2026 Plans
Medical & Prescription Drug Plans
These plans combine both your Medical & Part D coverage
Medical Only Plans
These plans are Medical only coverage and do not cover Part D
Medicare & Medicaid Dual Eligibility Plan
Members must have both Medicare and Medicaid to enroll
Medicare Broker Resources
Choosing a Medicare Advantage plan can feel complex, but we’re here to help.
How to choose the plan that’s right for you.
Consider your health needs.
Each Medicare Advantage plan offers different coverage beyond Original Medicare—consider your current medical conditions, medications and expected healthcare needs to identify how different options impact your healthcare coverage and costs.
Check the provider network.
When choosing a Medicare Advantage plan, find out which doctors and facilities are within the provider network to ensure you’ll be able to see your preferred healthcare providers.
Compare monthly premiums.
How much do you want to spend every month? Check the cost of premiums, deductibles, and copays of each Medicare Advantage plan to determine the best fit for your budget.
Consider prescription drug coverage.
Are you taking any prescription medication? Review the prescription drug coverage and copays of each Medicare Advantage Plan to make sure that your medications are sufficiently covered.
Look at additional benefits.
Everyone's health needs and lifestyle are different. Consider what’s valuable to your health when it comes to dental, vision, membership perks, and more.
Know what to do and when.
Medicare has specific timeframes for enrollment and missing your enrollment window can result in penalties. Learning more about Medicare Enrollment periods will ensure you enroll on time.
Most importantly — get help!
Connect with one of our Senior Health Plan experts to ask questions and explore what plans may be right for you.
Contact us todayWhere care means MORE choices.
for Silver Plus, Platinum and Platinum Plus Plans
Choose from 100s of in-network doctors without a referral.
See doctors from any of our premier health systems.
Search for a dentist near you.
Our plans cover comprehensive and preventative dental care.
Save money on prescription drug costs.
Find hassle-free drug coverage with many low or no-cost prescriptions.
The ABC’s (and D) of Medicare
Original Medicare has two parts – Hospital (Part A) & Medical (Part B)
Part A covers services such as hospital bed & board, skilled nursing & hospice.
- Generally, you pay no premium for Part A.
- No penalties to delay your enrollment, but no reason to not enroll as soon as you’re eligible.
Part B covers services like doctor’s visits, outpatient surgery, and diagnostic services.
- You do have a monthly premium for Part B (and it is income adjusted for high-income earners). The Part B premium can change each year and is generally withheld from your Social Security or RRB benefits.
- Penalties do apply if you don’t enroll in Part B when you’re eligible – see the “When to enroll” section for more information.
Medicare Advantage plans are called Part C
Part C combines the benefits of Original Medicare A & B into one plan. When you join a Medicare Advantage plan, the insurance company now pays the claims (which is why these plans are also called Medicare Replacement plans – we replace Medicare as the claims payer).
Medicare Advantage plans usually have a network of doctors that you will use to maximize your benefits and help you control your costs.
Medicare Advantage plans also usually cover things that Original Medicare doesn’t cover – like routine vision and hearing exams, transportation for rides to your doctors, over the counter benefits – even gym memberships. You can also choose a plan that includes coverage for outpatient prescription drugs – which brings us to:
Outpatient prescription drug coverage is called Part D
Part D plans can either be included with your Medicare Advantage plan or as a stand alone plan to go with Original Medicare.
Part D plans provide coverage for your prescription drugs and are offered by insurance companies. Medicare sets the structure of the Part D plans, so the difference between Part D plans are what drugs are covered and how much you’ll pay for them.
Help with drug costs:
Social Security does have a program to assist Medicare beneficiaries that are lower-income called Extra Help or Low-Income Subsidy. Depending on your income (and somewhat on your assets), you may qualify for this program. People that qualify for Extra Help will see lower monthly premiums & generally their copays are at the Catastrophic coverage levels.
If you qualify for Medicaid, your drug costs will be even lower.
| Deductible Stage | The amount you pay before you begin to pay copays in the Initial Coverage Limit. |
| Initial Coverage Stage | Your covered drugs are sorted into 5 different tier levels and your cost will depend on which tier level your drugs are in. You stay in the Initial Coverage stage until your total drug cost for the year reaches $2,100. |
| Catastrophic Stage | Once your total drug cost reaches $2,100, you pay nothing for your covered Part D drugs for the rest of the year. |
Generally you’re eligible to enroll in Medicare when you turn 65 (in fact, if you are collecting Social security benefits, you are automatically enrolled in Medicare A & B). Some people are eligible at a younger age due to a disability. If you are determined to be disabled, you will be automatically enrolled in Medicare A & B.
For simplicity, let’s look at the timelines for someone turning 65. You can start the enrollment process up to 3 months before your 65th birth month. If you are not collecting your Social Security retirement benefits, you can enroll online at www.ssa.gov or in person at your local Social Security Office.
If you are not covered under an employer plan, you will need to enroll in BOTH Medicare A & B to avoid penalties.
If you are still working and are covered under an employer plan (or you are the dependent of an ACTIVE employee), you can delay your Part B enrollment – when you retire, you can enroll in Part B with no penalties. NOTE: You should always check with Social Security to make sure you can delay your enrollment!
Yes! If you do not enroll in Medicare when you are eligible to do so, even though you receive your health care from Indian Health Services, you will still be penalized.
Questions?
Contact us today
2025 Plans
Medical & Prescription Drug Plans
These plans combine both your Medical & Part D coverage
Medical Only Plans
These plans are Medical only coverage and do not cover Part D
Medicare & Medicaid Dual Eligibility Plan
Members must have both Medicare and Medicaid to enroll
Medicare Broker Resources
Choosing a Medicare Advantage plan can feel complex, but we’re here to help.
How to choose the plan that’s right for you.
Consider your health needs.
Each Medicare Advantage plan offers different coverage beyond Original Medicare—consider your current medical conditions, medications and expected healthcare needs to identify how different options impact your healthcare coverage and costs.
Check the provider network.
When choosing a Medicare Advantage plan, find out which doctors and facilities are within the provider network to ensure you’ll be able to see your preferred healthcare providers.
Compare monthly premiums.
How much do you want to spend every month? Check the cost of premiums, deductibles, and copays of each Medicare Advantage plan to determine the best fit for your budget.
Consider prescription drug coverage.
Are you taking any prescription medication? Review the prescription drug coverage and copays of each Medicare Advantage Plan to make sure that your medications are sufficiently covered.
Look at additional benefits.
Everyone's health needs and lifestyle are different. Consider what’s valuable to your health when it comes to dental, vision, membership perks, and more.
Know what to do and when.
Medicare has specific timeframes for enrollment and missing your enrollment window can result in penalties. Learning more about Medicare Enrollment periods will ensure you enroll on time.
Most importantly — get help!
Connect with one of our Senior Health Plan experts to ask questions and explore what plans may be right for you.
Contact us todayWhere care means MORE choices.
for Silver Plus, Platinum and Platinum Plus Plans
Choose from 100s of in-network doctors without a referral.
See doctors from any of our premier health systems.
Search for a dentist near you.
Our plans cover comprehensive and preventative dental care.
Save money on prescription drug costs.
Find hassle-free drug coverage with many low or no-cost prescriptions.
The ABC’s (and D) of Medicare
Original Medicare has two parts – Hospital (Part A) & Medical (Part B)
Part A covers services such as hospital bed & board, skilled nursing & hospice.
- Generally, you pay no premium for Part A.
- No penalties to delay your enrollment, but no reason to not enroll as soon as you’re eligible.
Part B covers services like doctor’s visits, outpatient surgery, and diagnostic services.
- You do have a monthly premium for Part B (and it is income adjusted for high-income earners). The Part B premium can change each year and is generally withheld from your Social Security or RRB benefits.
- Penalties do apply if you don’t enroll in Part B when you’re eligible – see the “When to enroll” section for more information.
Medicare Advantage plans are called Part C
Part C combines the benefits of Original Medicare A & B into one plan. When you join a Medicare Advantage plan, the insurance company now pays the claims (which is why these plans are also called Medicare Replacement plans – we replace Medicare as the claims payer).
Medicare Advantage plans usually have a network of doctors that you will use to maximize your benefits and help you control your costs.
Medicare Advantage plans also usually cover things that Original Medicare doesn’t cover – like routine vision and hearing exams, transportation for rides to your doctors, over the counter benefits – even gym memberships. You can also choose a plan that includes coverage for outpatient prescription drugs – which brings us to:
Outpatient prescription drug coverage is called Part D
Part D plans can either be included with your Medicare Advantage plan or as a stand alone plan to go with Original Medicare.
Part D plans provide coverage for your prescription drugs and are offered by insurance companies. Medicare sets the structure of the Part D plans, so the difference between Part D plans are what drugs are covered and how much you’ll pay for them.
Help with drug costs:
Social Security does have a program to assist Medicare beneficiaries that are lower-income called Extra Help or Low-Income Subsidy. Depending on your income (and somewhat on your assets), you may qualify for this program. People that qualify for Extra Help will see lower monthly premiums & generally their copays are at the Catastrophic coverage levels.
If you qualify for Medicaid, your drug costs will be even lower.
| Deductible Stage | The amount you pay before you begin to pay copays in the Initial Coverage Limit. |
| Initial Coverage Stage | Your covered drugs are sorted into 5 different tier levels and your cost will depend on which tier level your drugs are in. You stay in the Initial Coverage stage until your total drug cost for the year reaches $2,100. |
| Catastrophic Stage | Once your total drug cost reaches $2,100, you pay nothing for your covered Part D drugs for the rest of the year. |
Generally you’re eligible to enroll in Medicare when you turn 65 (in fact, if you are collecting Social security benefits, you are automatically enrolled in Medicare A & B). Some people are eligible at a younger age due to a disability. If you are determined to be disabled, you will be automatically enrolled in Medicare A & B.
For simplicity, let’s look at the timelines for someone turning 65. You can start the enrollment process up to 3 months before your 65th birth month. If you are not collecting your Social Security retirement benefits, you can enroll online at www.ssa.gov or in person at your local Social Security Office.
If you are not covered under an employer plan, you will need to enroll in BOTH Medicare A & B to avoid penalties.
If you are still working and are covered under an employer plan (or you are the dependent of an ACTIVE employee), you can delay your Part B enrollment – when you retire, you can enroll in Part B with no penalties. NOTE: You should always check with Social Security to make sure you can delay your enrollment!
Yes! If you do not enroll in Medicare when you are eligible to do so, even though you receive your health care from Indian Health Services, you will still be penalized.
Questions?
Contact us today
