Medicare | Baylor Scott & White Health Plan (2024)

How Can We Help You?

Medicare Basics

Medicare is a national social insurance program administered by the US federal government. It guarantees access to health insurance for Americans ages 65 years old and older, people with disabilities and people with End-Stage Renal Disease (ESRD).

Overview of Medicare parts

Medicare has four parts: A, B, C and D. Each is designed to cover specific services based on different healthcare needs and budgets.

Compare HMO-POS and PPO Medicare Plans

What to Consider

Your Medicare Healthcare plan should meet your needs

There are a number of factors to consider when choosing a Medicare plan for the first time or changing your Medicare plan.

If you have current health or prescription drug coverage, get a clear understanding of how it works with Medicare. If you're covered through your employer, Indian Health or Tribal Health Program, talk to your benefits administrator or insurer before making any changes in your plan.

When you're ready to enroll in a new Medicare coverage plan, you can do so during designated enrollment periods.

Low Income Subsidies

If you have limited resources and income, you may be eligible for a low income subsidy (also called Extra Help), which helps pay your Medicare prescription coverage (lowers your premium payment amount), and in some cases, can help lower copay costs of prescriptions. This could add up to about $4,000 per year. How much lower your premiums may be depends on what percentage of the costs Medicare will cover for you.

• Learn More About Getting Extra Help
• Read about the Best Available Evidence for Low Income Subsidy (LIS) Beneficiaries

You must receive all routine care from plan providers.

Best Evidence Available for Low Income Subsidy (LIS) Beneficiaries

In accordance with the statutory requirement to provide a cost-sharing subsidy to Part D-eligible individuals who are full-benefit dual-eligible individuals or recipients of supplemental security income (SSI), Baylor Scott & White Health Plan (BSWHP) must provide access to Part D drugs at the correct LIS cost-sharing level when presented with evidence of LIS eligibility, even if the sponsor's systems and CMS's systems do not yet reflect that eligibility.

We also must update our own systems to reflect the LIS status indicated by the best available evidence and, if necessary, must submit a request to CMS so that, for the deemed population, the agency's systems can be updated as well. These requirements apply to all beneficiaries who are "deemed" subsidy-eligible including full benefit Medicare/Medicaid eligibles, partial dual-eligibles and people receiving SSI as well as those who must apply and are awarded LIS by the Social Security Administration (SSA).

Baylor Scott & White Health Plan offers BSW SeniorCare Advantage HMO-POS plans as a Medicare Advantage (MA) organization through a contract with Medicare. Baylor Scott & White Care Plan offers Covenant Health Advantage HMO plans as an MA organization through a contract with Medicare. Baylor Scott & White Insurance Company offers BSW SeniorCare Advantage PPO plans as an MA organization through a contract with Medicare. Enrollment in one of these plans depends on the health plan's contract renewal with Medicare.

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Y0058_BSWHPWEBSITE2024_C CMS 10/1/2023 | Last updated: 10/1/23

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