Regence Medicare Advantage
plans
Regence MedAdvantage is offered as an alternative to
Medicare Parts A and B and Medicare supplement plans.
Regence MedAdvantage is a Medicare Advantage plan that
provides the same benefits available as traditional Medicare,
plus additional benefits.
Service Area
The Regence MedAdvantage service area includes Ada,
Bannock, Benewah, Bingham, Boise, Bonner, Bonneville,
Boundary, Canyon, Clark, Elmore, Fremont, Gem, Gooding,
Jefferson, Kootenai, Latah, Madison, Minidoka, Nez Perce,
Owyhee, Payette, Power, Shoshone, Teton and Twin Falls
counties in Idaho and Asotin County in Washington.
Additional Resources
In addition to the important information, rules
and guidelines in the links above for you and your
staff to be familiar with as a contracted Regence MedAdvantage
provider, the following table includes some additional
resources for you:
| Learn
more about |
Description
of information |
| Identifying
members |
View a sample member card. |
| Payment
Vouchers (PDF) |
View a sample voucher. |
Benefit
Summary (PDF) |
For complete and current benefit,
copayment, or coinsurance information, access
the Provider
Center or contact
us.
We offer the following Medicare Advantage
plans:
- Regence MedAdvantage Basic (stand-alone medical
plan without prescription drug
coverage)
- Regence MedAdvantage + Rx Classic (medical
plan with standard prescription
drug benefit as required by CMS)
- Regence MedAdvantage + Rx Enhanced (medical
benefits and enhanced prescription benefits)
All copayments should be collected from the member at the time of service, except for members who are eligible for both Medicare and Medicaid benefits, when the state is responsible for paying any cost sharing amount. |
| Pre-authorization |
Physicians and other health care
professionals are responsible for pre-authorizing
all services listed on the Medicare Products Pre-authorization
List. |
| Provider
directory |
Services provided by Regence
MedAdvantage Preferred Provider Organization
(PPO) network physicians, other health care professionals
and facilities are reimbursed at the in-network
benefit level with low copayment and coinsurance
amounts. Services provided by out-of-network
providers are subject to higher copayment and
coinsurance amounts. |
| Radiology Quality Initiative |
Regence has partnered with American Imaging Management (AIM®) to administer this program. Beginning March 1, 2011, if an order number is not obtained from AIM prior to the imaging procedure being performed, the procedure will be denied as a provider responsibility. |
| BlueCard® Program |
Regence participates in MA PPO network sharing with other Blue Cross and/or Blue Shield Plans (Blue Plans). Regence MedAdvantage providers whose patients are MA PPO members from other Blue Plans will:
- Be reimbursed using Regence MedAdvantage contracted rates
- Receive payment for in-network benefits according to the member’s contract
- Extend the same contractual access to care to these members as Regence MedAdvantage members
|
Forms include:
- An Important Message From Medicare
About Your Rights form
- Notice of Medicare Non-Coverage (NOMNC)
instructions and forms
|
Important forms for discharge
from hospitals and skilled nursing facilities. |
Revised January 2012
Note: To print a PDF document, you need Adobe® Reader®. Download it now for free.
|
