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KelseyCare Advantage Rx+Choice

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Rx + ChoiceThis is a Medicare Advantage plan that covers prescription drugs. KelseyCare Advantage Rx+Choice provides Part D coverage in addition to the medical benefits of Medicare Parts A and B. This plan also offers a point-of-service benefit.

With this plan, you have the option of accessing certain specialists who are in or out of the KelseyCare Advantage provider network.

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  Description
Plan Summary The KelseyCare Advantage Rx+Choice plan works well for Medicare beneficiaries that need comprehensive coverage and low out of pocket expenses for their hospital, medical and prescription drug benefits. This plan also offers coverage for routine vision, routine hearing and medical transportation. The Rx+Choice plan offers members the option to access certain specialists who are outside of the KelseyCare Advantage provider network.
Eligibility
  • Be eligible for Medicare Part A and enrolled in Part B,
  • Continue to pay Part B premiums,
  • Live in the plan service area, and
  • Not have end-stage renal disease (permanent kidney failure).
Premium The monthly plan premium to enroll in the Rx plan is $57.00. Additionally, you must maintain your Medicare Part B coverage to be a member of the Rx+Choice plan. Most people will pay the standard premium amount, which is $99.90 in 2012. Please call Social Security at 1-800-772-1213 for information about your Part B premium.
Doctor and Hospital Choice KelseyCare Advantage Rx+Choice has formed a network of doctors, specialists and hospitals. You can use specialists who are in or out of the KelseyCare Advantage provider network. The health providers in our network can change at any time. Members can elect to have their Kelsey-Seybold Clinic physician "coordinate" their care or they can choose to "self-refer" for care from certain specialists outside of Kelsey-Seybold Clinic. Members receive a higher level of benefits and pay lower out-of-pocket costs when they use in-network providers.
Documents for Download For a description of the KelseyCare Advantage Rx+Choice benefits, download the Summary of Benefits PDF  PDF 2012. For comprehensive documentation of the benefits, limitations and exclusions for this plan, download the Evidence of Coverage PDF  PDF 2012.
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H0332_WB12001_CMSDateApproved_10/18/2011
Last Updated: 10/1/11