Advantra Freedom

With Advantra Freedom you are in control of your health care.  We offer a variety of plan options to meet your specific needs, each of which provides you with the freedom to choose your doctors, hospitals and specialists without network boundaries as long as they accept our terms and conditions of payment.  Some of the other advantages of Advantra Freedom include:

• Low or no premium plans
  
• Coverage for preventive services, such as annual physicals and routine vision and hearing exams
  
• Wellness services to help you meet your personal health goals
  
• Worldwide emergency room coverage wherever you travel
  

All for competitive rates where you can feel confident that you are getting value for your health care dollar.

 

 

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A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your doctor or hospital can continue to treat you if it agrees to accept our terms and conditions of payment, and thus may choose not to treat you, with the exception of emergencies.  If your doctor or hospital does not agree to accept our payment terms and conditions, they may choose not to provide health care services to you, except in emergencies. Providers can click on the following link to find the plan’s terms and conditions on this website.

Advantra Freedom (PFFS) is a Medicare approved Medicare Advantage Private Fee-for-Service plan offered through the following Coventry Health Care, Inc. subsidiaries: First Health Life & Health Insurance Company, Coventry Health and Life Insurance Company and Cambridge Health Insurance Company.

The Advantra Freedom (PFFS) contract with CMS is renewed annually and the availability of coverage beyond the contract year is not guaranteed.

You may only enroll in Advantra Freedom (PFFS) during specific time of the year.  For more information contact Advantra Freedom at 1-800-711-1607 (TDD/TTY: 1-888-788-4010), 8 a.m. to 8 p.m., seven days a week.

You are eligible to join Advantra Freedom (PFFS) if:
1) You are entitled to Medicare Part A and are enrolled in Medicare Part B. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
2) You reside within the plan's service area.
3) You have not been diagnosed with end-stage renal (kidney) disease, unless you are already a member of Advantra Freedom (PFFS) or had a successful kidney transplant.
4) You are not 65 but are disabled and have recently received disability benefits from Social Security or the Railroad Retirement Board for at least 24 months.

Advantra Freedom (PFFS) Part D benefits are only available to members of our Freedom 4, Freedom 5, Freedom 5 Plus – OTC, Freedom 5 Plus – Gap and Freedom 7 plans. If you are enrolled in Freedom 4, Freedom 5, Freedom 5 Plus – OTC, Freedom 5 Plus – Gap or Freedom 7, you must receive your Medicare Part D coverage through Advantra Freedom (PFFS). Enrollment in another Medicare Part D plan will cause you to be automatically disenrolled from Advantra Freedom (PFFS).  Enrollment in an Advantra Freedom (PFFS) MAPD plan which includes Part D prescription drug coverage will automatically end your enrollment in a Medicare prescription drug plan.

You must use network pharmacies to access your drug benefits, except under non-routine circumstances when you cannot reasonable use a pharmacy in the network.  For additional network pharmacy information visit our online pharmacy locator or contact 1-800-690-5924 or 1-800-690-4028 for NY residents (TTY/TDD 1-800-716-3231), 24 hours a day, seven days a week or write to us at Advantra Freedom: Coventry Health Care, Inc.  PO Box 7154, London, KY 40742-7154.     

If you enroll in an MA only plan that does not offer Medicare prescription drug coverage, you may obtain coverage from a separate Medicare prescription drug plan. If you do not have Medicare prescription drug coverage, or creditable prescription drug coverage (as good as Medicare’s), you may have to pay a late enrollment penalty if you enroll in Medicare prescription drug coverage in the future.

If you decide to switch to premium withhold or move from premium withhold to direct billing, it could take up to three months for it to take effect and you will ultimately be held responsible for those premiums.  For full information on Advantra Freedom (PFFS) benefits, call our Customer Service Department at 1-800-711-1607 (TDD/TTY: 1-888-788-4010), 8 a.m. to 8 p.m., seven days a week.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227).  TTY users should call 1-877-486-2048, 24 hours a day, seven days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday–Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for seventy five (75) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.  If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare may pay all or some portion of your plan premium. If Medicare pays only a portion of this premium, you will receive a coupon book to pay your remaining premium that Medicare does not cover.

If a person is discussing plan options with you, he or she may be either employed by or contracted with First Health Life & Health Insurance Company, Coventry Health and Life Insurance Company, and/or Cambridge Life Insurance Company, subsidiaries of Coventry Health Care, Inc. This person may be compensated based on your enrollment in the Advantra Freedom (PFFS) plan.

Medicare beneficiaries may also enroll in Advantra Freedom (PFFS) through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.medicare.gov.  For more information, contact Advantra Freedom at 1-800-711-1607 (TDD/TTY: 1-888-788-4010), 8 a.m. to 8 p.m., seven days a week.

The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits.  Additional information about benefits is available to assist you in making a decision about your coverage.  This is an advertisement; for more information contact the plan.

Plan documents are available in other formats.  For more information contact Advantra Freedom (PFFS) at 1-800-711-1607 (TDD/TTY: 1-888-788-4010), 8 a.m. to 8 p.m., seven days a week.