WVU Medicine -The Health Plan SecureCare HMO

H3672-025-HMO

Plan Overview

SecureCare (HMO) is a Medicare Advantage Health Maintenance Organization (HMO). It covers all of the health care you need, including preventive care, doctor visits, hospital stays, surgery and (if you choose) prescription drugs. In most cases, members must have access care from a network of providers.

Out-of-network coverage is limited to emergency services, urgently needed services, out-of-area renal dialysis and prior authorizations. Members have access to a broad network of health care providers from over 45 counties in Ohio and West Virginia.

If you have any questions regarding receiving care or services from an out-of-network provider, please contact The Health Plan Customer Service at 1.877.847.7907 (TTY: 711).

There are no plan deductibles.

If you would like to talk to someone regarding your possible plan options, or for more information on the Medicare Advantage Plans offered by The Health Plan, please call 1.877.847.7915 (TTY: 711) , or fill out a form to Request More Information.

Coverage Area

West Virginia
Berkeley, Harrison, Marion, Marshall, Mineral, Monongalia, Upshur, Wetzel, Wood

We have designed our Medicare managed care plans with a focus on choosing a doctor who knows you, a hospital that is close to home, access to doctors who specialize in care of seniors and service that is responsive and personal. We are giving you the health coverage you need, and the peace of mind you want. Below you will find links to documents that include more information about your coverage. Click on one of the links below to learn more.

 

Summary of Benefits

This document provides a summary of your medical and prescription drug benefits, including copay information.

 

Evidence of Coverage

Detailed explanation of the health and/or prescription drug benefits and services available to you.

 

Annual Notice of Change (ANOC)

Each fall, Medicare allows you to change your Medicare health and drug coverage during Annual Enrollment Period.

 

Medicare Health and Prescription Drug Plan Ratings

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. Medicare rates how well Medicare Advantage plans perform in different categories such as rating from patients, patient safety, customer service and detecting and preventing illness.

 

Coverage Decision, Appeals & Grievance

Includes information and documents about our coverage decision, appeals, and grievances processes.

 

Terminating Membership

Information refers to beneficiaries, plan rights, and your responsibility upon disenrollment.