Know Your Medicare Options.
It’s easier than ever to get the answers you need.
Call 833-503-6863 to speak to a Medicare Advantage Specialist.
What is Medicare and Medicare Advantage?
Medicare is an insurance program offered through the federal government that covers medical services and hospital care for people 65 or older, younger people with certain disabilities and people with End Stage Renal Disease (ESRD).
Medicare Advantage is insurance offered by Medicare approved private companies to provide all the benefits of Part A and Part B plus additional benefits that Medicare does not cover. Many Medicare Advantage plans cover prescription drugs within their plans.
Medicare Basics
Part A of Medicare helps cover:
- Inpatient hospital care
- Skilled nursing facility care
- Home health care
- Hospice care
- Blood
Part B of Medicare helps cover:
- Doctors office visits
- Outpatient care
- Home health care
- Durable medical equipment
- Some preventive services
- Prescription drugs-under certain circumstances
Additional Coverage Options
Part C of Medicare is a Medicare Advantage Plan. It covers:
- Part A
- Part B
- Sometimes part D of Medicare
Part D of Medicare Helps cover:
- Prescription Drugs
Are you eligible for Medicare Advantage?
You are entitled to Part A
You are enrolled in Part B (premium may be required)
You are a US Citizen or Lawful Resident
You are a permanent resident of the plan’s service area
Experience Care N’ Care
You deserve a Medicare Advantage plan that makes it easy to get the care you need, when you need it.
Care N’ Care is a local Medicare Advantage health plan owned by Southwestern Health Resources, providing North Texas Medicare beneficiaries in Collin, Cooke, Dallas, Denton, Erath, Hood, Johnson, Palo Pinto, Parker, Rockwall, Somervell, Tarrant, and Wise Counties affordable alternatives that improve and simplify Medicare coverage.
With both HMO and PPO Medicare Advantage health plans, Care N’ Care offers all of the benefits included in original Medicare plus additional benefits and services, including our Customer Experience Team to assist you throughout your healthcare experience.
Medicare Advantage Frequently Asked Questions
Q: Am I eligible for Medicare?
You are eligible for Original Medicare (A and B) if:
- You are at least 65 years old, or you are under 65 and qualify for disability.
AND
- You are a U.S. citizen or a legal resident who has lived in the U.S. for at least five consecutive years.
Q: Can I get Medicare if I am still working?
Yes! Even if you keep health insurance through an employer, speak to a Medicare Specialist to learn how you can ensure you’re not penalized when you enroll in Medicare later.
Q: What is Original Medicare as a Standalone
Part A of Medicare helps cover:
- Inpatient hospital care
- Skilled nursing facility care
- Home health care
- Hospice care
- Blood
Part B of Medicare helps cover:
- Doctors office visits
- Outpatient care
- Durable medical equipment
- Home health care
- Some preventive services
- Prescription drugs-under certain circumstances
› Copay and Coinsurance paid by you
› No Drug Coverage leaving you exposed to penalties
› No maximum out-of-pocket
Q: What can I expect when joining a Medicare Advantage Plan
- You will continue to pay your Part B Premium.
- Your current plan may be affected if you join a Medicare Advantage plan.
- You will use your plan’s member ID card instead of your Medicare card.
- Medicare Supplement (Medigap policy) and Medicare Advantage Plans (Part C) are not the same thing.
- Using network providers will help keep your costs lower.
- Medicare Advantage plans offer a Maximum Out-Of-Pocket amount.
- If you enroll in Part D late, you may have to pay a penalty.
- A Medicare Advantage plan offers additional benefits in addition to what Original Medicare covers.
- If receiving assistance from a sales agent, broker, or other individual employed by or contracted with a Medicare Advantage plan, he/she may be paid a commission based on your enrollment in the plan.
Q: How does an HMO plan work?
- You choose a Primary Care Physician who will help navigate your healthcare needs.
- You choose network providers and facilities to receive your healthcare services.
- Our network arrangements allow us to create savings that we share with you.
- If you need emergency or urgent services, go to the emergency room closest to you!
- You may need a referral to see specialists and receive certain services.
- Lower out-of-pocket costs
- You have the ability to select a different Primary Care Physician as needed.
Q: How does a PPO plan work?
- You have a network of doctors, specialist and facilities contracted with the plan to provide services.
- You can see providers out-of-network. Reminder– providers that do not contract with us are not obligated to treat you, except in emergency situations. Cost- sharing will be lower at in-network providers.
- You should expect to pay more if you choose to use out-of-network providers.
- PPO plans may not impose prior authorization requirements for Out-of-Network services but member or provider can request an advance determination of coverage.
Download the 2024 Medicare Questions? Answered. Guide
A resource to help you navigate your Medicare options.
Ready to Get Started?
Call one of our Medicare Specialist today at 833-503-6863 (TTY 711). They are available 8am to 8pm, CST seven days a week from October 1 – March 31, or 8am to 8pm, CST, Monday through Friday April 1 – September 30 to help with any questions you may have.
