2022 Liberty Medicare Advantage Nursing Home Plan

Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) is an Institutional Special Needs Plans (I-SNP) dedicated to providing personalized care to their members. All members get more than what is covered by Original Medicare. Under Liberty Medicare Advantage Nursing Home Plan, 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 Medicare Advantage Nursing Home Plan, 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 Medicare Advantage Nursing Home Plan can greatly improve the care you receive, resulting in better health and well-being. If you reside in a Nursing Home or Assisted Living Facility this plan was built for you.

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 Medicare Advantage Nursing Home Plan

You are eligible to join Liberty Medicare Advantage Nursing Home Plan if you have Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), and meet Liberty Medicare Advantage Nursing Home Plan’s eligibility requirements. Liberty Medicare Advantage Nursing Home Plan 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.

2022 I-SNP Benefit Highlights

How much is the monthly premium?
$35.80 per month. You also must keep paying your Medicare Part B premium.

How much is the deductible?
$203 per year for in-network services.
$480 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	Routine hearing exam and hearing aid fitting and contribution towards hearing aids.
Vision	Routine eye exam and eyewear allowance.
Transportation	$0 Copay for 20 one-way trips per year for non-emergency medical services
Primary Care Visits	$0 Copay for Primary Care visits
Skilled Nursing	No prior hospitalization required for a skilled nursing stay

Enrollment Period

The Open Enrollment for Institutionalized Individuals (OEPI) is continuous for eligible individuals. You may enroll in Liberty Medicare Advantage at any time if you are eligible.

Eligibility Requirements

You can join Liberty Medicare Advantage if you have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), reside in or are expected to reside in a participating Liberty Medicare Advantage facility for 90 days or longer, and meet Liberty Medicare Advantage’s eligibility requirements.

Service Area:

Alamance, Bladen, Buncombe, Chatham, Cumberland, Forsyth, Guilford, Hyde, Lee, New Hanover, Person, Rowan, Scotland, Watauga, Warren, Yadkin, Bertie, Brunswick, Catawba, Columbus, Davie, Franklin, Halifax, Johnston, Orange County, Robeson, Sampson, and Wake

Participating Nursing Facilities:

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Ready to Enroll in Liberty Advantage?

If you meet the eligibility criteria, you can enroll at any time, effective the first of the following month.

Call 1-844-854-6884 (TTY 711) to speak with a Liberty Medicare Advantage Representative, or click to download an Enrollment Form below and mail it to us at PO Box 3630, Little Rock, AR 72202.

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Safe Disposal

You can search for Drug Take Back programs near you: https://scdhec.gov/household-medicinepharmaceutical-disposal