Essence Healthcare is an HMO plan with a Medicare contract. Enrollment in Essence Healthcare depends on contract renewal. All Essence Healthcare plans include Part D drug coverage. To enroll in an Essence Healthcare plan, you must have both Medicare Parts A and B and reside in the Missouri counties of Barry, Boone, Christian, Greene, Jefferson, Lawrence, St. Charles, St. Louis, St. Louis City, Stone, Taney or Webster, or in the Illinois counties of Madison, Monroe, or St. Clair.
You must continue to pay your Medicare Part B premium. Enrollment in an Essence Healthcare plan may be limited to specific times of the year. The 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-insurance may change on January 1 of each year. The Formulary, pharmacy network, and /or provider network may change at any time. You will receive notice when necessary.
Members must use plan providers except in emergency or urgent care situations. If a member obtains routine care from an out-of-network provider without prior approval from Essence Healthcare, neither Medicare nor Essence Healthcare will be responsible for the costs.
Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
Essence Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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