2024 Liberty Medicare Advantage Plan
Documents
- Evidence of Coverage
- Summary of Benefits
- 6 Tier Comprehensive Formulary
- Multi Language Document
- Pharmacy Directory
- Request for Authorization
- Authorization Chart
- Annual Notice of Changes
- Notification of Availability of Electronic Materials
- IRA Addendum
- LMA Medication Therapy Management (MTM) Program
- MTM Program Standard Format Letter
- Notification of Availability of Electronic Materials
Liberty Medicare Advantage Plan (LMA) – (HMO C-SNP) is a Chronic Special Needs Plans dedicated to providing personalized care to our members.
LMA is more than a health plan. It’s peace of mind. Our goal is to keep you healthy and independent. With that in mind we have added Liberty Medicare Advantage Freedom Flex card along with other key benefits that cost you nothing!
Membership Advantages:
- Customized Care Team – Personalized health status check-in, coordinated clinical care and direct member access
- Liberty Flex Card:
- $2,000 per year to spend on hearing, dental or vision
- $70 a month allowance to spend on groceries and/or OTC items, no rollover
- $20 a month to spend on transportation and fitness, with a rollover of dollars not spent for each month.
- Meal Preparation
- No cost to you 14 meals following an acute inpatient stay
- Chronic condition meal coverage at no cost to you 180 days, twice yearly
- At Home Monitoring – No cost to you and LMA will provide remote monitoring of vital signs with referral from RN Case Manager.
- Personal Electronic Devices used for fall prevention
Eligibility Requirements
You are eligible to join Liberty Medicare Advantage (C-SNP) Plan if you have Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), and meet Liberty Medicare Heart and Diabetes Plan’s eligibility requirements.
Liberty Medicare Advantage Plan is best suited for people who have one of the following conditions: Diabetes, Chronic Heart Failure, or Cardiovascular Disorders.
Benefit Highlights
How much is the monthly premium?
$0 per month. You also must keep paying your Medicare Part B premium.
How much is the deductible?
$0 per year for in-network services.
$0 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 $3,500.
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.
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.
Service Area:
Our service area includes these counties in North Carolina: Alamance, Bertie, Bladen, Brunswick, Buncombe, Burke, Cabarrus, Caldwell, Catawba, Chatham, Columbus, Cumberland, Davidson, Davie, Durham, Forsyth, Franklin, Granville, Greene, Guilford, Harnett, Halifax, Henderson, Hyde, Johnston, Lee, Lenoir, Martin, Mecklenburg, Moore, New Hanover, Orange, Pender, Person, Pitt, Randolph, Richmond, Robeson, Rockingham, Rowan, Sampson, Scotland, Stokes, Vance, Union, Wake, Warren, Wayne, Watauga, Wilkes, Wilson, and Yadkin.
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 3325, Spring Hill, FL 34611
To connect with a licensed Enrollment Specialist who will assist you with enrollment, please email PQAT@LibertyMedicareAdvantage.com or call 1-844-854-6884.