SecureCare - Option I (HMO) is a 2015 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.
Advantage 1000 De Troubleshooting
The plan includes a full spectrum of covered services and direct access to specialists without the need to gain approval from a primary care doctor. Members have the freedom to see any health care professional or visit any facility in our nationwide network, including specialists, without a referral and without choosing a primary physician. Medicare Managed Care Manual Chapter 11 - Medicare Advantage Application Procedures and Contract Requirements (Rev. 83, ) NOTE: This chapter addresses Medicare Advantage contract requirements only, and does not address Medicare cost-based managed care contract requirements.
2015 Medicare Advantage Plan Details
| Plan Name: | |
|---|---|
| Plan ID: | H5151-012 |
| Provider: | The Health Plan |
| Plan Year: | 2015 |
| Plan Type: | Local HMO * |
| Monthly Premium C+D: | $35.00 |
| MOOP: | $6,700 |
- Strike (Fail-Secure) Use the following steps to connect the 232e keypad to an electric strike (fail-secure) (seeFigure6forreference): 1. Connect the red wire (V+) to the blue wire (common), and then connect them to the positive on the power supply. Connect the green wire (normally open) to the positive on the strike.
- Secure Care De 1000 Programing Advantage 1000DE Legacy Series: Advantage 1000 DE™ is two systems for the price of one. The Advantage 1000 DE™ can operate as a SMARTLOC™ system which is unlocked for normal traffic flow and will lock only when a monitored resident approaches the door.
Coverage Area for SecureCare - Option I (HMO)
(Click county to compare all available plans)
| State: | Ohio West Virginia |
|---|---|
| County: | Belmont, Guernsey, Harrison, Jefferson, Monroe, Muskingum, Noble, Washington, Barbour, Boone, Braxton, Brooke, Cabell, Calhoun, Clay, Doddridge, Fayette, Gilmer, Grant, Greenbrier, Hancock, Hardy, Harrison, Jackson, Lewis, Lincoln, Logan, Marion, Marshall, Mason, McDowell, Mercer, Monongalia, Monroe, Nicholas, Ohio, Pleasants, Pocahontas, Preston, Putnam, Raleigh, Randolph, Ritchie, Roane, Summers, Taylor, Tucker, Tyler, Upshur, Wayne, Webster, Wetzel, Wirt, Wood, Wyoming, |
The SecureCare - Option I (HMO) H5151-012 is available to residents in Ohio, West Virginia, 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 SecureCare - Option I (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 provideadditional 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
| 2015 Overall Rating |
|---|
| Part C Summary Rating |
| Part D Summary Rating |
| Staying Healthy: Screenings, Tests, Vaccines |
| Managing Chronic (Long Term) Conditions |
| Member Experience with Health Plan |
| Complaints and Changes in Plans Performance |
| Health Plan Customer Service |
| Drug Plan Customer Service |
| Complaints and Changes in the Drug Plan |
| Member Experience with the Drug Plan |
| Drug Safety and Accuracy of Drug Pricing |
Member Experience with Health Plan
| Total Experience Rating |
|---|
| Getting Needed Care |
| Timely Care and Appointments |
| Customer Service |
| Health Care Quality |
| Rating of Health Plan |
| Care Coordination |
Member Complaints and Changes in SecureCare - Option I (HMO) Plans Performance
| Total Rating |
|---|
| Members Leaving the Plan |
| Complaints about Health Plan |
| Health Plan Quality Improvement |
Health Plan Customer Service Rating for SecureCare - Option I (HMO)
Advantage 1000 Programming Manual
| Total Customer Service Rating |
|---|
| Timely Decisions About Appeals |
| Reviewing Appeals Decisions |
Staying Healthy, Screening, Testing, & Vaccines
| Total Preventative Rating |
|---|
| Breast Cancer Screening |
| Colorectal Cancel Screening |
| Cardiovascular Screening |
| Diabetes Care |
| Annual Flu Vaccine |
| Improving Physical |
| Improving Mental Health |
| Monitoring Physical Activity |
| Adult BMI Assessment |
Ratings For Managing Chronic And Long Term Care
| Total Rating |
|---|
| SNP Care Management |
| 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 |
Ratings For Member Experience with the Drug Plan
| Total Rating |
|---|
| Rating of Drug Plan |
| Getting Needed Prescription Drugs |
Drug Safety and Accuracy of Drug Pricing
| Total Rating |
|---|
| MPF Price Accuracy |
| High Risk Medication |
| Diabetes Treatment |
| Drug Adherence for Diabetes Medications |
| Drug Adherence for Hypertension (RAS antagonists) |
| Drug Adherence for Cholesterol (Statins) |
Ratings For Member Complaints and Changes in the Drug Plans Performance
| Total Rating |
|---|
| Complaints about the Drug Plan |
| Members Choosing to Leave the Plan |
| Drug Plan Quality Improvement |
SecureCare - Option I (HMO) Drug Plan Customer Service ratings
Secure Care Advantage 1000 De Manual
Source: CMS.Plans as of September 2, 2014.
Star Rating as of Oct 3, 2014.
Secure Care Advantage 1000 De Manual En
For More Information on Ratings Please See the CMS Tech Notes Here.
Notes: Data are subject to change. All contracts for 2015 have been finalized. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit
Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.