2014 SecureCare - Option I (HMO) H5151-004 By The Health Plan

SecureCare - Option I (HMO) By The Health Plan



SecureCare - Option I (HMO) is a 2014 Medicare Advantage ("Part C" or "MA Plan") plan by The Health Plan. This plan from The Health Plan works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for SecureCare - Option I (HMO) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from The Health Plan 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:
SecureCare - Option I (HMO)
Plan ID:
H5151-004
Provider: The Health Plan
Plan Year:2014
Plan Type: Local HMO *
Monthly Premium C+D: $16.00
MOOP: $3,400


Coverage Area for SecureCare - Option I (HMO)

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COMPARE AND SAVE ON MEDICARE INSURANCE




The SecureCare - Option I (HMO) H5151-004 is available to residents in Ohio, West Virginia, and has a in-network Maximum Out-of-Pocket limit of $3,400 MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in SecureCare - Option I (HMO) plan you will stop paying co-pays for the rest of the year once you pay out of pocket $3,400 This is a very nice safety net. This plan does not provide additional Medicare prescription drug (Part-D) coverage.

SecureCare - Option I (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 SecureCare - Option I (HMO) H5151

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 SecureCare - Option I (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 SecureCare - Option I (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.