Plans for Medicare Supplement
Today you need the protection of a Medicare Supplement Insurance policy because Medicare alone simply doesn’t cover all of your health care expenses.
What to expect with Medicare Supplement Insurance
- Helps pay for medical expenses not fully covered by Medicare.
- Choice of physician (For hospital services and our Select plans, the physician must have admitting privileges at a network hospital.) >>Click HERE to view our network of hospitals.
- Attractive premiums — Premiums are the lowest for most plans in the region
- 30-day free review of our plans
- Local agents right here in South Dakota and can come to your community — click here to find our locations or to an agent near you.
- Local toll-free customer service can be reached by calling toll free 1-877-548-0834. Your calls are answered by a live service representative who is ready to assist you with your coverage needs. Available from 8 a.m. to 5 p.m. CT, Monday through Friday.
- National coverage – When you travel, you don’t need to worry about emergencies.
- Buyers Guide — Choosing a Medigap Policy (pdf)
- Network Hospital Directory (pdf)
- Medicare Supplement Insurance Brochure (pdf)
Frequently Asked Questions
In order to be eligible for Medicare Supplement Insurance,
- You must be 65 years or older and you have Medicare Part A and Part B
- You are under 65 years of age and disabled, and you have Medicare Part A and Part B
- You have ALS, and you have Medicare Part A and Part B.
If you are on Medicaid, you might not need this insurance plan or any other Medicare supplement.
No. If this is your first Medicare supplement policy or you are replacing another Medicare supplement policy, Avera Health plans has no waiting periods for prior health conditions. When your application has been approved, your coverage will begin immediately on the effective date of your policy.
Yes. Open enrollment is a period of time when you cannot be denied coverage because of any prior health condition you may have. You will automatically be accepted for coverage if you are at least 65 years of age and apply for Avera Health Plans coverage within six months of your Medicare Part B effective date.
If you delay enrolling in Part B because you have group health coverage based on your current employment, your open enrollment period won’t start until you sign up for Part B.
You will automatically be issued an Avera Health Plans Medicare Supplement Insurance policy if you:
- Apply for an Medicare Supplement Insurance policy no later than 63 days after termination from a group health plan through your employer or union, and you provide evidence with a Certificate of Creditable Coverage.
- Apply for an Avera Health Plans Medicare Supplement Insurance no later than 63 days after dropping a Medicare Advantage Plan, a Medicare Supplement Plan or other Medicare Health Plan, as long as it is done within the first 12 months of enrolling in the plan, and it is the first time you have been in the plan.
NOTE: A Certificate of Creditible Coverage is a certificate which indicates effective date and termination date of your prior coverage.
Yes. You may see the physician of your choice. No referral slips are necessary. To receive full plan benefits when you need hospital services, your physician must have admitting privileges at an in-network hospital or be willing to refer you to one who does.
Because we have great relations with Avera providers, we can offer the best rates when going with our Select Medicare Supplement Insurance plan coverage. You can still see any doctor but if you require hospital services, you will be required to use an in-network hospitals.
Network Hospital Directory = List of hospitals available if you should require hospital services.
Our Service Center can also confirm whether the treatment you require is available from a participating in-network hospital and, if not available, will assist you in locating a hospital that provides the necessary service.
In an emergency, take care of yourself as you and your physician feel is appropriate. Avera Health Plans benefits will be paid at any Medicare-approved hospital or physician in an emergency.
When traveling outside of the service area, our benefits will be paid at any Medicare-approved hospital or clinic for up to 90 days.
NOTE: If you need treatment that is not available from an in-network hospital, you or your physician should call our Service Center for admission procedures to a non-network hospital. Call toll-free at 1-877-322-4885.
No. As long as you pay you premiums on time, your individual coverage cannot be canceled because of the size or number of claims you make.
Benefits are the same for all Medicare Supplment Insurance plans. For example, Plan F is the same Plan F benefits from all insurance carriers. There are different benefits between Plans A — L and there are also differences between Standard and Select plans. We are here to help you. Please call toll-free at 1-877-322-4885 and we will connect you to someone who can answer your questions.
We are available Monday through Friday and can set up a time to meet with you.
No. When you become an Avera Health Plans Medicare Supplement Insurance policyholder, you do not need another Medicare Supplement.
To avoid duplication of coverage and unneeded expense, our Medicare Supplement Insurance policy should replace any other Medicare Supplement Insurance you may have.
Whenever you have questions, just give us a call at 605-322-7373 or toll-free at 1-888-605-3229. We’ll be happy to talk with you about your coverage.