Medica HealthCare Plans offers Medicare Advantage HMO plans in Miami-Dade and Broward counties. These plans include benefits in addition to those covered under Original Medicare, including an integrated Medicare Part D prescription drug benefit.
Health Maintenance Organization (HMO) plans have a defined network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Medica Healthcare HMO plans require referrals for specialty care.
- Medica HealthCare Plans MedicareMax (HMO) 1
The Medica Healthcare Dual Eligible SNP plan is intended for consumers eligible for Medicare and Medicaid benefits. This plan requires referrals for specialty care.
- Medica HealthCare Plans MedicareMax Plus (HMO SNP) 2
1 Medica HealthCare is insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare,
2 Medica HealthCare is insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare, This plan is available to anyone who has both Medical Assistance from the State and Medicare.
Tools and Resources
- Medicare Advantage Copayment Guidelines
- Medicare Advantage Member Rights and Responsibilities
- Medicare Advantage Non-Contracted Provider Dispute and Appeal Rights
- Medicare Advantage Non-Contracted Provider Claim Payment Dispute Request Form
- Medicare Advantage Preventive Screening Guidelines
- Medicare Advantage Prior Authorization Reduction Frequently Asked Questions
- Medicare Advantage Service Area Reduction Frequently Asked Questions
- Readmission Review Program Clinical Guidelines
- Readmission Review Program Frequently Asked Questions
- Special Needs Plans (SNP) Benefit Plan Name Overview
- UnitedHealthcare Administrative Guide
Coverage options may vary depending upon your location. To learn more about a plan in your service area, go to Medicaplans.com.
To learn more about Medicare Part D prescription drug coverage or to access related forms, please review the Prescription Drug Resources materials available on MedicaPlans.com. This section contains information and forms for direct member reimbursement, medication prior authorization, and the prescription drug transition process.