Frequently Asked Questions
- Who is eligible
- What are the
different parts of Medicare?
- How can I compare
HNE’s different plans?
- Why should
I choose HNE?
- How do I know
if my drugs are covered?
- How and when
do I sign up?
Medicare is health insurance for people aged 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or kidney transplant).
There are 4 parts of Medicare:
Part A: Hospital Insurance
Hospital insurance (Part A) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care. Most people age 65 or older who are citizens or permanent residents of the United States are eligible for free Medicare hospital insurance (Part A). For more information on Part A eligibility information or get a refresher on Medicare basics, you may want to take a look at the Social Security publication Medicare. (Click on the link to download or print a copy.)
Part B: Medical Insurance
Part B is optional and primarily covers provider services, outpatient hospital care and more, for a low monthly premium that changes from year to year. However, these programs nearly always carry a deductible and coinsurance.
Part C: Medicare Advantage
Part C, usually referred to as Medicare Advantage Plans, are health plan options (like HMOs and PPOs) approved by Medicare and run by private companies. These plans cover ALL Medicare Part A and Part B benefits. These plans may also offer additional benefits, such as vision, hearing, dental, and/or health and wellness programs. Members of these plans may need to choose a primary care physician and use participating providers within the plan's network. You are eligible to enroll in a Medicare Advantage plan if you are entitled to Part A and enrolled in Part B; you live in the Medicare Advantage Plan's service area; and you don't have End-Stage Renal Disease (ESRD).
Part D: Prescription Drug Plans
Medicare offers prescription drug coverage through Prescription Drug plans run by private companies. This coverage is called "Part D." There are two ways to get Medicare Part D coverage, through: (1) stand-alone Prescription Drug Plans (PDPs) and (2) Medicare Advantage Part D (MA-PD) Plans. Part D plans also commonly use a variety of benefit management tools such as a formulary, co-pay tiers, step therapy and prior authorization.
Use this chart to compare our different Medicare Advantage plans. Or, you can call Member Services
HNE Medicare Advantage Plans provide personal and local service our members are used to, and the plans provide all the same benefits as Original Medicare plus more. We pay for additional benefits that Original Medicare doesn't cover. Here are some of the benefits you’ll get from HNE Medicare Advantage Plans:
- No Deductibles*
- Emergency care anywhere in the world*
- No referrals needed to see an in network specialist*
- Additional benefits*+:
- Prescription Eye Wear allowance
- Dental allowance
- Fitness Club/Weight Watchers®/Safety Items allowance
- Wig allowance (if on or recently undergone chemotherapy)
- Routine hearing exam
- Routine eye exam
+ HNE additional benefits include allowances that must be used within the one or two calendar year period, as well as other additional benefits including compression stockings. Refer to the Summary of Benefits or call Member Services if you have questions about what items and services are covered.*Remember, most services require you to pay a copayment, and coverage for some services may be limited or require prior approval. Copayments, limits, and services that require prior approval are described in the HNE Medicare Advantage plans', see Evidence of Coverage. Benefits, formulary, pharmacy, network, premium and/or co-payments/co-insurance may change on January 1 of each year.
Click to view our 2013 Formulary. When it comes to benefits and prescription drugs, we’re constantly re-evaluating our customers’ needs. We’ve taken a lot of care to ensure that our prescription drug plan for Medicare offers coverage for many commonly prescribed, brand name and generic drugs.
Medicare Beneficiaries may enroll in the HNE Medicare Advantage Plan:
- Online: Click on Enroll Now via hne.com/medicare or the CMS Online Enrollment Center at www.Medicare.gov
- In person: come in to our office (click here for directions)
- Telephone: call Member Services and ask to enroll in our plan.
- By mail: fill out and mail us an enrollment form (click here for enrollment form and instructions)
Our Key Enrollment Dates page tells you dates and times that you can enroll.