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Disclaimers
- You will need to keep Medicare Parts A and B and you must continue to pay your Medicare Part B premium, even if the plan premium is $0.
- The Health Plan’s contract with CMS (Medicare/Medicaid Services), is renewed annually and the availability of coverage beyond the end of the current contract year is not guaranteed.
- THP Insurance Company's contract with CMS (Medicare/Medicaid Services), is renewed annually and the availability of coverage beyond the end of the current contract year is not guaranteed.
SecureCareHMO
I understand that beginning on the date The Health Plan SecureCareHMO coverage begins, I must use plan providers except in emergent or urgent care situations or for out-of-area renal dialysis. If I obtain routine care from out-of-network providers neither Medicare nor The Health Plan will be responsible for the costs. Services authorized by The Health Plan/THP and other services contained in my SecureCareHMO Evidence of Coverage document (also known as a member contract or subscriber agreement) will be covered. Without authorization, NEITHER MEDICARE NOR THE HEALTH PLAN WILL PAY FOR THE SERVICES.
SecureChoicePPO
I understand that when THP Insurance Company SecureChoicePPO coverage begins, using services in-network can cost less than using services out-of-network, with the exception of emergency or urgently needed services or out-of-area dialysis services. THP Insurance Company provides reimbursement for all covered benefits regardless of whether they are received in-network as long as they are medically necessary. Services authorized by The Health Plan/THP Insurance Company and other services contained in my SecureChoicePPO Evidence of Coverage document (also known as a member contract or subscriber agreement) will be covered. Without authorization, NEITHER MEDICARE NOR THP INSURANCE COMPANY WILL PAY FOR THE SERVICES.
Changing your method of premium payment: If you decide to switch to premium withhold or move from premium withhold to direct bill, it could take up to three months for it to take effect and you will be ultimately held responsible for those premiums.
