A Healthy CollaborationSM

Any Questions about Today’s Options?

Today’s Options plans let you choose the doctors and hospitals you trust most1—with low co-pays and your choice of optional prescription drug coverage.

Q: How does a Medicare Advantage PFFS (Private Fee-for-Service) plan work?

When you enroll in Today’s Options, you are still part of the Medicare program, and still entitled to all medically necessary healthcare services that are covered by Medicare. As a Today’s Options member, however, you’ll enjoy the added advantages of low co-payments for doctor and hospital visits, plus all the built-in advantages that promote your health, safeguard your right to choose and save you money. That means you can choose any doctor, specialist or hospital in the U.S. that accepts the terms and conditions of the Today’s Options PFFS plan.

Q: Am I eligible for Today’s Options?

You can enroll in Today’s Options if:

  • You have both Medicare Part A (hospital insurance) and Part B (medical insurance).
  • You live in the service area of the plan.
  • You do not have End-Stage Renal Disease (permanent kidney failure treated by dialysis or a transplant, sometimes called ESRD).
  • However, if you do have ESRD and are currently enrolled in a Medicare Advantage PFFS, you may join Today’s Options.

If you have questions about your eligibility, ask a Today’s Options representative for more information.

Q: What if I already have a Medicare Supplement policy?

A Medicare Supplement policy will not cover any co-pays or deductibles associated with a Private Fee-for-Service plan. Generally, it is not proper for anyone to sell you a Medicare Supplement policy while you are enrolled in a Medicare Advantage (Part C) program.

Q: Can I try Today’s Options without losing my Medicare Supplement?

Although you can keep your Medicare Supplement as long as you’d like, you’ll probably find that our plans cover the same benefits at a lower cost to you, so maintaining your Medicare Supplement at the same time you are covered by Today’s Options may not be economically optimal. If this is the first time you’ve joined a Medicare Advantage plan, you may have special protections that give you the right to get your old Medigap policy back if you choose to leave the plan within the first year. It’s best to check with a Today’s Options representative to make sure you don’t miss out on important benefits.

Q: If I choose a Medicare Advantage plan with prescription drug coverage “powered by” CCRx, how will I know if the medicines I currently take will be covered?

Our plans have a formulary, or list of covered drugs. To learn if your medicines are covered, please contact a Today’s Options representative at 1-866-568-8921 (TTY/TDD for the hearing impaired: 1-800-958-2692). You can also see our formulary online.

Q: What drugs are excluded from Medicare Advantage Prescription Drug Plans (MAPD)?

The drugs that are excluded by Medicare are:
  • Medications used to treat anorexia, weight loss, or weight gain
  • Medications used to promote fertility
  • Medications used for cosmetic purposes or hair growth
  • Medications used to treat erectile dysfunction
  • Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparation
  • Non-prescription drugs

Outpatient medications for which the manufacturer requires that associated tests or monitoring services be purchased exclusively from the manufacturer as a condition of sale. In addition, if a medication is covered by Medicare Parts A or B, it cannot be covered under Part D (Medicare Advantage Prescription Drug Plan). Some examples of Parts A or B medications include: diabetic test strips, injectables solely administered in the physician’s office and medications administered in the hospital. Also, each Medicare Advantage Prescription Drug plan may have its own specific exclusions.

Q: What if my prescription medicine is not on the formulary?

If your specific medicine is not on our formulary, there might be a similar, high-quality medicine available that offers the same benefits. For example, if you’re taking a cholesterol-lowering medicine, there might be a suitable alternative on our formulary. We’ll work with you and your doctor to find a covered medicine that best suits your condition.

Q: Are my doctors permitted to bill me for services?

No. Today’s Options does not allow doctors, hospitals, and other providers to bill you for more than the plan pays for services.

Q: Does Today’s Options have materials that are in Spanish?

Yes, Today’s Options has Spanish materials available, such as the 2009 Summary of Benefits. You can request that Spanish materials be mailed to you by calling 1-866-714-3976 (TTY for the hearing impaired: 1-800-958-2692) 8 AM to 8 PM in your local time zone, 7 days a week. A Today’s Options representative will be happy to help you.

1Provider must accept the plans terms and conditions.

M0018_PFFSWebv4_1208 CMS (1/2009) Last updated: 1/1/2022

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