AGENT LOGIN

Call Us Today At 317-328-0800 For All Of Your Insurance and Retirement Needs

  • About
  • Health Insurance
    • Individual Insurance
    • Group Insurance
    • Disability Insurance
    • Voluntary Benefits
  • Senior Division
    • Medicare Supplements
    • Medicare Advantage >
      • Medicare Adv Options
      • Beneficiary Protections
      • Benefits and Limitations
      • Medicare Managed Plans
    • Long Term Care
  • Retirement Division
    • Life Insurance
    • Annuities
  • Login
  • Contact

BENEFICIARY PROTECTIONS OF MEDICARE ADVANTAGE PLANS

Medicare Advantage Plans: Beneficiary Protections
  • Guaranteed Issue:  The plan must enroll you if you meet the requirements.
  • Care must be available 24 hours per day, seven days a week.
  • You must have access to specialists.
  • Doctors must be allowed to inform you of all treatment options.
  • The plan must have a grievance and appeal procedure.
  • If a layperson would think that a symptom could be an emergency, then the plan must pay for the emergency treatment.

Medicare Advantage Managed Care Plans: Beneficiary Protections
  • The plan cannot charge more than a $50 copayment for visits to the emergency room.
  • You or your doctor can appeal a denial of service and the appeal must be handled in a "timely" way.  The plan must make an initial determination within 14 days.  Reconsideration of a decision must be made within 30 days.  Decisions regarding urgent care must be made within 72 hours.
  •  The plan must have a process for identifying and evaluating persons with complex or serious medical conditions.  A treatment plan must be developed within 90 days of your enrollment. 
  • If your treatment plan includes specialists, you must have direct access to those specialists.  You do not need a referral from your primary care physician.

LEARN MORE ABOUT:

Medicare Adv Overview
Medicare Adv Options
benefits and limitations
Managed Care Plans

More Senior Products

Medicare Supplements
Long Term Care

    Have Questions?

Submit
CONTACT:

Phone: 317-328-0800

Fax: 317-328-3462


Address:
5730 W. 74th St.
Indianapolis, IN 46278
SITEMAP:
Health Insurance:
Individual Health
Group Health

Disability
Senior Products:
Medicare Supplements
Medicare Advantage
Long Term Care
Retirement Products
Annuities
Life Insurance
Members Only
Quoting Engines 
Carrier Forms
Midwest Insurance Marketers of America, Inc., and/or its affiliates, which issue insurance proposals for Individual Health, Group Health, Life, Disability, Long Term Care, Annuities, Senior Life and Health products consisting of Final Expense Life Insurance, Medicare Supplement plans,  Part “C” Advantage Plans and Part “D” Prescription Drug plans are authorized/certified on behalf of various insurance carriers to transact business in Indiana and various other states as a Licensed Insurance Agency. The availability of these and other products varies by carrier and state. Each insurer represented is solely responsible for its’ own financial condition and contractual obligations.