SilverSneakers is a nationwide gym membership program designed to help Medicare clients stay fit. It is accepted at more than 16,000 locations including YMCA, 24 Hour Fitness, LA Fitness, Curves, YouFit, Local Rec centers, and many more. SilverSneakers is not included in Medicare Parts A and B, or with TriCare for Life. SilverSneakers is included in some Medicare Part C plans, also known as Medicare Advantage plans, which are offered by companies like Humana or UnitedHealthcare. You must have Medicare Parts A and B to enroll.
What is a Medicare Part C Plan?
Medicare Part C began in 2002, and has grown to over 21 Million members and growing every year. Medicare Part C plans are required to provide the same level of coverage as Medicare Part A and B, but are allowed to offer additional benefits such as dental, hearing, vision and SilverSneakers.
For most clients, the confusing part is that this plan is zero premium. How is that possible? Because you paid into Medicare your whole life and also pay a premium every month for your Medicare Part B . Medicare pays Humana every month that you are enrolled in the plan. You are just deciding to receive your Medicare benefits with a company (Humana) that offers additional benefits that better fits your needs.
TriCare for Life is, in my opinion, the most comprehensive medical coverage you can get because it pays all of the copays and coinsurance not covered by your Medicare plan (original Medicare Part A and B OR Medicare Part C) and includes drug coverage that is superior to regular Part D drug coverage.
TriCare for Life remains secondary, regardless if you stay on original Medicare A and B, or if you switch to Medicare Part C. TriCare for Life provides coverage in these ways:
– Deductible for Hospital stays on Medicare Part A
– Pays the 20% coinsurance and deductible, not covered by Medicare B
– Pays the Copays of Medicare Part C
– Provides excellent prescription drug coverage
One difference between Original Medicare and Medicare Part C is that Part C plans charge members a flat copay amount for care ($10 doctors visit) but on Original Medicare the structure is Medicare pays 80% and you pay 20% for Medicare Part B charges. (TriCare for Life pays the 20%). If you enroll in a Medicare Part C plan, TriCare for Life will still pay all copays, like they do with Medicare Part A and B. So in summary, the medical benefits are the same on Medicare Part C as on Medicare Part A and B, and your drug coverage is not affected in any way by enrolling in this plan.
Humana offers a zero premium Medicare Part C plan without drug coverage in certain parts of the country, that is designed for TriCare for Life members, which includes SilverSneakers. It is important to enroll in a Medicare Part C plan WITHOUT drug coverage because the coverage from TriCare for Life (Express Scripts) is better than regular Part D drug coverage. So nothing is affected will your drug coverage, because this plan purposely does not have any drug coverage to conflict your your current plan.
These plans with Humana are not a HMO, but instead a PPO (Preferred Provider Organization) which means you do not need a referral to see a specialist, and you can see any doctor that accepts Humana nationwide. Most clients want to be able to continue to see their existing doctors. Most doctors that accept Medicare also accept Medicare Part C plans from the largest providers like Humana or UnitedHealthcare, but you should definitely check before enrolling. Enrolling in a Medicare Part C plan NEVER affects any care your receiving “on base” or at the VA.
Humana offers this plan in certain areas of the country with a high concentration of retired military such as Alabama, Arizona, Colorado, Texas, Southern California, Florida, Michigan, Missouri, North Carolina, Ohio, South Carolina, Georgia, Virginia, Oregon and Washington. See the list below for more specifics. Some states also include a Medicare Part B credit each month, which means Humana credits you that amount every month for your Medicare Part B premium. This means you’ll get more a month in your Social Security check.
You can enroll in a Medicare Part C plan during Annual Enrollment Period (AEP) from October 15th- December 7th, effective January 1st, 2020. Below is a list of areas of the country where there is a plan available that works well with TriCare for Life for 2020.
Humana– includes $50/month Medicare Part B credit, Dental ($2000 year) and SilverSneakers- available in these counties-
Anderson, Aransas, Armstrong, Atascosa, Austin, Bandera, Bastrop, Bee, Bell, Bexar, Bosque, Brazoria, Brazos, Brooks, Burleson, Burnet, Caldwell, Calhoun, Callahan, Cameron, Camp, Carson, Chambers, Cherokee, Coleman, Collin, Colorado, Comal, Comanche, Cooke, Coryell, Dallas, Dawson, Deak Smith, Delta, Denton, Dimmit, Eastland, Ector, Edwards, El Paso, Ellis, Erath, Falls, Fannin, Fayette, Fort Bend, Franklin, Frio, Galveston, Gray, Grayson, Gregg, Grimes, Guadalupe, Hamilton, Hardin, Harris, Harrison, Hays, Henderson, Hidalgo, Hill, Hood, Howard, Hudspeth, Hunt, Jefferson, Jim Wells, Johnson, Jones, Karnes, Kayfman, Kendall, Kenedy, Kerr, Kinney, Kleberg, Lampasas, Lee, Leon, Liberty, Live Oak, Llano, Lubbock, Marion, Martin, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Montgomery, Morris, Navarro, Nueces, Orange, Palo Pinto, Panola, Parker, Polk, Potter, Randall, Real, Refugio, Robertson, Rockwall, Rusk, San Jacinto, San Patricio, Shackelford, Shelby, smith, Tarrant, Taylor, Tom Green, Travis, Trinity, Tyler, Upshur, Uvalde, Van Zandt, Victoria, Walker, Waller, Washington, webb, Wharton, Williamson, Wilson, Wise, Wood and Zavala.
UnitedHealthcare Essentials– RenewActive gym membership
San Antonio – Atascosa, Bexar, Comal, Guadalupe, Kendall and Wilson
Dallas – Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, Van Zandt and Wise.
Rest of Texas – Aransas, Bastrop, Bell, Cameron, El Paso, Falls, Hays, Hidalgo, Hill, Kleberg, Maverick, Mclennon, Nueces, San Patricio, Starr, Travis, Victoria, Webb, Willacy, Williamson and Zavala
Colorado– RenewActive gym membership
UnitedHealthcare Essentials- Includes $50/month Medicare Part B credit
Denver Metro– Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas and Jefferson
Rest of Colorado– El Paso, Fremont, Larimer, Pueblo, Teller and Weld- $30/month Part B credit.
Humana– Available in most of the state and includes $50/month Medicare Part B credit and $2000 year Dental benefit, Acupuncture 0 copay 25 visits year.
North Carolina- UnitedHealthcare Essentials
Alamance, Alexander, Avery, Buncombe, Burke, Cabarrus, Caldwell, Caswell, Catawba, Chatham, Cherokee, Clay, Cleveland, Cumberland, Davidson, Davie, Durham, Forsyth, Franklin, Gaston, Graham, Granville, Guilford, Harnett, Haywood, Henderson, Iredell, Jackson, Johnston, Lee, Lincoln, Macon, Madison, McDowell, Mecklenburg,Mitchell, Mitchell, Orange, Person, Polk, Randolph, Richmond, Rockingham, Rowan, Rutherford, Sampson, Stokes, Swain, Transylvania, Union, Vance, Wake, Wayne, Wilkes, Wilson, Yadkin and Yancey counties.
Humana– Available in entire state of North Carolina
Aiken, Beaufort, Berkeley, Calhoun, Charleston, Clarendon, Colleton, Dorchester, Georgetown, Horry, Lexington, Newberry, Orangeburg, Pickens, Richland, Sumter and Williamsburg
Humana– Available in the entire state of South Carolina with $50/month Medicare Part B credit, $2000 dental benefit and vision.
UnitedHealthcare Essentials– San Diego, Los Angeles, Orange, Riverside, San Bernardino and Kern counties
Humana offers a plan in these states, that includes SilverSneakers and these additional benefits:
Florida– Humana available in the entire state.
Georgia- Humana available in the entire state with $50/month Medicare Part B credit, $2000 year dental benefit and vision.
Alabama– Humana available in the entire state with $20/ Month credit and $2000 year dental coverage and vision.
Virginia– Humana avaliable in the entire state includes $1000 year dental benefit.
Arizona– Humana available in the entire state with $50/month Medicare Part B credit, $2000 year dental benefit and Acupuncture 0 copay 25 visits year.
Missouri– Humana available in the entire state with a $40/month Medicare Part B credit, $1000 year dental benefit and vision.
Oregon– Humana plan available in these counties- Benton, Clackamas, Columbia, Crook, Deschutes, Hood River, Jefferson, Lincoln, Linn, Malheur, Multnomah and Washington.
Includes $1000 Dental benefit, Acupuncture 0 copay 25 visits a year
Washington– Humana plan available in these counties- Clark, Cowlitz, Island, King, Kitsap, Kittitas, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla and Whatcom.
Includes $1000 Dental benefit, Acupuncture 0 copay 25 visits a year
Ohio– Humana available in the entire state with a $40/month Medicare Part B credit, $1000 year dental coverage and vision.
Michigan– Humana available in the entire state with a $40/ month Medicare Part B credit, $1000 year dental coverage and vision.
Blue Sky Medicare Coverage map
My name is Steve Schrader, also known as “Medicare Steve”, I work exclusively in the Medicare market as an agent for Humana and UnitedHealthcare. I am one of the few agents in the country that specializes in working with TriCare for Life members, helping them understand this plan. I am licensed in Alabama, Arizona, California, Colorado, Florida, Georgia, Missouri, North Carolina, Oregon, South Carolina, Michigan, Ohio, Texas, Virginia and Washington.
Give me a call at 303-501-3125 or I can email you more info about these plans by sending me an email that includes basic info about yourself = Name, Zip code, Email address and Phone number.
You can click on “Get 2020 Plan Info” tab above and I will email you the plan specifics in your area. I do not sell your info, if you you’d prefer I don’t call you, just enter 555-555-5555 in the phone field.
You can also use the “Live Chat” at the bottom of the screen to ask me any questions in real time. As an agent, I can enroll you in a plan if you decide to do so in the future and will always be available to you anytime you need me after enrollment.
Give me a call at 303-501-3125
or email MedicareSteve1@gmail.com