Medicare Advantage plans cover everything that Original Medicare covers, plus more. Many Medicare Advantage plans, including Aspire Health plans, cover Part D prescription drugs, transportation, acupuncture, and chiropractic. What’s more, our plans do not have an annual medical or hospital deductible — so you are covered from the start.
Full Answer
Is aspire health plan a Medicare plan?
Aspire Health Plan is a Medicare Advantage HMO plan sponsor with a Medicare contract. Enrollment in Aspire Health Plan depends on contract renewal. This information is not a complete description of benefits.
What does Medicare Advantage cover?
Most Medicare Advantage Plans offer coverage for things Original Medicare doesn't cover, like fitness programs (like gym memberships or discounts) and some vision, hearing, and dental services. Plans can also cover even more benefits.
What are the different types of Medicare Advantage plans?
Other less common types of Medicare Advantage Plans that may be available include HMO Point of Service (HMOPOS) Plans and a Medicare Medical Savings Account (MSA) Plan. Who can join a Medicare Advantage Plan?
What costs are lower in a Medicare Advantage plan?
Health or prescription drug costs that you must pay on your own because they aren’t covered by Medicare or other insurance. may be lower in a Medicare Advantage Plan. If so, this option may be more cost effective for you. Note: You may be charged
What is included in a Medicare Advantage plan?
Medicare Advantage Plans must offer emergency coverage outside of the plan's service area (but not outside the U.S.). Many Medicare Advantage Plans also offer extra benefits such as dental care, eyeglasses, or wellness programs. Most Medicare Advantage Plans include Medicare prescription drug coverage (Part D).
Does Medicare cover aspire?
Medicare Advantage plans cover everything that Original Medicare covers, plus more. Many Medicare Advantage plans, including Aspire Health plans, cover Part D prescription drugs, transportation, acupuncture, and chiropractic.
What is a key advantage of Medicare Advantage plans?
If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
What is the difference between Medicare Advantage and Medicare Advantage PPO?
A Preferred Provider Organization (PPO) plan is a Medicare Advantage Plan that has a network of doctors, specialists, hospitals, and other health care providers you can use, but you can also use out-of-network providers for covered services, usually for a higher cost.
What is Aspire health?
Aspire Wellbeing offers a wide range of services to promote health, independence and wellbeing for individuals and those close to them – especially individuals experiencing sudden and/or long-term issues that have reduced their ability to live independently and feel safe and well.
Does insurance cover aspire?
Aspire General car insurance is only available in California....Age GroupAnnual CostAnnual Savings after Switching to Aspire Advantage with Jerry55-64$1,382$84665+$1,001$3475 more rows
What are 4 types of Medicare Advantage plans?
Below are the most common types of Medicare Advantage Plans.Health Maintenance Organization (HMO) Plans.Preferred Provider Organization (PPO) Plans.Private Fee-for-Service (PFFS) Plans.Special Needs Plans (SNPs)
What is the most popular Medicare Advantage plan?
AARP/UnitedHealthcare is the most popular Medicare Advantage provider with many enrollees valuing its combination of good ratings, affordable premiums and add-on benefits. For many people, AARP/UnitedHealthcare Medicare Advantage plans fall into the sweet spot for having good benefits at an affordable price.
What are the advantages and disadvantages of Medicare Advantage plans?
Medicare Advantage offers many benefits to original Medicare, including convenient coverage, multiple plan options, and long-term savings. There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling.
Can you have Medicare and Medicare Advantage at the same time?
“Dual eligibles” can have both Medicare Advantage and Medicaid at the same time. 4. Private healthcare providers offer specialized plans for dual eligibles that can coordinate Medicaid benefits with a Medicare Advantage plan.
What is the biggest disadvantage of Medicare Advantage?
Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.
Do doctors prefer HMO or PPO?
PPOs Usually Win on Choice and Flexibility If flexibility and choice are important to you, a PPO plan could be the better choice. Unlike most HMO health plans, you won't likely need to select a primary care physician, and you won't usually need a referral from that physician to see a specialist.
What does Medicare include?
Original or traditional Medicare includes Part A and Part B. Medicare Part A is hospital insurance and helps cover: Inpatient hospital care Skilled...
How does Medicare work?
Original Medicare beneficiaries usually don’t pay a monthly premium for Medicare Part A (hospital insurance) coverage if either they or their spous...
What about prescription drugs?
For prescription drug coverage, you may join a stand-alone Prescription Drug Plan (PDP) or a Medicare Advantage Part C (MAPD) plan such as Aspire H...
What is a Medicare Advantage plan?
Medicare Advantage plans are referred to as Medicare Part C. They are offered by private companies who have a contract with the Centers for Medica...
Why choose a Medicare Advantage plan instead of Original Medicare?
One third of Medicare beneficiaries are on Medicare Advantage plans. Medicare Advantage plans cover everything that Original Medicare covers, plus...
What is a coordinated care plan?
A coordinated care plan provides the right care in the right place at the right time. Aspire works directly with members and their care providers (...
Why choose our Aspire Health Plan over a Medicare supplement (Medigap) plan?
Insurance companies offer Medicare Supplement insurance. Aspire Medicare Advantage, however, is more than that. Our plans include prescription drug...
Can I continue to see my doctor?
Aspire partners with all four hospitals and more than 700 doctors and other providers in Monterey County. Our network of primary care physicians an...
How is Aspire’s HMO-POS plan different than the two HMO plans that Aspire offers?
All of our Medicare Advantage plans use an HMO network of doctors, specialists, hospitals, and other medical service providers. With any Aspire Hea...
Why Aspire Health Plan?
Our Aspire Health Value (HMO), Aspire Health Advantage (HMO) and Aspire Health Plus (HMO-POS) Medicare Advantage plans offer more benefits than original Medicare at affordable rates.
Important plan documents
Important documents about your plan, or to help you decide which Aspire Health Plan option is right for you.
Health and wellness benefits
Aspire Health Plan offers additional health and wellness benefits to our members to support their well-being through coaching, education, screenings, a fitness benefit and even door-to-door transportation.
Drug coverage
Everything you need to know about Aspire Health Plan’s covered Part D drugs.
Service area
Aspire Health Plan’s service area is all of Monterey County, California. It serves the needs of beneficiaries in cooperation with local doctors, hospitals, and caregivers.
Testimonials
Hear from Aspire members why they chose their Medicare Advantage plan.
What is Aspire Health Plan?
Aspire Health Plan’s prescription drug formulary or “Drug list” is a list of prescription drugs covered by the plan. The drugs on this list are selected by the plan with the help of doctors and pharmacists. The list includes both brand name and generic drugs. To search for your medications, please visit our Formulary:
What is MTM in Aspire?
MTM is a service offered by Aspire Health Plan at no additional cost to you! The MTM program is required by the Centers for Medicare and Medicaid Services (CMS) and is not considered a benefit. This program helps you and your doctor make sure that your medications are working.
What is a Medicaid printout?
a screen printout from the state’s Medicaid information system showing that individual’s institutional status based on at least a full calendar month stay for Medicaid payment purposes.
Where do you fill prescriptions for long term care?
The prescription must be filled at a network pharmacy . (Please note that the long-term care pharmacy may provide the drug in smaller amounts at a time to prevent waste.) For those members who have been in the plan for more than 90 days and reside in a long-term care (LTC) facility and need a supply right away:
Can a prescription drug transition plan offer a temporary supply?
Prescription drug transition policy. Under certain circumstances, the plan can offer a temporary supply of a drug to you when your drug is not on the Drug List or when it is restricted in some way.
Does Aspire Health Plan cover step therapy?
Step Therapy. In some cases, Aspire Health Plan may require you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. This is called Step Therapy. For more details on Step Therapy, click here.
How long do you have to apply for enhanced benefits?
If you don’t elect coverage at that time, you will have a short grace period in which you may still add the Enhanced Benefits, but you must apply for them within 90 days of your health plan effective date. After the 90-day window has passed, you will have to wait until the next Annual Election Period (AEP) to add them.
Do you have to pay a monthly premium for Medicare?
Original Medicare beneficiaries usually don’t pay a monthly premium for Medicare Part A (hospital insurance) coverage if either they or their spouse paid Medicare taxes while working. However, those who don’t qualify for Part A at no cost can still buy Part A. Part B (medical insurance) does require that Medicare beneficiaries pay a monthly premium.
Does Aspire offer Medicare Supplement?
Insurance companies offer Medicare Supplement insurance. Aspire Medicare Advantage, however, is more than that. Our plans include prescription drug coverage, making them a one-stop shop for all your healthcare needs, so you get an all-in-one plan with just one card.
Does Medicare cover acupuncture?
Finally, Medicare supplement premiums can vary widely and typically do not cover prescription drugs or other additional benefits, such as transportation, gym membership, chiropractic, and acupuncture. With a Medicare Advantage plan such as ours, premiums remain the same regardless of your age and health history.
Does Medicare require a monthly premium?
Part B (medical insurance) does require that Medicare beneficiaries pay a monthly premium. This amount can vary, depending on income level, and is often deducted from your Social Security check. You can contact Social Security for more information about Part A and Part B premiums.
Does Medicare Advantage cover chiropractic?
Medicare Advantage plans cover everything that Original Medicare covers, plus more. Many Medicare Advantage plans, including Aspire Health plans, cover Part D prescription drugs, transportation, acupuncture, and chiropractic. What’s more, our plans do not have an annual medical or hospital deductible — so you are covered from the start.
What is Medicare Advantage?
Most Medicare Advantage Plans offer coverage for things that aren't covered by Original Medicare, like vision, hearing, dental, and wellness programs (like gym memberships). Plans can also cover more extra benefits than they have in the past, including services like transportation to doctor visits, over-the-counter drugs, adult day-care services, ...
What happens if you have a Medicare Advantage Plan?
If you have a Medicare Advantage Plan, you have the right to an organization determination to see if a service, drug, or supply is covered. Contact your plan to get one and follow the instructions to file a timely appeal. You also may get plan directed care.
How much is Medicare Advantage 2021?
In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan. In 2021, the standard Part B premium amount is $148.50 (or higher depending on your income). If you need a service that the plan says isn't medically necessary, you may have to pay all the costs of the service.
What is Medicare health care?
Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine. under Medicare. If you're not sure whether a service is covered, check with your provider before you get the service.
Is Medicare Advantage covered for emergency care?
In all types of Medicare Advantage Plans, you're always covered for emergency and. Care that you get outside of your Medicare health plan's service area for a sudden illness or injury that needs medical care right away but isn’t life threatening.
Does Medicare cover hospice?
Medicare Advantage Plans must cover all of the services that Original Medicare covers. However, if you’re in a Medicare Advantage Plan, Original Medicare will still cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies. In all types of Medicare Advantage Plans, you're always covered for emergency and Urgently needed care.
Why do you keep your Medicare card?
Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. Below are the most common types of Medicare Advantage Plans. An HMO Plan that may allow you to get some services out-of-network for a higher cost.
What is MSA plan?
Medicare Medical Savings Account (Msa) Plan. MSA Plans combine a high deductible Medicare Advantage Plan and a bank account. The plan deposits money from Medicare into the account. You can use the money in this account to pay for your health care costs, but only Medicare-covered expenses count toward your deductible.
What is a special needs plan?
Special Needs Plans (SNPs) Other less common types of Medicare Advantage Plans that may be available include. Hmo Point Of Service (Hmopos) Plans. An HMO Plan that may allow you to get some services out-of-network for a higher cost. and a. Medicare Medical Savings Account (Msa) Plan.
Does Medicare Advantage include drug coverage?
Most Medicare Advantage Plans include drug coverage (Part D). In many cases , you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs.
What to know about Medicare Advantage?
Things to know about Medicare Advantage Plans. You're still in the Medicare Program. You still have Medicare rights and protections. You still get complete Part A and Part B coverage through the plan. Some plans offer extra benefits that Original Medicare doesn ’t cover – like vision, hearing, or dental. Your out-of-pocket costs may be lower in ...
Can you check with a health insurance plan before you get a service?
You can check with the plan before you get a service to find out if it's covered and what your costs may be. Following plan rules, like getting a Referral to see a specialist in the plan's Network can keep your costs lower. Check with the plan.
Can you pay more for a Medicare Advantage plan than Original Medicare?
Medicare Advantage Plans can't charge more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care. Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services.