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Provider Manual

Benefit Explanation

Last Updated on January 24, 2019

The following pages describe the Medicare Advantage benefit package generally. When reading the benefit information, keep the following in mind:

  • The regular fee-for-service Medicare program was designed to help pay medical bills. Medicare was never intended to pay all expenses.
  • Medicare alone forces members to be responsible for both professional and facility deductibles.
  • Medicare Advantage plans do not have in-network deductibles. However, members are responsible for copayments and coinsurance on some benefits.
  • Coverage is subject to member eligibility, Medicare Advantage guidelines (written in the Medicare Advantage Evidence of Coverage (EOC)).

Coverage will be provided in accordance with Medicare guidelines. Services that are not covered by Medicare are not covered by Medicare Advantage plans, except as specifically set forth in the EOC.

Benefits are subject to change. Verification of benefits should be directed to Security Health Plan Customer Service representatives at 1-877-998-0998 or 715-221-9897. Copies of the current Rx and non-Rx EOCs which contain the details of Medicare Advantage coverage are available upon written request.