Marketing Disclaimer

ESSENCE is a Medicare Advantage HMO with a Medicare contract. Anyone with Medicare Parts A and B living in our service areas may apply. Members must use ESSENCE plan providers for routine care, and an additional cost may be assessed for using out-of-network providers. Members must continue to pay their Medicare Part A and B premiums.

ESSENCE’s government contract is renewed annually and the availability of coverage beyond the end of 2010 is anticipated but not guaranteed. Enrollment in our plan is limited to specific times of the year. Members must receive prescription drug benefits from ESSENCE, and such benefits are subject to a formulary. In general, members must use network pharmacies to access their prescription drug benefits.

The benefit information provided on certain pages of this site is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. These pages constitute an advertisement; for more information, contact us. Plan documents are available in alternative formats. For more information about ESSENCE benefits or contracted providers/pharmacies, please contact us.

The ESSENCE AdvantageHMO SNP (HMO) is offered in select service areas and is only for Medicare beneficiaries with diabetes, and ESSENCE is required to check and make sure all new members have diabetes. People who join the ESSENCE AdvantageHMO SNP (HMO) and do not have diabetes must be disenrolled.

You may be able to get extra help to pay for your prescription drug premiums and costs. If eligible, Medicare could pay for 75% of drug costs including monthly prescription drug premiums, annual deductibles and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or late enrollment penalty. Many people are eligible for these savings and don’t even know it. 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. Or, call the Social Security Administration at 1-800-772-1213 between 7 am and 7 pm, Monday – Friday. TTY/TDD users should call 1-800-325-0778. Or, call your State Medicaid Office.

The people pictured and/or quoted on this web site were ESSENCE members as of 8/01/2009.

The Medicare program rates how well plans perform in different categories (for example, detecting and preventing illness, ratings from patients and customer service). If you have access to the web, you may use the web tools on www.medicare.gov and select “Compare Medicare Prescription Drug Plans” or “Compare Health Plans and Medigap Policies in Your Area” to compare the plan ratings for Medicare plans in your area. You can also contact us directly to obtain a copy of the plan ratings for this plan.

M0037_MK1380409A CMS Approved 11/30/2009 - Information current as of 11/09/2009