A health plan that may offer more benefits for less money

Created date

November 7th, 2016
health care professional with patient

The employees of Erickson Living strive to provide residents with extra services that may make life easier. Among these services is a Medicare Advantage health plan called Erickson Advantage, which has been offered exclusively to Erickson Living community residents for over ten years now.

Different plans for individual needs

Erickson Advantage (EA) is not intended to be one-size-fits-all health insurance. Some Erickson Advantage plans offer supplemental benefits such as preventive dental services, routine podiatry care, falls prevention, and eyeglass and hearing aid coverage. In certain Erickson Advantage plans, transportation to medical appointments is available (up to 12 round trips or 24 one-way trips a year to and from in-network medical appointments). This can be especially helpful in cases of inclement weather or when you simply don’t feel up to driving.*

Chronic health conditions can be complex or difficult to manage. According to the U.S. Department of Health and Human Services, about two-thirds of older adults live with two or more chronic health conditions. The U.S. health care system is primarily organized to provide care on a disease-by-disease basis, and care coordination is often the missing link. According to the U.S. Department of Health and Human Services, if care is coordinated, then medical and social service providers bring their respective expertise to bear on each individual’s health problems in the most effective and coordinated manner.

Support for residents’ health

Erickson Advantage plans offer care coordination support services for their members. This service is provided by an on-campus nurse care coordinator who can work with you and your health care team to help improve quality of care. The overall goal of a nurse care coordinator is to assist with managing your health conditions and activities to help you improve your health. 

They strive toward this goal in several ways. They can help reduce the confusion when you are trying to organize your daily health care tasks, assist you in obtaining preventive care, and be a resource for your health-related questions and concerns. Because it can be difficult to juggle multiple medical appointments, a nurse care coordinator can help arrange necessary services in a way that is more manageable for you. 

Support for the business side of health care

Sifting through the details of how your health insurance works can take up your precious time. That’s why Erickson Advantage provides member services representatives to help answer questions about health plan-related issues such as benefits or details about your plan coverage. There is no need to navigate your way through a phone tree as these member services representatives are on site at each Erickson Living campus. 

Opportunities to save costs

In 2017, premiums and copays will be lower than in 2016 for some Erickson Advantage plans. That’s great news, but there is another way Erickson Advantage members may save more. 

As it stands now, some Original Medicare beneficiaries who need a stay at a skilled nursing facility after a hospitalization may have to pay for it out-of-pocket. That’s because Original Medicare beneficiaries must be classified as a hospital inpatient for three days beforehand in order to receive coverage for a skilled nursing stay. 

This requirement means some beneficiaries have been responsible for a hefty bill. A 2016 Genworth Financial survey showed that, in the U.S., the median cost for a 30-day skilled nursing facility stay is about $7,000.

For Erickson Advantage members, however, the three-day stay requirement is waived. In fact, members who have a medically necessary need may go to a skilled facility even if they haven’t been admitted to a hospital.

Make your insurance decision soon

There could be changes to your current health insurance plan.  Premiums may increase or your benefits may be different. It is important to review your health insurance plans every year. You don’t want to miss out on your opportunity to change to a health plan that may better meet your needs.

Open enrollment runs from October 15 through December 7, and during this period, Medicare beneficiaries have the opportunity to consider switching to another plan. If you are an Erickson Living resident who wants to learn more about Erickson Advantage, you can talk with your community licensed sales agent. They can conduct an insurance review, which can help you understand details about your current benefits and compare them to Erickson Advantage benefits. Your licensed sales agent will explain the differences so you can make an informed decision.

*This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium, and/or copayments/coinsurance may change on January 1 of each year.

Plans are insured through UnitedHealthcare Insurance Company or one if its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare.                 

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

For information on all Medicare insurance plans, call 1-800-MEDICARE, (TTY 1-877-486-2048), 24 hours a day, 7 days a week.