2014 Health Partners Medicare Basic (HMO) H9207-001 By Health Partners Medicare

Health Partners Medicare Basic (HMO) By Health Partners Medicare



Health Partners Medicare Basic (HMO) is a 2014 Medicare Advantage ("Part C" or "MA Plan") plan by Health Partners Medicare. This plan from Health Partners Medicare works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for Health Partners Medicare Basic (HMO) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from Health Partners Medicare and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.



2014 Medicare Advantage Plan Details

Plan Name:
Health Partners Medicare Basic (HMO)
Plan ID:
H9207-001
Provider: Health Partners Medicare
Plan Year:2014
Plan Type: Local HMO *
Monthly Premium C+D: $-
MOOP: $6,700


Coverage Area for Health Partners Medicare Basic (HMO)

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COMPARE AND SAVE ON MEDICARE INSURANCE




The Health Partners Medicare Basic (HMO) H9207-001 is available to residents in Pennsylvania, and has a in-network Maximum Out-of-Pocket limit of $6,700 MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in Health Partners Medicare Basic (HMO) plan you will stop paying co-pays for the rest of the year once you pay out of pocket $6,700 This is a very nice safety net. This plan does not provide additional Medicare prescription drug (Part-D) coverage.

Health Partners Medicare Basic (HMO) is a Local HMO *. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you need special care for a physician specialist, your primary care physician will make the arrangements and tell you where you can go in the network. You will need your PCPs okay, called a referral. Without getting a referral or services received from out-of-network providers are not typically covered by the plan.



Ratings for Health Partners Medicare Basic (HMO) H9207

2014 Overall Rating
Part C Summary Rating
Total Experience Rating
Complaints, Improvements
Total Customer Service Rating
Total Preventative Rating
Chronic And Long Term Care


Member Experience Rating for Health Partners Medicare Basic (HMO)

Total Experience Rating
Getting Needed Care
Timely Care and Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination


Member Complaints, Problems Getting Service and Improvements in Health Plans

Total Rating
Members Leaving the Plan
Complaints about Health Plan
Access to Service
Performance Problems
Health Plan Quality Improvement


Customer Service Rating for Health Partners Medicare Basic (HMO)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions
Call Center


Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancel Screening
Cardiovascular Screening
Diabetes Care
Glaucoma Testing
Annual Flu Vaccine
Improving Physical
Improving Mental Health
Monitoring Physical Activity
Adult BMI Assessment


Ratings For Managing Chronic And Long Term Care

Total Rating
Medication Review
Functional Status Assessment
Pain Screening
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Diabetes Care - Cholesterol
Controlling Blood Pressure
Rheumatoid Arthritis
Improving Bladder Control
Reducing Risk of Falling
Plan - Cause Readmissions


Source: CMS.
Plans as of September 3, 2013.
Star Rating as of September 27, 2013.
For More Information on Ratings Please See the CMS Tech Notes Here.
Plans are subject to change as contracts are finalized.
Includes 2014 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.