Health First Offers Numerous Plans to Meet Every Need

If you’re nearing retirement age, or perhaps find yourself in a situation where you’re providing care or advice to a senior citizen, one of the biggest issues you’re going to have to deal with is health care. Medicare offers a number of different options, and Health First is positioning itself to help you manage them.

Let’s start with the original Medicare. There are two different types – Medicare A covers hospital insurance, while Medicare B covers medical insurance. You have your choice of doctors, hospitals and other medical providers, contingent upon whether they accept Medicare. With Medicare A, services like lab tests, surgeries and doctor visits are covered along with supplies like wheelchairs or walkers as long as they are considered medically necessary to treat a disease or condition. Hospital care, skilled nursing facility care, nursing home care, hospice and home health services are all included.

Medicare B usually comes with a monthly premium (in 2013, it was $104.90 with a $147 deductible. Those numbers may change in 2014). It covers medically necessary services or supplies that are needed to treat your medical condition as long as they meet accepted standards of medical practice. It also handles preventive services to avert illnesses like the flu. Also covered under Plan B are clinical research, ambulance services, durable medical equipment, mental health services, inpatient and outpatient care, partial hospitalization, getting a second opinion before surgery and limited outpatient prescription drugs.

The Right Plan, Managed Right

It is not only important to choose the right Medicare program, but also the right health plan to help you manage it. Health First Health Plans received a 4.5 star rating (out of a possible 5) for 2013 from the Medicare Program, which rates all health and prescription drug plans based on quality and performance.

Health First has several Medicare Advantage plans that offer everything the original Medicare plan does along with additional benefits like allowances for dental care, vision and gym memberships. There are no deductibles or cost for preventive services, and you don’t need a referral to see any of the 1,100 in-network providers. Emergent care worldwide is also covered.

There are three plans that include prescription drug coverage – Classic (HMO-POS), Value (HMO) and Rewards (HMO) — and a Secure plan that comes without prescription drug coverage. Each plan has its own unique features. To view them in their entirety, visit health-first.org/ and look up Medicare under the Health Insurance Plans banner.

Counting the Cost

In general terms, the plans have a cost that is added to the Medicare B premium. The Classic plan, for instance, comes with an additional $89 monthly premium and no co-pay for each Medicare-covered visit to your primary physician (there is a $20 co-pay for each Medicare-covered specialist visit).

The Value plan has an additional $29 a month premium. Under that plan, it would cost $5 for a Medicare-covered primary care physician visit and $30 to see a Medicare-covered specialist.

Health First’s Rewards plan has no extra cost to your Medicare B premium, but the co-pay for doctor’s visits jumps to $15 and $45 depending on which type of doctor you see. If that doesn’t suit your needs, Health First also offers three Medicare supplement policy options known as Medigap; there is a Plan A, Plan F and Plan N.

Breaking Down the Plan Types

Plan A offers the lowest premiums, while Plan F includes coverage for Medicare’s Part A and B deductibles and foreign travel emergencies. Plan N covers Medicare’s Part A deductible and foreign travel emergencies. In addition, subscribers receive a free fitness center membership that is not covered by Medicare.

For those simply looking for a stand-alone Prescription Drug Plan (PDP), there is a Basic Plan for 2014. You must live in Florida to join the plan, and you must be entitled to Medicare Part A and enrolled in Medicare Part B. The Health First Basic Plan has a network of pharmacies, and you must use a network pharmacy to receive your benefits.

Health First offers free seminars to go over all of the Medicare benefits it provides. To reserve a seat at a seminar, ask questions about benefits or enrollment, or request a Medicare consultant to visit your home call 1-800-716-7737.