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Health Alliance

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CMS Best Available Evidence
 
  Health Alliance is a health plan with a Medicare contract.

Health Alliance offers a variety of Medicare plans for practically every need and budget:

Medicare Advantage


Medicare HMO 20—Your costs for covered services are capped at $500 each year. You choose among the doctors and hospitals in our broad network for routine care. Available to all beneficiaries in a 10-county area of east central Illinois. Basic or comprehensive Part D pharmacy coverage can be added to Medicare HMO 20.

Medicare PPO 30—With Medicare PPO 30, you have the flexibility of visiting any provider, but your coverage will be greater when you see in-network providers. You also enjoy a $3,000 out-of-pocket maximum for in-network medical services and lower monthly premiums. In exchange, the copayments for services received may be slightly higher than those for other Health Alliance Medicare plans. Available to all beneficiaries in a 40-county area of central Illinois. Basic or comprehensive Part D pharmacy coverage can be added to Medicare PPO 30.

Medicare PPO 10—For a moderate monthly premium, you get comprehensive medical coverage, and your costs for covered in-network services are capped at $1,500 each year. With PPO 10, you can choose to use non-plan providers to get covered services; however, if you do so for care that is not emergency care, it may cost you more to use them. Available to all beneficiaries in a 40-county area of central Illinois. Basic or comprehensive Part D pharmacy coverage can be added to Medicare PPO 10.

Medicare PPO Basic—If you're looking for a $0 premium, then Medicare PPO Basic might be right for you. You'll pay higher costs for any health care or medical services you receive including doctor visits, but you'll avoid a monthly premium. Available to all beneficiaries in a 40-county area of central Illinois. Basic or comprehensive Part D pharmacy coverage can be added to Medicare PPO Basic.

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Medicare Supplement—Our supplement plans—Plan A, Plan C and Plan F—offer three coverage levels to suit your individual needs and no restrictions on which doctors and hospitals you use. Available to beneficiaries throughout Illinois.

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Most Recent HEDIS Results

All information on this website is available in alternative formats. For more information, please contact Health Alliance Medicare Services.

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  • Health Alliance Medicare is a health plan with a Medicare contract.
  • If you join an HMO plan and obtain care from an out-of-network plan provider, neither Medicare nor Health Alliance Medicare will be responsible for the costs.
  • If you are enrolled in an HMO plan, care or services you get from non-plan providers will not be covered, except for ambulance services, emergency care, including post-stabilization care, urgently needed care, renal dialysis (kidney), and any services which were ordered through an appeals process.
  • If you join an PPO plan and use a non-plan or non-preferred provider, you could pay more for services.
  • If you are enrolled in a PPO plan and get health care service from a plan provider, this is known as an "in-network" service. A health care service you get from a non-plan provider is known as "out-of-network" service.
  • You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
  • You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help call:
    • 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week);
    • The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or
    • Your State Medicaid office
  • You may be entitled to Medicare Part A and enrolled in Part B and you must continue to pay you Medicare Part B premium to remain eligible, unless under Medicaid or paid for by a third party.
  • Individuals with End State Renal Disease are generally not eligible to enroll in Health Alliance Medicare HMO unless they are members of our organization and have been since dialysis began.
  • You must live in the Health Alliance Medicare HMO service area.
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    Pending CMS Approval


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