Disclaimers
AveraAdvantage is offered by The Pyramid Life Insurance Company and American Progressive Life & Health Insurance Company, Medicare Advantage Private Fee-for-Service organizations that contract with the Centers for Medicare and Medicaid Services (CMS). Our plan is available to anyone enrolled in Part B and entitled to Part A of Medicare through age or disability who continues to pay any applicable Medicare premiums and lives in the plans service area. You must continue to pay your Medicare Part B premium. The Pyramid Life Insurance Company and American Progressive Life & Health Insurance Company and its agents are not connected in any way with the federal or state government or Medicare.
A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your doctor or hospital is not required to agree to accept the plan's terms and conditions, 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 healthcare services to you, except in emergencies. Providers can find the plan's terms and conditions at www.todaysoptions.com.
Enrollment Limitations
Members may enroll only during specific times of the year. Contact AveraAdvantage at 1-866-568-8921 (TTY/TDD users call 1-800-958-2692), 8 AM to 8 PM, 7 days a week to obtain more information.
Potential for Contract Termination
The AveraAdvantage benefit package, premiums, copayments and service areas are all subject to change annually at AveraAdvantage contract renewal time with the Centers for Medicare and Medicaid Services (usually January 1). Availability of coverage beyond the end of the current contract year is not guaranteed.
Availability of Medicare Subsidy Information
Beneficiaries interested in determining qualifications for extra help with Medicare Prescription Drug Plan costs should call:
- 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 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 between 7 a.m. and 7 p.m., Monday thru Friday. TTY/TDD users should call 1-800-325-0778.
Low Income Subsidy Premium Disclaimer
If you qualify for extra help with your Medicare Prescription Drug Plan costs, your premium and drug costs may be lower. When you join <plan name>, 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 users should call 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 between 7 a.m. and 7 p.m., Monday thru Friday. TTY/TDD users should call 1-800-325-0778.
Medigap Disclaimer
If you have a Medicare Supplement (Medigap) policy that includes prescription drug coverage, you must contact your Medigap Issuer to let them know that you have joined a Medicare Prescription Drug Plan. If you decide to keep your current Medigap supplement policy, your Medigap Issuer will remove the prescription drug coverage portion of your policy and adjust your premium. Under certain circumstances, you can also buy a different Medigap policy without prescription drug coverage sold by your Medigap Issuer. Your Medigap Issuer cannot charge you more based on any past or present health problems. Call your Medigap Issuer for details.
