A Healthy CollaborationSM

Frequently Asked Questions For Members

See answers to questions that other members have asked.

Q: I’ve heard about some penalties that arise if I don’t join a plan with prescription drug coverage. What are those?

If you didn’t join a plan by May 15, 2022 (and were eligible to do so at that time), and didn’t have a drug plan that, on average, covered at least as much as standard Medicare prescription drug coverage, when you do join, your premium cost will go up at least 1% for every month that you waited to join since May 2006. You will have to pay this penalty for as long as you have Medicare prescription drug coverage. You have the option to appeal this penalty. The next enrollment period is November 15 to December 31, 2008. Remember, while you must enroll during this period, your coverage will not take effect until January 1, 2009.

Q: If I join and develop a medical condition, will my membership be cancelled?

No. Once you join a Medicare Advantage plan, your continued membership is guaranteed and will not be cancelled because of a medical condition you may develop. The government has, however, established some limits on membership. People who have End Stage Renal Disease (ESRD) (permanent kidney failure treated with dialysis or a transplant) may not be able to enroll in a Medicare Advantage plan. However, if you develop ESRD while you are a member, you will not be disenrolled.

Q: If I have never enrolled in a Medicare Advantage plan, can I try out a Generations Healthcare plan without losing my Medicare Supplement?

You can keep your Medicare Supplement as long as you’d like, but you’ll probably find that our plans cover the same benefits at a lower cost to you. If you join a Medicare Advantage plan or other Medicare health plan when you first become eligible for Medicare, or if this is the first time you’ve joined a Medicare Advantage plan or other Medicare health plan, you may have special Medigap protections that give you the right to get your old Medigap policy back or buy a new one later if you choose to leave your plan within the first year. It’s best to check your options with a Real Help Representative so you can ensure that you’re not missing out on important benefits.

Q: Who do I contact when I have questions related to benefits or claims?

For questions related to benefits or claims contact Member Services at 1-866-422-5009 (TTY 1-800-958-2692) 8 am to 5 pm local time, Monday – Friday.

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

Yes, Today’s Options PPO has Spanish materials available, such as the 2009 Summary of Benefits. You can request that Spanish materials be mailed to you by calling 1-866-422-5009 (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 PPO representative will be happy to help you.

M0018_TOPPO_209 Pending CMS Approval Last updated: 4/1/2022

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