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Frequently Asked Questions (FAQs) About Medicare and Medicare-Medicaid Plans

What is a Medicare-Medicaid plan?

A Medicare-Medicaid plan combines all the benefits of Medicare and Medicaid under a single health plan with one ID card.

In Michigan, this type of health plan is called an integrated care organization (ICO). It includes a network of providers, hospitals, pharmacies, nursing facilities, and home and community-based service providers. As a member, you will also have a care team and a Care Coordinator to work directly with you and your health care providers.

Why should I join AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid plan)?

Better care
You get all of your health care services from a Medicare-Medicaid plan of your choice.

Better value
You will have a care team that you choose and that works with you and your providers to create a personal care plan. You choose your providers.

Better health
You will have benefits that help you achieve your health goals. There are even options to stay at home with your family as long as possible instead of using long-term care facilities.

What's different about AmeriHealth Caritas VIP Care Plus?

Our Medicare-Medicaid plan offers you a personal Care Coordinator and a care team. They help you figure out what services you need and where you can get them. By joining AmeriHealth Caritas VIP Care Plus, you will get all the services you need. There are no monthly plan premiums and no costs for covered provider visits or hospital care.

How will I get health care?

When you join AmeriHealth Caritas VIP Care Plus, you can keep seeing your current providers. You can still get all your services while you and your care team create your personal care plan. Your personal care plan will address your specific health and care needs. If you do not have a primary care provider (PCP), we can help you choose one that best meets your needs.

If you have an emergency, you can go to any hospital or urgent care center.

What about my prescription drugs?

You do not need a separate Part D drug plan: AmeriHealth Caritas VIP Care Plus will cover your prescriptions. Our in-network pharmacies will take care of your prescription drug needs. See our list of covered drugs (PDF — July 16, 2019).

What are the basic parts of Medicare?

Medicare is made up of four parts: Part A, Part B, Part C, and Part D.

  • Part A is hospital coverage. It helps cover the costs of being in the hospital as an inpatient, as well as long-term hospitalization. Most people who qualify for Medicare automatically get Part A at no monthly cost.
  • Part B is medical coverage. It helps cover your doctor visits and outpatient care, as well as some preventive services that help maintain your health. Medicare Part B has a monthly premium. After you meet a certain amount of spending, known as your deductible, Part B generally covers about 80 percent of your costs for Medicare-approved services.
  • Part C is also known as a Medicare Advantage plan. Part C is provided by plans like AmeriHealth Caritas VIP Care Plus that have been approved by Medicare and have a contract with the Centers for Medicare and Medicaid Services (CMS) to cover medical and hospitalization care for their members. They can also offer extra benefits that Original Medicare doesn't cover.
  • Part D is prescription drug coverage. Like Part C, it is also provided by private companies like AmeriHealth Caritas VIP Care Plus that have contracts with Medicare. It is designed to lower the amount that you pay for your prescription drugs. You can purchase a Part D plan to go with Original Medicare, or prescription drug coverage may be included with a Medicare Advantage plan.

Who is eligible for Medicare?

Turning 65? Medicare is the federal government's health insurance program. It is also known as Original Medicare. Medicare provides medical and health-related services to:

  • People age 65 or older.
  • People 21 years old and older who have a permanent disability.
  • People of any age who have kidney disease that requires dialysis or a transplant.
  • People of any age who have Lou Gehrig's disease (also called amyotrophic lateral sclerosis [ALS]).

How do I enroll in Medicare?

You are automatically enrolled in Medicare when you turn 65 if you're receiving Social Security benefits or Railroad Retirement Board payments.

  • If you're receiving Social Security benefits or Railroad Retirement Board payments, you'll receive information in the mail three months before your 65th birthday explaining your options.
  • If you become eligible for Medicare because of a disability and have been receiving Social Security Disability Insurance (SSDI) or railroad disability annuity checks for 24 months, you should automatically be enrolled in both Medicare Parts A and B at the start of your 25th month.
  • If you are not yet receiving Social Security payments, then you will have to contact Social Security to enroll.
  • You can call the Social Security Administration at 1-800-772-1213 (TTY/TDD 1-800-325-0778), visit them online at http://www.ssa.gov/, or apply at your local Social Security office. It's a good idea to do this well before your 65th birthday so you can start receiving benefits as soon as you are eligible.

When can I enroll in Medicare?

Medicare limits the times when most people can add, change, or drop coverage. These times are known as election or enrollment periods. However, MI Health Link enrollees may add, change, or drop coverage at any time during the year.

NOTE: Effective January 1, 2019, if you’re in a drug management program, you may not be able to change plans.

What is a health maintenance organization (HMO)?

An HMO is a type of health plan that uses a network of health care providers. These providers — doctors, dentists, nurse practitioners, pharmacies and hospitals—treat members and help prevent them from getting sick.

Ready to enroll?

For information on AmeriHealth Caritas VIP Care Plus and other options for your health care, call Michigan ENROLLS at 1-800-975-7630 (TTY 1-888-263-5897). Office hours are Monday through Friday, 8 a.m. to 7 p.m.

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