About Medicare and Medicare Advantage

There are different parts of Medicare which cover specific services:

• Medicare Part A (Hospital Insurance)
  Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
• Medicare Part B (Medical Insurance) 
  Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
• Medicare Part D (prescription drug coverage)
  Part D adds prescription drug coverage to:
  • Original Medicare
  • Some Medicare Cost Plans
  • Some Medicare Private-Fee-for-Service Plans
  • Medicare Medical Savings Account Plans

These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

• Understanding Your Medicare Choices
• Medicare Enrollment Help
• Medicare Complaint Form

Medicare Advantage Plans, also called Part C Plans, are offered by private health insurance companies that are contracted with the Medicare program.

These plans provide all the benefits offered through Medicare Parts A, B, C and D together in one package.

One of our registered nurses will work with you and your family to develop a care plan to determine what services are needed. 

Our Service Area includes Albany, Broome, Columbia, Delaware, Erie, Greene, Madison, Monroe, Niagara, Oneida, Onondaga, Otsego, Rensselaer, Saratoga, and Schenectady counties.

Frequently Asked Questions

What is Medicare Parts A, B, C and D?

What do Medicare Advantage plans cover?

Medicare Advantage, is also known as Medicare Part C. You get all of your Medicare Part A coverage (hospital benefit), Medicare Part B coverage (medical benefit), and other health benefits through a single plan. Most Medicare Advantage plans also include prescription drug coverage.

What is a Medicare Advantage HMO plan?

A Health Maintenance Organization (HMO) is a type of Medicare Advantage plan that usually requires you to receive your care and services from providers in the plan’s network. If your doctor or health care provider leaves the plan, you will be notified by the plan.

How does a Medicare Advantage Special Needs Plan (SNP) work?

A Special Needs Plan (SNP) is a type of Medicare Advantage plan that tailor care and services to best serve individuals with unique needs. Enrollment in restricted to beneficiaries with specific diseases or characteristics. Nascentia Health Plus offers Special Needs Plans for dually eligible beneficiaries (D-SNP) and those who have had or expected to need nursing home level of care for 90 days or longer (I-SNP).

What is a "dually eligible beneficiary"?

“Dual eligible beneficiaries” generally describes beneficiaries eligible for both Medicare and Medicaid. The term includes beneficiaries enrolled in Medicare and receiving full Medicaid benefits and/or assistance with Medicare premiums or cost sharing.

Do I still have to pay my Part B premium?

Yes, you must continue to pay your Part B premium to remain enrolled in a Medicare Advantage plan. In some cases, Medicaid will cover your Part B premium.

What is Nascentia Health Plus?

Nascentia Health Plus is an HMO SNP plan with a Medicare contract and a Coordination of Benefits Agreement with New York State Department of Health. Enrollment in Nascentia Health Plus depends on contract renewal. 

To Learn more about Nascentia Health Plus download the Nascentia Health Plus Overview (pdf).

Last Updated on August 18, 2024