Medicare Select Plan Description
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Medicare Select Plan Description
Medicare Select is a type of Medigap policy designed to supplement original Medicare and is made available to those who are entitled to Medicare Parts A and B. Members do not need to choose a primary care physician (PCP) and are not required to obtain referrals or prior authorizations. These are individual coverage plans and are not open to new enrollment.
Medicare Select fills the gaps in Medicare by paying for deductibles, coinsurance and other benefits not covered under the basic Medicare plan. All members pay a monthly premium.
Health Net's existing members have one of the following Medicare Select standard plan designs:
- Plan A
- Plan E
- Plan I without pharmacy
- Plan I with pharmacy
The Medicare Select identification card identifies the Medicare Select plan type A, E or I.
The plan honors all claims for covered services from any Medicare provider and pays on a fee-for-service (FFS) basis using the applicable Medicare Fee Schedule.
Medicare Select Basic Coverage
All Medicare Select members have the following basic coverage:
- Inpatient hospital costs: Covers the Part A coinsurance plus coverage for 365 additional days after Medicare coverage ends.
- Medical costs: Covers the Part B coinsurance (generally 20 percent of Medicare-approved amount) or copayments for hospital outpatient services.
- Blood: Covers the first three pints of blood each year.
Medicare Select Plan A
Medicare Select Plan A is the most limited supplemental plan. This plan covers the basic benefits listed above in the Medicare Select Basic Coverage in addition to Medicare Preventive Care Part B coinsurance.
Medicare Select Plan E
Medicare Select Plan E provides coverage for:
- Basic benefits as listed in the Medicare Select Basic Coverage section.
- Medicare Part A deductible.
- Skilled nursing facility (SNF) care.
- Foreign travel emergency (up to plan limits)*.
- Medicare Preventive Care Part B coinsurance.
- Preventive care not covered by Medicare (up to $120).
*Member must pay a separate deductible for a foreign travel emergency ($250 per year)
Medicare Select Plan I without Pharmacy
Medicare Select Plan I is the most comprehensive supplemental plan offered by the plan. This plan provides coverage for:
- Basic benefits as listed in the Medicare Select Basic Coverage section.
- Medicare Part A deductible.
- Medicare Part B excess.
- Skilled nursing facility (SNF) care.
- Foreign travel emergency (up to plan limits)*.
- At-home recovery (up to plan limits).
- Medicare Preventive Care Part B coinsurance.
*Member must pay a separate deductible for a foreign travel emergency ($250 per year)
Medicare Select Plan with Pharmacy
Medicare Select Plan with pharmacy includes the following:
- Basic benefits as listed in the Medicare Select Basic Coverage section.
- Medicare Part A deductible.
- Medicare Part B excess.
- Skilled nursing facility (SNF) care.
- Foreign travel emergency (up to plan limits)*.
- At-home recovery (up to plan limits).
- Medicare preventive care Part B coinsurance.
- Basic prescription drugs ($1,250 annual limit).
*Member must pay a separate deductible for a foreign travel emergency ($250 per year).