Legal Language
Low Income Subsidy (LIS) Extra Help
Contact Social Security’s Office of Medicaid to inquire about Low Income Subsidy (LIS).
General Health Alliance Medicare Disclaimers
Health Alliance Medicare is a health plan with a Medicare contract.
Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B premium. Members may enroll in the plan only during specific times of the year. Contact Health Alliance Medicare for more information.
Medicare beneficiaries may enroll in Health Alliance Medicare through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Limitations, copayments and restrictions may apply.
Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2013.
In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances. Quantity limitations and restrictions may apply.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week;
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or
- Your State Medicaid Office.
Note:
Documents are available in alternate formats or languages. Call Health Alliance Medicare at 1-800-965-4022 (TTY/TDD 1-866-883-8551) Monday through Friday from 8 a.m. to 8 p.m.
Stand-Alone Prescription Drug Coverage
Health Alliance Medicare is a stand-alone prescription drug plan with a Medicare contract.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week;
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778;
- Your State Medicaid Office.
In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances. Quantity limitations and restrictions may apply.
For HMO Plans
You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers, neither Medicare nor Health Alliance Medicare will be responsible for the costs.
For PPO Plans
It may cost more to get care from out-of-network providers, except in an emergency and urgent care situations.