AbilityCare (HMO SNP)
2012 AbilityCare Member Materials
- Summary of Benefits (.pdf)
- Member Guide (.pdf)
- Evidence of Coverage - WITH Medicare (.pdf)
- Evidence of Coverage - WITHOUT Medicare (.pdf)
- Primary Care Clinic Network Listing (.pdf)
- Provider Directory (.pdf)
- Comprehensive Formulary (.pdf)
- Supplementary Drug List - WITH Medicare (.pdf)
- CMS Best Available Evidence Coverage (web)
- 1863 H5703 Part C Plan Rating (.pdf)
- 1866 H5703 Part D Plan Rating (.pdf)
Search Online: AbilityCare WITH Medicare
Search Online: AbilityCare
Health Promotions Vouchers
Note: PDF format requires Adobe Reader® software. If you don't have it, download it for free here.
Call Member Services
Toll-free: 1-866-567-7242
or 711 (hearing impaired)
AbilityCare is a Special Needs Basic Care program for people with disabilities who live in our 12-County service area. AbilityCare is designed to help people with disabilities access the health care, medications, and support services they need. There are no additional costs to join AbilityCare. To be eligible for AbilityCare one must:
- Be certified disabled by the Social Security Administration or State Medical Review Team (SMRT);
- Be at least 18 and under the age of 65 at the time of enrollment;
- Be eligible for Medical Assistance;
- Have Medicare Parts A and B, or no Medicare;
- Live in our service area (see map).
For people with Medicare and Medical Assistance, AbilityCare provides Medicare Part A (hospital), Part B (medical), Part D (prescription drug), and Medical Assistance coverage.
Some plan members may be paying a premium for Medicare Part A and/or Medicare Part B, although many members do not pay these premiums due to Medical Assistance eligibility. If you are paying for your Medicare Part B, you must continue to pay your Medicare Part B premium to stay a member of our plan.
There is no premium and no deductible for AbilityCare.
For people without Medicare, AbilityCare provides Medical Assistance coverage.
AbilityCare Features:
- A large network of providers where members can receive care without referrals
- Someone located in the county who helps members get the services and supports they need
- A formulary (list of covered drugs) that is designed for people with disabilities
- A 24-hour nurse advice line
HIV Screening
Did you know that annual screening for Human Immunodeficiency Virus (HIV) is a covered benefit for South Country members? Call Member Services toll free at 1-866-567-7242 for specific benefit information. If you are at risk, be safe! Get Tested!
Not a Member Yet?
There are many more benefits to being an AbilityCare member, and the best part is, there is no extra cost to you! See How to Enroll for more information. Or, if you wish to speak with someone about your enrollment questions, please call us toll free at 1-866-567-7242, 8:00am-8:00pm, seven days a week. We are happy to help!
Enrollment Questions and Assistance
Call: 1-866-567-7242 (toll free)
For the hearing impaired: 7-1-1 (TTY)
Hours: 8:00am–8:00pm, seven days a week
Disenrollment
You may end your membership in our plan at any time. Ending your membership in our plan may be voluntary (your own choice) or involuntary (not your own choice). Please refer to Chapter 10 of the 2011 Certificate of Coverage (see under Member Materials in the right column of this page) for more information.
Potential for contract terminations
All health plans in the Medicare program agree to stay with the program for a full year at a time. Each year the plans decide whether to continue for another year. Even if a Medicare health plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for health care coverage in your area and give you information about your rights to other Medicare coverage. You can choose another health plan if one is available.