Top 10 Things to Know Before Enrolling in Medicare

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Essence Healthcare is an HMO plan with a Medicare contract. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. 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 plan service area. 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.

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.

For accommodations of persons with special needs at meetings, call 1-866-509-5398 (TTY: 711).

Every year, Medicare evaluates plans based on a 5-star rating system.