AmeriHealth 65® Basic
Product Description
Benefits listed here are effective January 1, 2007. Benefits, formulary, pharmacy, network, premium and/or copayments/coinsurance may change on January 1, 2008. Please contact Amerihealth 65 Basic for details.
$0 Premium – effective January 1, 2007
You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or any other third party.
What's covered?
With AmeriHealth 65 Basic, you're covered for many health care services you may need, just as you Benefits, formulary, pharmacy, network, premium and/or copayments/coinsurance may change on January 1, 2008.
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 within the United States
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Radiation therapy
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Urgently needed care within the United States
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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:
- 12 (non-emergency) roundtrip transportation to plan approved providers
- Eyewear benefit
- Routine hearing exams and hearing aids
- Healthy Lifestyles programs (such as fitness, weight loss, and smoking cessation)
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 Basic, 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
- 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.
To have the costs covered by Medical Assistance, you must show both your AmeriHealth 65 Basic and Medical Assistance Access identification cards when receiving services. Please note: In some cases, MedicalAssistance copays will apply.
Learn more about the Low Income Subsidy.
AmeriHealth 65 Basic provides people with Medicare and Medicaid (full benefit dual eligibles) with Medicare Standard Part D Prescription Drug coverage. The only costs for full benefit dual eligibles are a $0 copay for generic drugs and a $3.10 copay for brand drugs.
For complete details of covered services, copayments, and deductibles for this AmeriHealth 65 Basic plan, see the Summary of Benefits.
What's the premium?
The AmeriHealth 65 Basic Plan has NO monthly plan premium ($0). As Medicare Advantage regulations require, you must continue to pay your Medicare Part B (and Part A, if applicable) premium to the Government.
Where can I get more information?
Call us toll-free: 1-866-282-3235 (TTY/TDD 1-877-219-5457) 8:00 am to 8:00 pm seven days a week.
