Am I Eligible for Medicare Supplement Insurance?
To be eligible for Medicare Supplement Insurance, you must:
- Be 65 years of age or older and have Medicare Part A and Part B
- Be under 65 years of age and disabled and have Medicare Part A and Part B
- Have ALS (Lou Gehrig’s disease) and have Medicare Part A and Part B
On Medicaid?
If you are on Medicaid, you may not need this insurance plan or any other Medicare Supplement Insurance.
No Wait to Cover Pre-Existing Health Conditions
Whether you’re choosing your first Medicare Supplement Insurance policy or replacing a different Medicare Supplement policy, Avera Health Plans has no waiting periods for pre-existing health conditions. Once we approve your application, your coverage begins immediately on the effective date of the policy.
Open Enrollment Period
Avera Health Plans Medicare Supplement Insurance open enrollment period is a time when anyone qualified for Medicare can apply for Medicare Supplement Insurance.
During an open enrollment period:
- No health questions are asked
- You will automatically be accepted for coverage if you’re at least 65 years old and apply for Avera Health Plans coverage within six months of your Medicare Part B effective date
If you have group health coverage from a current employer and delay enrolling in Medicare Part B, your open enrollment period won’t start until you sign up for Part B.
Cancellation
As long as you pay your premiums on time, your Medicare Supplement coverage can’t be canceled because of the number or size of your claims.
Right to Return Policy
If you find that you're not satisfied with your policy, you may cancel it within 30 days of receiving it. We'll treat your policy as if it had never been issued and will return all of your payments. In order to make a cancellation, contact your agent.
Refund of Premium
If we receive written notice that you wish to terminate your coverage, any premium paid beyond the termination date will be refunded to you.
Doctors, Hospitals & Other Medicare Supplement Benefits
With an Avera Health Plans Medicare Supplement policy, you may see the physician of your choice—and you won’t need a referral for basic care.
To receive full plan benefits when you need hospital or outpatient surgery services, make sure your physician has admitting privileges at an in-network hospital or is willing to refer you to a physician who does.
In-Network Hospitals for Medicare Supplement Select Plans
With a Medicare Supplement Select Plan, you’ll get the best rates because you benefit from our great relationships with our contracted providers. You can still see any doctor, but you must use in-network hospitals for outpatient surgery or hospital-based care, including laboratory and imaging services.
Review our Network Hospital Directory for Select plans.
What Happens in an Emergency or While Traveling?
In emergencies, Avera Health Plans benefits will be paid to any Medicare-approved hospital or physician, so you can take care of yourself as you and your doctor feel is best.
When you travel outside our service area, benefits will be paid to any Medicare-approved hospital or clinic for up to 90 days from the first day you receive care, once per calendar year.
Get Help from Our Service Center
Our service center can confirm whether you can get the treatment you need from a participating in-network hospital. If not, we’ll help you find a hospital that provides the service. If you need treatment that’s not available from an in-network hospital, you or your doctor should ask about admission procedures at a non-network hospital. For information:
