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1-833-779-7999

Your call may be directed and answered by a licensed insurance sales agent.

TTD Users

1-866-620-2520

Monday through Sunday, from 8:00 a.m. to 8.00 p.m.

Get to Know Medicare

Medicare is the federal government's health insurance

For people
over 65 years old

For disabled people of any age

The Medicare coverage is divided into four parts

Original
Medicare

part
a

Covers hospitalization, hospice services, skilled nursing services, and home health care.

part
b

Helps pay outpatient medical services. Also covers laboratories, ambulance services, emergencies, durable medical equipment, and diagnostic services, such as lab tests and x rays.

Medicare
Advantage

part
c

Covers all the benefits of Original Medicare and offers additional benefits, such as eyeglasses, dental care, and hearing aids. In most cases, it also covers prescription drugs.

Drugs

part
d

This is the prescription drug coverage included in many Medicare Advantage plans.

Medicare Advantage includes all the benefits of the original Medicare
plus additional health care benefits so you can enjoy greater wellbeing.

  • Prescription
    Drugs

  • Dental
    Services

  • Eyeglasses

  • Blood Pressure
    Monitor

  • Alternative
    Medicine

  • Wellness
    Programs

  • Hearing
    Aids

  • OTC

  • Transportation

Access to

TeleConsulta, our 24/7 health care hotline
TeleConsejo, our hotline for emotional support

Get more health care for less
Make it easier on your pocket with

  • Copay

    $0

    Fixed amount of
    cost-sharing with the plan
  • Coinsurance

    $0

    Percentage of costs
    shared with the plan
  • Deductible

    $0

    Amount you pay before
    the plan starts paying

With Original Medicare, you pay the deductibles and coinsurances
Medicare Advantage covers those annual deductibles

What you need to do to have a Medicare Advantage plan

In order to enjoy the excellent benefits of Medicare Advantage (Part C), you must first be a beneficiary of Medicare Part A and B.

A
Part A- Hospital Insurance
  • If you’re already receiving Social Security, you get it automatically and at no cost as soon as you turn 65 years old.
  • If you do not have Social Security:
    • - You must enroll 3 months before your 65th birthday.
    • - You or your spouse must have contributed to the Social Security for 10 years or 40 quarters
B
Part B- Medical Insurance
You must enroll during the Initial Enrollment Period, which spans 7 months:
  • 3 months before turning 65 years old
  • 1 month – Your birthday month!
  • 3 months after the month you turn 65 years old
If you do not enroll during this period:
  • You will have to pay a late enrollment penalty fee, so your Part B premium will be higher
  • You have the option to enroll from January 1 to March 31, with coverage starting on July 1

Remember: You mus have A and B before C!

C
Parte C- Medicare Advantage

Once you receive Part A and enroll in Part B, then you can become a MA plan (Part C) affiliate.

These are the dates when you may enroll:

Initial period

Affiliation for new Medicare (Parts A and B) beneficiaries

Annual Election Period (AEP)

Open enrollment from October 15 to December 7
Coverage starts the January 1 of the following year

Special Enrollment Period (SEP)

If you have a 5-star plan
For people who move to Puerto Rico
If you lose your group coverage
Platinum (Medicare and Medicaid) beneficiaries may change once every 3 months

Open Enrollment Period (OEP)

Enrollment from January 1 to March 31
Allows 1 change, within the first 3 months of the year, to another Medicare Advantage or Original Medicare plan

Member Service

1-888-620-1919

TTY/TDD users

1-866-620-2520

Monday thru Sunday,
from 8:00 am to 8:00 pm

Service for Providers

1-855-886-7474

Monday thru Friday,
from 8:00 am to 5:00 pm

TeleConsulta

1-800-255-4375

Teleconsejo

1-877-879-5964

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