Michigan

Welcome to Fidelis SecureCare of Michigan

Currently, Fidelis SecureCare is available to qualified individuals in the following counties:

  • Allegan
  • Bay
  • Genesee
  • Jackson
  • Kalamazoo
  • Kent
  • Macomb
  • Muskegon
  • Oakland
  • Saginaw
  • Washtenaw
  • Wayne

Our Michigan provider network comprises credentialed primary care physicians, specialists, hospitals, pharmacies and other clinical professionals selected for their experience in geriatric medicine. For a comprehensive list of the Fidelis SecureCare Provider Network, click here.

Fidelis SecureCare expands coverage beyond original Medicare and includes Part D Prescription Drug Coverage on all plans. We offer the following three types of plans:

  • Institutional Plans — specially created to meet the unique needs of individuals who live in a nursing or assisted living facility
  • Institutional Community Plans — designed for individuals with complex and often disabling medical conditions, who live in the community, but would otherwise qualify for institutional-level care
  • Dual-eligible Plan — intended for people who live in a community setting and receive financial help from their state Medicaid program and qualify for Medicare. This plan is available to individuals residing in Macomb, Oakland and Wayne counties.

Additional Help for Low Income Members
You may be one of the millions of beneficiaries who qualify for reduced premiums and increased cost-sharing for their prescription drug benefits. Check the low-income subsidy table to evaluate your eligibility.

The chart below highlights some of the most sought-after features and benefits. For more detailed information on the plan of your choice see the Summary of Benefits.

Fidelis Secure Plan Highlights - 2013

Institutional Plans Institutional Community Plans Dual-eligible Plan
Fidelis
Secure
Comfort
Fidelis
Secure Comfort
Plus
Fidelis
Secure
Independence
Fidelis
Secure
Freedom
Fidelis
Secure
Liberty
Monthly
Premium

Covers your
medical and
Part D Rx Drug
coverage.
$34.20
(in addition to your
Part B premium)
$98
(in addition to your
Part B premium)
$149
(in addition to your Part B premium)
$16.60
(in addition to your Part B premium)
Your costs may
be as low as $0,
depending on your
level of Medicaid
eligibility.
Inpatient
Hospital Care
Medicare cost shares apply Days 1-10/$75 day
Days 11+/$0 day
Days 1-10/$65 day
Days 11+/$0 day
Medicare cost shares apply Medicare/ Medicaid cost shares apply
Skilled Nursing Facility
100 day benefit period prior
hospital stay NOT REQUIRED
$0 $0 $0 Medicare cost shares apply Medicare/ Medicaid cost shares apply
Comprehensive Part D
Prescription
Drug Coverage


For Rx Drug
Benefit details,
click here
$325 deductible
25% coinsurance
$0 deductible
Tier 1: $ 5
Tier 2: $30
Tier 3: $65
Tier 4: 33%
$0 deductible
Tier 1: $ 5
Tier 2: $30
Tier 3: $65
Tier 4: 33%
$325 deductible
25% coinsurance
$0 deductible
Tier 1:
$0/$1.15/$2.65
All other drugs: $0/$3.50/$6.60
Primary Care Physician Visits $0 $0 $0 $0 $0
Specialist/ Podiatry/
Chiropractic
Visits
20% coinsurance $0 $0 20% coinsurance $0 - 20%
coinsurance
Dental/Vision/
Hearing
Supplemental Basket Benefits
$0 copay
$500 annual
benefit
$0 copay
$500 annual
benefit
$0 copay
$400 annual
benefit, plus
Dental = $400
Eyewear = $150
Hearing aids = $250
$0 copay
$400 annual
dental benefit, plus
$400 vision,
hearing & supplemental benefits
$0 copay
$400 annual
dental benefit, plus
$325 vision,
hearing & supplemental
benefits
Transportation
(12 trips to approved
locations)
$0 $0 $0 $0 $0
Preventive Wellness & Education
Services
$0 copay for all Medicare-covered Preventive, Wellness & Education Services

Depending on your level of Medicaid eligibility, you may not have any cost-sharing responsibility for original Medicare services and your share for Part D covered drugs may be less than stated above. Certain limitations and exclusions may apply to these and other benefits.

Out-of-Network Coverage
You generally must receive your care from a network provider. In most cases, care you receive from an out-of-network provider (a provider who is not part of our plan’s network) will not be covered. The only exceptions are emergencies, urgently needed care when the network is not available (generally, when you are out of the area), out-of-area dialysis services, and cases in which Fidelis SecureCare authorizes the use of an out-of-network provider. In these situations, you may pay the same as you would pay if you got the care from a network provider.

Fidelis Secure Plans - 2013

Click on the plan of your choice to review the Summary of Benefits.

Institutional Plans Institutional Community Plans Dual-eligible Plan
Fidelis Secure Comfort
Fidelis Secure Independence Fidelis Secure Liberty
Fidelis Secure Comfort Plus Fidelis Secure Freedom

For a Fidelis Secure Plan Enrollment Form, click here.

We welcome the opportunity to discuss all the benefits of Fidelis SecureCare to help you find the plan that’s right for you.
Contact us today.

For additional information about Medicare coverage and other Medicare-related questions, visit the official Medicare website www.Medicare.gov.

Disclaimer Information

Fidelis SecureCare is a Medicare Advantage organization with a Medicare contract. To join our plan you must have Medicare Part A and Part B, and reside within the service area. You may enroll in the plan or make changes to coverage you already have only during specific times of the year and must continue to pay your Medicare Part B premium. The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. For more information contact the plan. Additional information about benefits is available to assist you in making a decision about your coverage. Documents may be available in a different format or language. Certain restrictions and limitations may apply. Benefits, Formulary, pharmacy network, premium and/or co-payments/coinsurance may change January 1, 2014. This is an Advertisement.

Our plan is required to notify beneficiaries that it is authorized by law to refuse to renew its contract with the Centers for Medicare & Medicaid Services (CMS), that CMS also may refuse to renew the contract, and that termination or non-renewal may result in termination of your enrollment. In addition, the plan may reduce its service area and no longer offer services in the area where you reside. In the event this happens, you will receive advance notice. For more information, please refer to the Evidence of Coverage or contact our Customer Service Department at: 877-372-8085, Mon – Fri. between 8:00am – 8:00pm. TTY/TTD users, call: 888-844-5530.

As a member of Fidelis SecureCare, you have rights and responsibilities upon disenrollment. You may end your membership in our plan only during certain times of the year, known as enrollment periods. However, there are certain situations, in which you may be eligible to end your membership at other times of the year. This is known as a Special Enrollment Period. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the Medicare Advantage Disenrollment Period.

For more information on disenrollment, please refer to your Evidence of Coverage, Chapter 10 "Ending your membership in the plan" or call our Customer Service Department at 877-372-8085, Mon. – Fri. between 8:00am – 8:00pm, TTY/TTD users should call: 888-844-5530.

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Y0030_2013_Web378 (8)
CMS Approval: 05/21/2013
Last Updated: Thursday, May 23, 2013 9:44:14 AM
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