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Basic MA Only

Basic MA Only

Choosing PrimeTime Health Plan

We believe that people choose PrimeTime Health Plan because of our person-to-person service, affordability, and clinical care coordination team. Our members are like our family. Whether they call or stop by our offices, the PrimeTime Team is always ready to talk with them and help them understand their Medicare choices. PrimeTime Health Plan is a Medicare Advantage Organization with a Medicare contract. Enrollment in the basic Medicare coverage plan depends on contract renewal.

Since 1997, PrimeTime Health Plan has been available to Medicare eligible individuals in the local communities we serve. Founded on the values of affordable pricing and service excellence. We serve: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Trumbull, Tuscarawas, and Wayne counties.

Our Promise to You: When you call, someone will pick up. Your claims will be processed quickly. Your questions will be answered. And we’re always searching for the better way to do things for you.

Learn more about our 5-Star Rating and Quality Recognition.

Local, Affordable Service Makes a Difference

PrimeTime Health Plan Members Receive:

  • Affordable, cost-effective premiums
  • HMO-POS Plans with and without Part D prescription coverage
  • Unlimited lifetime coverage
  • Worldwide coverage for emergent care
  • Outstanding personal customer service
  • A dedicated team that's here for you

 

Eligibility Requirements - Basic MA Only Plan

With PrimeTime Health Plan Basic-MA Only (HMO-POS) there are no deductibles to pay. Instead, your cost-sharing consists of co-payments or co-insurances for the services that you receive.

You are eligible for membership in our basic Medicare coverage plan as long as:

  1. You live in our service area: Carroll, Columbiana, Harrison, Holmes, Mahoning, Medina, Portage, Stark, Summit, Trumbull, Tuscarawas, and Wayne Counties --and--
  2. you have both Medicare Part A and Medicare Part B (When you enroll in a Medicare Advantage Plan, you continue to pay your Medicare Part B premium.)
  3. you are a United States citizen or are lawfully present in the United States

Ways to Enroll - Basic MA Only Plan

People may enroll in the plan only during specific times of the year. Contact PrimeTime Health Plan for more information. If you have questions or require language assistance, please call Customer Service at 330-363-7407 or 1-800-577-5084. For people who are hearing impaired, please call our TTY line at 711. Interpreter services are provided free of charge to you. A customer service representative is available to assist you Monday through Friday from 8:00 a.m. to 8:00 p.m. (October 1st – March 31st, we are available 7 days a week, 8:00 a.m. to 8:00 p.m.)

ONLINE

Beginning October 15, 2021, you can complete a secure online enrollment application by continuing with the green button below.

  • $0 Monthly Premium
  • $0 Annual Deductible
  • $3,400 Annual Out-of-Pocket Max

You will get an enrollment packet in the mail from PrimeTime Health Plan within seven to ten calendar days of enrolling online.


IN PERSON

You can visit us during our office hours Monday through Friday from 8:00 a.m. to 4:30 p.m. to drop off your completed enrollment application. Additionally, a PrimeTime Health Plan staff person is available to meet with you to discuss your plan options. You can complete an enrollment application during this appointment or take one with you to fill out and return. To schedule an appointment, please call 330-363-7407 or 1-800-577-5084. TTY users call 711. Our call center is available Monday through Friday from 8:00 a.m. to 8:00 p.m. (October 1st – March 31st, we are available 7 days a week, 8:00 a.m. to 8:00 p.m.).

PrimeTime Health Plan

Morrow House

2600 Sixth St SW

Canton, Ohio 44710

 

Download the application form (PDF)


BY MAIL

You can also choose to print and complete an enrollment application. When completed, mail the enrollment application to our office at:

PrimeTime Health Plan

Morrow House 2600 Sixth St SW

Canton, Ohio 44710

 

Download the application form (PDF)

Summary of Benefits - Basic MA Only

Benefit category

Basic MA- Only (HMO-POS)

No Rx coverage

Plan Premium

$0 per month

Primary Care Physician

You pay a $0 copay for each Medicare-covered PCP visit.

Telehealth available

Teladoc® available

Specialist

$40 copay for each Medicare-covered specialist visit Telehealth available

Urgent Care (Inside United States)

$65 copay for Medicare-covered urgently-needed-care visits

Urgent Care (Outside United States)

$85 copay for Medicare-covered urgently-needed-care visits

Emergency Care (Worldwide Coverage)

$85 copay for Medicare-covered emergency room visits

Inpatient Hospital Coverage

$275 copay per day, days 1 – 6; then $0 copay per day for Medicare-covered hospital stays

Outpatient Surgery (Ambulatory/Outpatient Surgery)

25% of the cost for each Medicare-covered surgical service, annual out-of-pocket maximum cost of $1,200

Home Delivered Meal Benefit

$0 copay; Benefit is limited to 5 days, up to 10 meals, and following an inpatient hospital stay at a network facility, with a doctor’s order.

Ambulance Services

$200 copay for Medicare-covered ambulance benefits

Durable Medical Equipment

20% of the cost for Medicare-covered durable medical equipment

Diabetic Testing Supplies (test strips, lancets, certain glucometers) 0% of cost for Medicare-covered diabetic testing supplies

Other Diabetic Supplies 20% of the cost for Medicare-covered diabetic supplies

Diagnostic Tests and Procedures

$100 copay for Medicare-covered general diagnostic tests (not including x-rays)

Diagnostic Radiology Services (MRI/CT/PET/Thallium Scans)

$250 copay for Medicare-covered complex diagnostic radiology services (not including X-rays)

Outpatient X-rays

$100 copay for Medicare-covered X-ray services

Lab Services

$0-$35 copay for Medicare-covered lab services.

Radiation Therapy

20% of the cost for Medicare-covered therapeutic radiology services

Part B Prescription and Chemotherapy Drugs

20% of the cost for Medicare-covered Part B drugs

Part D Prescription Drug Coverage

This plan does not include Part D Prescription Drug Coverage

Preventive Services

$0 copay for all preventive services covered under Original Medicare at zero cost sharing.

Health & Wellness Education Programs

$0 copay for the programs below:

  • Tele-monitoring Services – Enrollees diagnosed with any of the conditions below may be eligible:
    • Heart Failure
    • Diabetes
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Behavioral Health Conditions
  • Stroke Prevention Program – offered to members who have health conditions that put them at higher risk for stroke.
  • In-Home Safety Assessment -evaluates your home for potential safety concerns. For example: proper lighting, fall hazards,and grab bars. The benefit is available in our service area with the plan's contracted network.
  • 24 Hour Nursing Hotline (330) 363-7600 or 1-855-409-6448 ‍
  • The Silver&Fit® Exercise & Healthy Aging Program –offers members access to a fitness center membership at a participating fitness center or select YMCA at no additional cost.

Supplemental Vision and Dental

Reimbursement up to $300 annually combined for non-Medicare-covered dental and vision costs.

You pay a copayment of $595, $695, or $895 per hearing aid depending on the brand and model selected.

Out of Pocket Maximum (per calendar year)

$3,400

Ways to Enroll - Basic MA Only Plan

People may enroll in the plan only during specific times of the year. Contact PrimeTime Health Plan for more information. If you have questions or require language assistance, please call Customer Service at 330-363-7407 or 1-800-577-5084. For people who are hearing impaired, please call our TTY line at 711. Interpreter services are provided free of charge to you. A customer service representative is available to assist you Monday through Friday from 8:00 a.m. to 8:00 p.m. (October 1st – March 31st, we are available 7 days a week, 8:00 a.m. to 8:00 p.m.)

ONLINE

Beginning October 15, 2021, you can complete a secure online enrollment application by continuing with the green button below.

  • $0 Monthly Premium
  • $0 Annual Deductible
  • $3,400 Annual Out-of-Pocket Max

You will get an enrollment packet in the mail from PrimeTime Health Plan within seven to ten calendar days of enrolling online.


IN PERSON

You can visit us during our office hours Monday through Friday from 8:00 a.m. to 4:30 p.m. to drop off your completed enrollment application. Additionally, a PrimeTime Health Plan staff person is available to meet with you to discuss your plan options. You can complete an enrollment application during this appointment or take one with you to fill out and return. To schedule an appointment, please call 330-363-7407 or 1-800-577-5084. TTY users call 711. Our call center is available Monday through Friday from 8:00 a.m. to 8:00 p.m. (October 1st – March 31st, we are available 7 days a week, 8:00 a.m. to 8:00 p.m.).

PrimeTime Health Plan

Morrow House

2600 Sixth St SW

Canton, Ohio 44710

 

Download the application form (PDF)


BY MAIL

You can also choose to print and complete an enrollment application. When completed, mail the enrollment application to our office at:

PrimeTime Health Plan

Morrow House 2600 Sixth St SW

Canton, Ohio 44710

 

Download the application form (PDF)

Contact one of our friendly representatives.

We are here to help you.

Call one of our friendly representatives or click the button below to complete our contact us form. You can also check out our upcoming live webinars or on-demand archived webinars for more information.

Contact Us 

Trisha Witts PrimeTime Health Plan Team Member
Trisha Witts
330-363-2046
Debbie Banal PrimeTime Health Plan Team Member
Debbie Banal
330-363-2006
Karen Krantz PrimeTime Health Plan Team Member
Karen Krantz
330-363-2020