GuildNet Health Advantage - Medicare Advantage Prescription Drug and Medicaid Advantage Plan is designed
for people who have both Medicare and Medicaid (Dual Eligible). Some of the services we cover are:
- Physician care (primary and specialty care covered with no referral requirement)
- Inpatient hospital care
- Home health care
- Emergency and Urgent Care
- Rehabilitation
- DME / Supplies
- Hearing Services
- Vision Services
- Health/Wellness Education
- Dental *
- Transportation (Routine* and Emergent)
- Medicare Part D Prescription Drugs
Not all covered services are listed. Please see the
Summary of Benefits
and Evidence of Coverage
for more information. * Dental and Transportation benefits are not covered in all counties.
Plan Premium and Extra Help
Because GuildNet Health Advantage members have Medicaid, they automatically receive extra help paying for
their premiums, deductibles and co-pays. As a member of GuildNet Health Advantage, you pay:
- $0 Plan Premium for medical and prescription drug benefits
- $0 Deductible
- $0 co-pays for covered medical benefits
- $0 to $6.50 for Part D prescription drugs, depending on the drug tier and your level of extra help.
- No Part D coverage gap
Members who pay a Medicare Part B premium must continue to pay it.
For more information about Extra Help, contact Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m.,
Monday through Friday or your local Medicaid office. TTY/TDD users should call 1-800-325-0778; call 1-800-MEDICARE (1-800-633-4227),
24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.
Benefits may change each year on January 1st. Please contact GuildNet for details.
GuildNet’s contract with Medicare is renewed annually and coverage beyond the end of
the contract year is not guaranteed.
Eligibility Requirements for Enrollment
- Age 18 or older
- Reside in Brooklyn, Queens, Manhattan, the Bronx, Nassau or Suffolk
- Have full Medicaid and Medicare Part A & B.
CLICK HERE TO ENROLL
(by clicking here you will be leaving the GuildNet website)
Medicare beneficiaries may enroll in GuildNet Medicare plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
To contact us:
GuildNet
15 West 65th Street
New York, NY 10023
Phone: 800-815-0000
Mon-Fri 8am-8pm
800-662-1220 TTY/TDD
E-mail: guildnetinfo@jgb.org
E-mail us, and a sales agent will call you to discuss
the Medicare Special Needs Plans. The person that
will be discussing plan options with you is employed
by a Medicare health plan that is not the Federal government,
and they may be compensated based on your enrollment in plan.
E-mailing us does NOT affect your current enrollment, nor will it
enroll you in a Medicare Advantage Plan, Prescription Drug Plan,
or other Medicare plan.
If you have a complaint related to our plan, providers, or pharmacies, please call our
Member Services Department at 1-800-815-0000, Monday – Friday 8:00am to 8:00pm and we will
do our best to assist you over the phone. TTY users should call 1-800-662-1220. You can also
write to us at the address above or file a complaint electronically by clicking here
File a Complaint
(by clicking here you will be leaving the GuildNet website)
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