (PDP) or included in a Medicare Advantage Prescription Drug (MAPD) plan like Integra Managed Care Harmony Plan.

If you enroll in a Medicare Advantage Plan, you do not need, and can’t use, a Medigap policy. With Integra Managed Care HMO plans you must use plan providers.

Medicare enrollment begins three months before your 65th birthday and continues for 7 months until your Initial enrollment period is exhausted. So, knowing your options and benefits concerning Medicare and Medicare Advantage Plans like Integra Managed Care Harmony plan is critical to getting to most benefits for your health care dollars.

Generally, if you are currently receiving Social Security retirement income benefits, you don't need to do anything and you will be automatically enrolled in Medicare Parts A and Part B effective the first day of your birth month you turn 65. However, calling and confirming your benefits with the local Social Security Administration local office is a smart move.

If you are not receiving Social Security benefits, then you will need to sign up for Medicare Part A and Part B by calling the local Social Security Administration office in your area.

If you are still working when your become eligible for Medicare and have an employer or union group health insurance plan or if you are retired and still covered under your employer's health plan, it is possible you do not need to sign up for Medicare Part B right away.

Furthermore, you should find out from your current employer or your former employer from where you retired, whether the employer's plan is the primary insurer. If Medicare, rather than the employer's plan, is the primary insurer, then you will still need to sign up for Part B. Even if you aren't going to sign up for Part B, you should still enroll in Medicare Part A, which may help pay some of the costs not covered by your group health plan.

It is critical that you understand and know all of the rules in this type of situation. If you opt not to take your Part B Medicare benefit when you become eligible during your Initial Enrollment Period, you may have to wait to be enrolled during the Annual Enrollment Period (AEP) which is October 15 to December 7 of each year. Also, your Medicare Part B premium may go up 10 percent for each 12-month period that you could have had Medicare Part B, but did not take it, so this could expose you to a period of not having any medical coverage and higher costs down the road.

From January 1st through March 31st, Medicare Advantage enrollees can disenroll from their current plan and return to FFS or Original Medicare and choose a Prescription Drug Plan. Moving forward, unless you qualify for a Special Enrollment Period, you will not be able to switch to another Medicare Advantage Plan until October 15th.

However, there are exceptions:

  • If you will be turning 65, you can select a plan 3 months prior and up to 3 months after the month of your birthday
  • If you have recently moved out of your previous plan's coverage area
  • If you have recently lost employee group coverage
  • If you have both Medicare and Medicaid
  • If you qualify for Low Income Subsidy (LIS)

If you're unsure whether you are eligible to join a Medicare Advantage Plan, the best thing to do is give us a call 24/7 at 1-877-388-5195 or 711 (TTY)

Medicare does not pay for everything. Much of the balance not covered by Medicare can be covered by purchasing a "Medigap" insurance policy from a private insurer. Medicare also offers Medicare Part C (also called Medicare Advantage). You must be enrolled in Medicare Parts A and B to join a Medicare Advantage plan like the plan types offered by Integra Managed Care.

Unlike Medicare Supplements that pay the costs not covered by Medicare like Deductibles and Co Insurance, a Medicare Advantage Plan like Integra Managed Care Harmony plan will provide all of your Part A and Part B coverage, and it may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Integra Managed Care Harmony include Medicare Part D prescription drug coverage and therefore you will not need to purchase a separate Part D Prescription Drug plan.

NOTE: People with limited income and resources may qualify for extra help to cover their prescription drugs for little or no cost. To find out more, contact the Social Security Administration at 1-800-772-1213, or visit http://www.socialsecurity.gov, or contact your Local State Medical Assistance (Medicaid) Office.

If you need more coverage than Original Medicare, enrolling in a Medicare Advantage plan with Integra Managed Care could save you money. Integra Managed Care has Medicare Advantage plans with $0 plan premium and $0 copay that includes Part D prescription drug coverage.

To explore your Medicare options further, you can visit the following websites: http://www.Medicare.gov and select “Find out What Medicare covers” or http://www.Medicare.gov to view the “Medicare and You Handbook”. Choose the publications link on the bottom of the page.


Review 2019 Integra Managed Care Medicare plans in more detail

Member & Provider Services

  • 1-877-388-5195 TTY: 711
  • 8:00 a.m. to 8:00 p.m. Eastern time
  • October 1 to March 31 7 days a week
  • April 1 to September 30 Monday through Friday

Sales Representative

  • 1-877-388-5190 TTY: 711
  • 8:00 a.m. to 8:00 p.m. Eastern time
  • October 1 to March 31 7 days a week
  • April 1 to September 30 Monday through Friday

Enrollment

  • You may download, complete, sign and date an enrollment form
  • Enrollment Form
  • Pre-Enrollment Checklist
  • Once you have completed the form please fax it to: 1-516-321-4638
  • Or mail it to: Integra Managed Care 1981 Marcus Avenue – Suite 100 Attention: Medicare Lake Success, NY 11042