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Medicare plan notices

Medicare contract information

Both Health Alliance Plan of Michigan and Alliance Health and Life Insurance Company have a contract with the Centers for Medicare & Medicaid Services (CMS), the government agency that runs Medicare.

Health Alliance Plan of Michigan has HMO, HMO C-SNP, HMO-POS and PPO plans with Medicare contracts. HAP Medicare Complete Duals (HMO D-SNP), HAP Medicare Complete Assist (PPO D-SNP) and HAP CareSource™ MI Coordinated Health (HMO D-SNP) are Medicare health plans with a Medicare contract and a contract with the Michigan Medicaid Program that provides benefits of both programs to enrollees. Enrollment depends on contract renewals.

If the contract is terminated or we leave the Medicare program for some other reason, or if we change our service area so that it no longer includes the area where you live, we will tell you in writing. If this happens, your membership in the Health Alliance Plan Medicare Advantage plan will end and you will have to find another way of getting your Medicare benefits. Your choices will always include Original Medicare.

Commercial plan non-discrimination statement

Health Alliance Plan of Michigan and its subsidiaries do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations.

Medicare Supplement (Medigap) plan contract information

Alliance Health and Life Insurance Company is a wholly-owned subsidiary of Health Alliance Plan of Michigan.

Medicare disclaimers

If you are enrolling in a $0 monthly plan premium Medicare Advantage plan, you must continue to pay your Medicare Part B premium. If you have a late enrollment penalty, it will still apply.

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.

Health Alliance Plan by Henry Ford Health has one of the largest provider networks in Michigan.
Source: Ideon Network Analysis

Use of the Health Alliance Plan Visa® Prepaid Card is subject to the Cardholder Agreement. This card may not be used everywhere Visa® debit cards are accepted. This card is issued by The Bancorp Bank, N.A., Member FDIC, pursuant to a license from Visa® U.S.A. Inc. No cash or ATM access.

This is a solicitation of Alliance Health and Life Insurance Company Medicare Supplement (Medigap) insurance. You may be contacted by a licensed, authorized Health Alliance Plan Medicare Supplement (Medigap) plan salesperson.

Pharmacy disclaimers

Except in an emergency or urgent care situation, there is no coverage for prescription drugs purchased at a non-network pharmacy. In an emergency or urgent situation, if prescription drugs are obtained at a non-network pharmacy, you will be responsible for costs incurred above the Health Alliance Plan-negotiated pharmacy rate. Quantity limitations and restrictions may apply. We cannot pay for prescription drugs purchased outside of the United States, even for a medical emergency.

If you have limited income and resources, you may qualify for Extra Help to help you with the costs for your prescription drug coverage.

Part D benefits are provided through a network of contracted pharmacies. There are more than 2,000 pharmacies in the Health Alliance Plan network. We meet Centers for Medicare & Medicaid Services (CMS) standards for access based on our service areas, as follows:

  • 100% of beneficiaries who live in rural areas have a pharmacy within a 15-mile radius
  • 100% of beneficiaries who live in suburban areas have a pharmacy within a 5-mile radius
  • 100% of beneficiaries of who live in urban areas have a pharmacy within a 2-mile radius

The pharmacy network may change at any time. You will receive notice when necessary.

To be covered by your Medicare Advantage plan, you must have your prescriptions filled at either plan retail pharmacies or our mail-order pharmacies. In some cases, prescriptions filled at a non-plan pharmacy may also be covered.

For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. These requirements and limits are described in the Evidence of Coverage for your plan.

The Medicare drug formulary (drug list) may change at any time. You will receive notice when necessary.

Pharmacy Advantage is a Henry Ford Health specialty and mail order pharmacy providing free home delivery of prescription drugs and other pharmacy benefit support services to Health Alliance Plan members.