CLA_Eligibility Medicare

Eligibility Overview

Please review the items below to see if you qualify for an Amerivantage plan.

You must be eligible for Medicare Part A (hospital insurance) and enrolled in Part B (medical insurance). To check your eligibility, review your red, white and blue Medicare card for Part A and Part B effective dates.

You must also be eligible for Medicare Part D prescription drug coverage.

If you once had End-Stage Renal Disease (ESRD) but have had a successful kidney transplant or were able to regain native kidney function and no longer require a regular course of dialysis, you may be eligible to enroll in one of our plans.

You must reside in our service area. In 2017, our service area in Washington includes King and Snohomish counties.

Non-Discrimination Notice: The plan documents may be available in other languages. Or, if you have special needs, the documents may be available in other formats. Please review the Notice of Non-Discrimination in Health Programs and Activities and call Customer Service for details.

Amerigroup is a HMO plan with a Medicare contract. Enrollment in Amerigroup depends on contract renewal.

This information is not a complete description of benefits. Contact the
plan for more information.

Limitations, copayments, and restrictions may apply.

Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

You must continue to pay your Medicare Part B premium.

This plan is available to anyone who has both Medical assistance
from the State and Medicare. (Applicable only to Duals Special Needs Plans (DSNP)).

The Formulary, pharmacy network, and/or provider network may
change at any time. You will receive notice when necessary.

Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Call 1-877-470-4131 (TTY: 711).

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-470-4131 (TTY: 711).

Eligibility Overview

Please review the items below to see if you qualify for an Amerivantage plan.

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