2021 Liberty Advantage Plan
Member Materials
I-SNP
- Evidence of Coverage
- Summary of Benefits
- Annual Notice of Change (ANOC)
- LIS Premium Summary
- Medication Transition Policy
- Medication Therapy Management
- Comprehensive Formulary
- Step Therapy
- Pharmacy Prior Authorization
- Part D Coverage Determination Form
- Part D Coverage Redetermination Form
Liberty at Home
Liberty Advantage (HMO I-SNP), and Liberty at Home (HMO I-SNP) are Institutional Special Needs Plans (I-SNPs) dedicated to providing personalized care to their members. All members get more than what is covered by Original Medicare. Under Liberty Advantage, you will receive all benefits covered under Medicare Part A and Part B, Medicare Part D Prescription Drug Coverage, and many supplemental benefits such as routine hearing and eye exams. Additionally, when you enroll in Liberty Advantage, a customized care team, supported by a nurse practitioner or physician will develop, enact, and coordinate your personal care plan. If you or your loved one is eligible, Liberty Advantage can greatly improve the care you receive, resulting in better health and well-being.
Membership advantages include:
- Medicare Part D Prescription Drug Coverage
- Preventative screenings
- Regular visits from a nurse practitioner or physician with the goal of better care coordination and more personalized care which leads to fewer unwanted trips to the hospital
- A personalized care plan that ensures that you are receiving the best and most appropriate care possible
- Open communication between you, your family, your care team, and nursing facility staff
- One point of contact for communication between you, your family, your care team, and nursing facility staff
You have choices with Liberty Advantage
You are eligible to join Liberty Advantage Plan if you have Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), and meet Liberty Advantage Plan’s eligibility requirements.
Liberty Advantage I-SNP
Liberty Advantage is best suited for people who reside in one of our participating assisted living communities and meet a nursing facility level of care or reside in one of our participating nursing facilities for greater than 90 days.
2021 I-SNP Benefit Highlights
How much is the monthly premium?
$30.30 per month. You also must keep paying your Medicare Part B premium.
How much is the deductible?
$198 per year for in-network services.
$445 per year for Part D prescription drugs.
Is there a Maximum Out-Of-Pocket Cost per year?
Yes, similarly to all Medicare plans, we protect you by establishing a maximum amount that you will pay out of pocket for covered services. The yearly Maximum Out-Of-Pocket Cost is $6,600.
After reaching this limit, the plan will pay for all covered services and procedures. Please note: you will still have to pay your monthly premiums and cost-sharing for Part D prescription drugs.
Is there a limit on how much the plan will pay?
The plan does have a yearly coverage limit for certain in-network benefits. Please contact us for more information.
Below is a chart of Benefits that our plan offers. These Benefits are provided in addition to all Original Medicare benefits.
| Benefits | Coverage |
|---|---|
| Podiatry | $0 Copay for 4 routine foot care visits per year |
| Hearing | $0 Copay for routine hearing exam and hearing aid fitting and evaluation + up to $2,000 for hearing aids every three years |
| Vision | $0 Copay for routine eye exam + up to $300 for eyewear every year |
| Transportation | $0 Copay – You Pay Nothing for 20 one-way trips per year for non-emergency medical services |
| Skilled Nursing | No prior hospitalization required for a skilled nursing stay |
Liberty Advantage Management
An effective post-acute care delivery system is composed of many things, each a critical component to care. First is building a system that combines the talents of an interdisciplinary team in a variety of settings to meet patient needs. Equally important is access to services. Liberty Healthcare and Rehabilitation Services helps patients to overcome setbacks following injury, illness or accident. As a network of post-acute services situated throughout North Carolina, South Carolina and Virginia, Liberty Advantage provides a continuum of care including skilled rehabilitation facilities, independent and assisted living, home health, hospice, palliative care and respite services with support from the durable medical equipment and pharmacy divisions. As a family-owned and operated company, with a strong commitment to Caring with Excellence, Liberty Advantage has developed and operated health care services in North Carolina since 1870.
Our philosophy is to offer the communities we serve with a complete senior care continuum, close to home and family. This means offering in-patient short term rehabilitation, long-term care, out-patient services with select centers offering assisted living. Hospice and respite care are also offered within our in-patient level of care and the continuum extends beyond the walls of our skilled nursing facilities and to the company’s home health, pharmacy and medical equipment branches to meet the needs of patients following discharge. Liberty Advantage represents a natural transition for Liberty Advantage by offering a plan that supports our most fragile residents.