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How Vital works with Medicare?


If you have Medicare, your Vital coverage works in a different way. Medicare is health insurance for people who are age sixty-five (65) and older, and for some people of any age who Social Security says are disabled. People with end stage renal disease can have Medicare too.

These are the different parts of Medicare:

  • Part A is for hospital stays, skilled nursing facility care, home health care, and hospice care.
  • Part B is for your doctor’s services and outpatient care.
  • Part D is for prescription medicines.

There are also other ways to have Medicare. These are called Medicare Health Plans (these plans are sometimes called Medicare Part C). These plans put all of the parts A, B, and D together for you in one plan.

To learn more about Medicare, call them at 1-800-633-4227. It’s a free call.

If you have Medicare, your Vital coverage works differently:

  • Your Medicare is your first (primary) insurance. Hospitals, doctors and other health care providers will bill Medicare first.
  • Vital is your second (secondary) insurance. After your providers bill Medicare, they will also bill Vital.

If you have Medicare Part A:

  • Vital will pay once you have reached the limit of what Medicare pays for.
  • Vital will not pay for your Part A deductibles.
  • You will pay copay for services depending on what type of Vital you have. See the copay chart on page twenty (20) of your Enrollee Handbook for more information.

If you have Medicare Part A and Part B:

  • Vital will pay for your pharmacy and dental services.
  • Vital will not pay for your Part A deductibles.
  • Vital will pay for your Part B deductibles and copayments.

If you have Medicare Part C:

  • You have the option to choose a Platino Plan, which will cover services your Medicare Health Plan doesn’t cover.