Whether you're trying to choose a plan, understand Medicare and Social Security rules, or save money on your healthcare expenses, we encourage you to ask questions and learn more. Good information can help you make the right decision.
Contact our customer service representatives to reserve your seat at a free seminar, ask questions about benefits and enrollment, request a Medicare Consultant visit your home, and more.
Member Legal Rights and Responsibilities
SHINE (Serving the Health Insurance Needs of the Elderly) is a volunteer program sponsored by the Florida Department of Elder Affairs that offers free, unbiased insurance counseling. SHINE provides educational materials to seniors, their caregivers, and family members, on a variety of topics, including Medicare, Medicaid, prescription assistance, long-term care planning, and more. Offices are located throughout Brevard, and staff can visit your home if necessary. Visit www.floridashine.org or call 1-800-963-5337 for more information.
My Advocate™ by Altegra Health is a private social service organization that we contract with to provide free education to our members and help them through the process of enrolling in an array of federal, state and local social programs, such as Medicare Savings Programs (to help pay for Part B premiums), and Low Income Subsidy (to help pay for Part D prescription drug premiums and copays). Their mission is to ensure every eligible person receives the social program benefits to which she or he is entitled.
Members and non-members can visit Social Service CheckUp to see if you qualify for discounts on social services and community assistance programs like meals, utilities, home care, and more. It's just one way My Advocate™ assists in connecting you with programs designed for saving money.
For more information, please contact Florida Hospital Care Advantage's Customer Service Department.
Visit www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week (TTY/TDD: 1-877-486-2048 for the hearing impaired).
Our Customer Service Representatives are dedicated to personally solving any problems you may have with us and our providers to your full satisfaction. If you prefer to contact the Centers for Medicare and Medicaid Services (CMS) directly, please visit Medicare's web site:
Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal.
The benefit information provided is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Limitations, co-payments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/co-insurance may change on January 1 of each year.
Availability of coverage beyond the end of the current contract year is not guaranteed. Members may enroll in these plans only during certain times of the year. Contact Health First Health Plans for more information. Individuals must have both Medicare Part A and Part B to enroll in the plan. You must continue to pay your Medicare Part B premium. Limitations, copayments, and restrictions may apply.
You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances when you cannot reasonably use a network pharmacy. Quantity limitations and restrictions may apply.
Health First Medicare Advantage Plans cover emergency services and unforeseen urgently needed medical care outside the United States, including when you are on a cruise ship. If you receive covered care from a provider outside the United States that does not participate with Medicare, you may be asked to pay up front for the services and be reimbursed from the plan later. We will pay up to 115% of the Medicare-allowed amount in our service area (Medicare's limiting charge for non-participating providers), less any applicable cost-share. Please note that Medicare-allowed amounts can be much less than the provider charges you, and you will be responsible for paying the difference.
This information is available for free in other languages. Please call our Customer Service Department at 1-800-716-7737, or through TDD/TTY relay 1-800-955-8771 any day of the week from 8 am to 8 pm. Esta información está disponible de forma gratuita en otros idiomas. Comuníquese con nuestro Servicio al Cliente al 1-800-716-7737, TTY/TDD 1-800-955-8771 (lunes-domingo 8 am-8 pm).
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't even know it. For more information about this extra help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.
You can also contact Social Security or Medicaid to find out your LIS status or level. Unless your plan includes POS or Visitor/Travel program benefits, you must use plan providers except in emergency or urgent care situations, or for out-of-area renal dialysis. With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers. Health First Health Plans cannot require out-of-network providers to see our members. If your plan does not include POS or Visitor/Travel program benefits and you obtain routine care from out-of-network providers, neither Medicare nor Health First Health Plans will be responsible for the cost.
Medicare beneficiaries may enroll in Health First Medicare Plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
For more information on authorizations, eligibility, enrollment, pharmacies, prescriptions, or any other benefits, please contact Health First Health Plans Customer Service:
Y0089_MP3862FH Approved 04082014
Last updated: 03/04/2014