Thank you for your interest in becoming a member of Fresenius Health Partners (PPO SNP). You will find some important information below that will be helpful to you.
Fresenius Health Partners is a (PPO SNP) (Preferred Provider Organization) plan in select counties in Georgia, North Carolina, Tennessee and Texas. FMCHP operates as a Chronic Care Special Needs Plan.
You must live in our service area to be eligible for the plan. Fresenius Health Partners (PPO SNP) is available in these states and counties:
| State | Counties |
|---|---|
| Georgia | Chatham, Cherokee, Clayton, Cobb, DeKalb, Evans, Forsyth, Fulton, Gilmer, Gwinnett, Rabun, Rockdale, Stephens |
| North Carolina | Caswell, Chatham, Cleveland, Durham, Granville, Lee, Orange, Wake |
| Tennessee | Claiborne, Cocke, Hardeman, Knox, Monroe, Roane, Sevier, Shelby |
| Texas | Dallas, El Paso, Hill, Hood, Tarrant |
Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2013. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Limitations, copayments and restrictions may apply.
Members may enroll in the plan only during specific times of the year. Contact the plan for more information.
Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B premium.
Members must use network pharmacies to access the prescription drug benefit, except in non-routine circumstances. Quantity limitations and restrictions may apply to some drugs.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486- 2048, 24 hours a day/ 7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your Medicaid Office.
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your 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.
You must also use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Fresenius will be responsible for the costs.
