LET OUR TEAM GUIDE YOU

713.442.7526

Monday - Friday | 8 am - 5 pm

Are You Turning

65
in the
NEXT YEAR?

When you turn 65 you will become eligible for Medicare. Read below to understand the Kelsey-Seybold Clinic Medicare policy.

What Do I Need to Know?

Your health is important to us and we want you to be able to continue your care at Kelsey-Seybold Clinic.

Because of this, we want to make you aware that Kelsey-Seybold Clinic does NOT accept Original Medicare, in most cases.

Instead, Kelsey-Seybold Clinic contracts with certain Medicare Advantage plans to see Medicare patients.

Why Doesn't Kelsey-Seybold Clinic Accept Original Medicare?

At Kelsey-Seybold Clinic, we strive to be Your Doctors for Life. To us, this means delivering comprehensive and quality care at each of life's stages. Our goal is to deliver quality health care and we have made investments in health improvement programs and quality measures that are important to you and essential for quality care. Original Medicare doesn't reimburse these added benefits for our patient's health. Therefore, in order to keep these programs and offer the level of service that you have come to expect, Kelsey-Seybold Clinic does not accept Original Medicare as a form of reimbursement for medical services. However, Medicare offers an option that we do accept: Medicare Advantage.

In order to maintain the levels of service, management, and care that you have come to expect from Kelsey-Seybold Clinic, we will only accept Medicare Advantage plans that are contracted with Kelsey-Seybold Clinic.

Learn More

What is a Medicare Advantage Plan?

Medicare Advantage Plans include hospital insurance, medical insurance, and most include prescription drug coverage.

What Plans are Contracted with Kelsey-Seybold Clinic?

Kelsey-Seybold Clinic contracts with two Medicare Advantage Plans (Part C) based on your county of residence.

When is the Best Time to Enroll?

NOW is the time to learn more in order to take action to keep your Kelsey-Seybold doctors.

How to Get Help & Support

Don't worry! Our team is here to help no matter what you decide.

What is a Medicare Advantage Plan?

A

COVERS HOSPITAL-RELATED SERVICES AND EMERGENCY CARE

B

COVERS DOCTOR'S OFFICE VISITS

C

COVERS BOTH PART A AND PART B AND OFTEN HAS ADDITIONAL COVERAGE

D

COVERS PRESCRIPTION DRUGS

A Medicare Advantage Plan is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies that Medicare approves. If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare.

Medicare Advantage Plans cover all Medicare Part A and Part B services. In all types of Medicare Advantage Plans, you're always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care and some care in qualifying clinical research studies. Original Medicare covers hospice care and some costs for clinical research studies, even if you're in a Medicare Advantage Plan.

Medicare Advantage Plans may offer extra coverage, like vision, hearing, and other health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you might pay a monthly premium for the Medicare Advantage Plan.

You can join a Medicare Advantage Plan contracted with Kelsey-Seybold Clinic. If so, you'll generally get your services from Kelsey-Seybold Clinic providers.

What Else Should I Know About Medicare Advantage Plans?

You have Medicare rights and protections, including the right to appeal.
You can check with the plan before you get a service to find out if it's covered and what your costs may be.
You must follow plan rules. It's important to check with the plan for information about your rights and responsibilities.
If you go to a doctor, other healthcare provider, facility, or supplier that doesn't belong to the plan's network, your services may not be covered, or your costs could be higher. In most cases, this applies to Medicare Advantage HMOs and PPOs.
Providers can join or leave a plan's provider network anytime during the year. Your plan can also change the providers in the network any time during the year. If this happens, you may need to choose a new provider.
If you join a clinical research study, some costs may be covered by Original Medicare and some may be covered by your Medicare Advantage Plan.
Medicare Advantage Plans can't charge more than Original Medicare for certain services, like chemotherapy, dialysis, and skilled nursing facility care.
Medicare Advantage Plans have a yearly limit on your out of pocket costs for medical services. Once you reach this limit, you'll pay nothing for covered services. This limit may be different between Medicare Advantage Plans and can change each year. You should consider this when choosing a plan.

Information about Medicare Advantage Plans provided by Medicare & You 2016. Visit Medicare.gov to learn more.

Kelsey-Seybold Accepts the Following Medicare Advantage Plans*

* Kelsey-Seybold Clinic does NOT accept Original Medicare. Medicare Advantage plan access is based on county of residence.
Please call 713.422.7526 to learn more.

** Existing members only.

What Happens if I Continue Working?

If you plan to continue working full-time after age 65,

you may be able to continue accessing medical services from Kelsey-Seybold Clinic using your employer-sponsored medical plan.

Please call 713.442.7526 to confirm.

If you will NOT have employer medical coverage after age 65,

you will need to contact our team to learn how to keep your Kelsey-Seybold Clinic doctors.

If you lose your employer-sponsored medical coverage,

you typically have an 8-month window in which you must enroll in a Medicare or Medicare Advantage plan to avoid paying a late enrollment penalty. Contact our team for more information.

What Do I Need to Do and When?

First, know that you are not alone. We are here to provide objective guidance to support your decision.

When You Turn 64

Get information about the Medicare Advantage plans contracted with Kelsey-Seybold Clinic. Start considering doctor access, coverage, and budget requirements that are important to you and your future.

Every situation is unique. Call our team so we can understand your coverage needs and offer objective advice based on your unique situation.

3 Months Before Your 65th Birthday

You are now eligible to apply for Medicare benefits, including enrollment in a contracted Medicare Advantage plan.

If you will continue to work after age 65 and will retain your employer-sponsored coverage, call us to let us know what coverage you will use after you turn 65.

1-2 Months Prior to Your 65th Birthday

No matter what type of plan you're considering, our team is here to help.

Month You Turn 65 & Up to 3 Months After

Be sure you receive your coverage cards and that they properly reflect your plan selection.

If you applied for Original Medicare and discovered that your Kelsey-Seybold Clinic providers are not covered, you still have time to enroll in a contracted Medicare Advantage plan.

4 Months After Turning 65

Your initial enrollment window has closed for all plans.

Your next opportunity will be during the annual enrollment period, which occurs each year from October 15 - December 7.

Let Our Team Guide You on This Journey

Call 713.442.7526

Monday - Friday, 8:00 am - 5:00 pm

Click the button above to fill out an online form to request that someone from our team contact you.

Kelsey-Seybold Clinic is not a Medicare Advantage plan. Please understand that it is your decision whether or not to join a Medicare Advantage plan. You do not have to enroll in a Medicare Advantage plan. You can always go to another provider who provides services through Original Medicare.