Features of AmeriHealth 65 Plus
By selecting AmeriHealth 65 Plus, a Medicare Advantage Point-of-Service (POS) Plan, you have the freedom to see any provider in or out of the network. You get all the health care coverage of the AmeriHealth 65 HMO plus the freedom to seek care from any provider in or out of the network without a referral from your primary care physician and still be covered.
If you choose to self-refer or go outside of the network, your out-of-pocket costs may be higher.
AmeriHealth 65 Plus Medical Only
- No Prescription Drug coverage
- $86.00 monthly premium
AmeriHealth 65 Plus Rx Option II
- Includes Medicare Part D coverage with no deductible
- $124.80 monthly premium
Extra Help
If you qualify for extra help with your Medicare Prescription Drug Plan costs, your premium and drug costs will be lower. When you join AmeriHealth 65 Plus, Medicare will tell us how much extra help you are getting. Then, we will let you know the amount you will pay. If you aren't getting any extra help, you can see if you qualify by calling:
- 1-800-MEDICARE (1-800-633-4227) (TTY/TDD 1-877-486-2048) 24 hours a day/7 days a week or
- your State Medicaid Office, or
- the Social Security Administration at 1-800-772-1213 (TTY/TDD 1-800-325-0778) 7 am to 7 pm, Monday through Friday.
Learn more about the Low Income Subsidy.
What's covered?
With our AmeriHealth 65 Plus Plans, you're covered for many health care services you may need, just as you would be with Original Medicare. These services include:
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Primary Care Physician visits
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Skilled nursing facility stays
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Specialist visits
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Home health care
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Inpatient hospital care
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Hospice care
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Inpatient mental health care
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Chiropractic care
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Outpatient surgery
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Podiatry
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Outpatient rehabilitation services
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Durable medical equipment
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Outpatient mental health care
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Prosthetic devices
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Outpatient substance abuse care
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Diabetes self-monitoring training and supplies
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Ambulance services
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Diagnostic tests, x-rays and lab services
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Emergency medical care
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Radiation therapy
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Urgently needed care
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Preventive health services
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Health and wellness reimbursements if you qualify
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Prescription Drug Coverage
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You're also covered for many health care services that Medicare doesn't cover, such as:
- Some dental services
- Some vision services
- Routine hearing exams and hearing aids
- AmeriHealth Healthy LifestylesSM programs (such as fitness, weight loss, and smoking cessation)
Use any provider in or out of the network – without a referral from your primary care physician!
With the AmeriHealth 65 Plus option, you're always free to visit any of the thousands of plan providers in the AmeriHealth network. You also have the choice of seeing any provider in or out of the network without a referral. The plan will pay 70% of the allowed amount and you pay the balance for self-referred care (prior authorization is required for certain services.)
Enroll
You may enroll by mail, by phone or online.
Refer to your Summary of Benefits for:
- applicable conditions and limitations
- premiums
- cost-sharing (e.g., copayments, coinsurance and deductibles) and
- any conditions associated with receipt or use of benefits
Download an AmeriHealth 65 Plus Product brochure.
Download an Explanation of Benefits (EOB) Question and Answer.
Evidence of Coverage
The Evidence of Coverage is our contract with you. It explains your rights, benefits, and responsibilities as a member of our plan.
