ADVANTAGE Health Solutions Medicare Advantage Offerings

ADVANTAGE Health Solutions, Inc., Medicare Advantage Offerings

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Medicare Offerings

•	Preferred Provider Organization (PPO)

•	Health Maintenance Organization (HMO)

•	Special Needs Plan (SNP)

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Health Maintenance Organization (HMO) MODEL OF CARE

ADVANTAGE continues to offer our HMO Plan options through three network choices; Community Health Network, Franciscan St. Francis Health and Wishard Health Services Network. These options combine your Medicare medical benefits and Part D pharmacy benefits to give you a low premium plan. The hospital and physician networks contract with ADVANTAGE giving you access to in network local providers, these include:

Primary Care Physicians (PCP) and specialty physicians
Hospitals within the health system network
Rehabilitation providers
Lab and x-ray providers
Specific programs offered through the health system network

The network contracts with providers that use the same health system, giving you easy access to any provider in the network.

Features of our HMO Plan Offerings:

Over 6,000 providers in network
Communication between PCP and other providers who serve you
More personal care that helps you stay healthy
Low monthly premiums
Low co-pays
Yearly Preventive Services at no cost
Dental and Vision benefits
Prescription drug coverage which includes coverage in the gap (for most plans)
Gym Membership at participating facilities

You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor ADVANTAGE Health Solutions, Inc. will be responsible for the costs.


ADVANTAGE Network HMO $19 / month Includes Medical and Prescription Coverage Tier I & II Prescription Coverage in the Part D Coverage Gap $0 Co-pay for Generic Drugs In Network Benefits only* Dental and Vision Benefits Yearly Preventive Services at no cost Gym Membership at participating facilities View Benefit Details		ADVANTAGE Network HMO $19 / month Includes Medical and Prescription Coverage Tier I & II Prescription Coverage in the Part D Coverage Gap $0 Co-pay for Generic Drugs In Network Benefits only* Dental and Vision Benefits Yearly Preventive Services at no cost Gym Membership at participating facilities View Benefit Details

Members choosing Community Health Network or Franciscan St. Francis Health must live in one of the following counties: Hamilton, Hancock, Johnson, Marion, Morgan.


ADVANTAGE Network HMO $19 / month Includes Medical and Prescription Coverage Tier I & II Prescription Coverage in the Part D Coverage Gap $0 Co-pay for Generic Drugs In Network Benefits only* Dental and Vision Benefits Yearly Preventive Services at no cost Gym Membership at participating facilities View Benefit Details		Wishard Complete Care Basic (HMO) $0 / month Includes Medical and Prescription Coverage Unlimited transportation to approved locations In Network Benefits only* Dental and Vision Benefits For detailed information, please contact an ADVANTAGE Health Solutions Representative View Benefit Details

Members choosing a Wishard plan must live in Marion County.

*You must use plan providers except in emergency or urgent care situations, or for out of area renal dialysis. If you obtain routine care from out of network providers neither Medicare nor ADVANTAGE Health Solutions will be responsible for the costs.

You must continue to pay your Medicare Part B premium.

If you decide to change the way you pay your Plan premium, it may take up to three months for the change to take place.

All Medicare Advantage Plans agree to stay in the program for a full calendar year at a time. Plan benefits and cost-sharing may change from calendar year to calendar year. Each year, plans can decide whether to continue to participate with Medicare Advantage. A plan may continue in their entire service area (geographic area where the plan accepts members) or choose to continue only in certain areas. Also, Medicare may decide to end a contract with a plan. Even if your Medicare Advantage Plan leaves the program, you will not lose Medicare coverage.

The Medicare Program rates how well our plan performs.

Information on our Part C and D rating