Member FAQ
Q: I’ve heard about some penalties that arise if I don’t join a plan with prescription drug coverage. What
are those?
A: If you didn’t join a plan by May 15, 2006 (and were eligible to do so at that time), and didn’t have a drug
plan that, on average, covered at least as much as
standard Medicare prescription drug coverage,
when you do join, your premium cost will go up
at least 1% for every month that you waited to join
since May 2006. You will have to pay this penalty
for as long as you have Medicare prescription drug
coverage. The next enrollment period is November 15
to December 31, 2008. Remember, while you must
enroll during this period, your coverage will not
take effect until January 1, 2009.
Q: If I join and develop a medical condition, will my membership be cancelled?
A: No. Once you join a Medicare Advantage plan, your continued membership is guaranteed and will not be
cancelled because of a medical condition you may
develop. The government has, however, established
some limits on membership. People who have End
Stage Renal Disease (ESRD) (permanent kidney failure treated
with dialysis or a transplant) may not be able to enroll
in a Medicare Advantage plan. However, if you
develop ESRD while you are a member, you will
not be disenrolled.
Q: If I have never enrolled in a Medicare Advantage
plan, can I try out a TexasFirst Health Plan
without losing my Medicare Supplement?
A: You can keep your Medicare Supplement as long
as you’d like, but you’ll probably find that our plans
cover the same benefits at a lower cost to you. If you
join a Medicare Advantage plan or other Medicare
health plan when you first become eligible for
Medicare, or if this is the first time you’ve joined
a Medicare Advantage plan or other Medicare health
plan, you may have special Medigap protections that
give you the right to get your old Medigap policy back
or buy a new one later if you choose to leave your plan
within the first year. It’s best to check your options
with a Real Help Representative so you can ensure
that you’re not missing out on important benefits.
Q: I’m eligible for both Medicare and Medicaid. Which
one of your plans is right for me?
A: Please contact a Real Help Representative for details
about our plans designed especially for those who
have both Medicare and Medicaid. |
