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• Medicare Part D
• 2012 Plan Site

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Important Disclaimers

Essence is a Medicare Advantage HMO with a Medicare contract. Anyone with Medicare Parts A and B and living in the Essence service area may join our plan, but must continue to pay their Part B premium. Please note that enrollment is limited to specific times of the year. Contact us for more information.

The benefit information provided on these pages is a brief summary, not a comprehensive description of benefits. Limitations, co-payments and restrictions may apply. For more information, contact our plan.

Essence members must use in-network plan providers except in emergency or urgent care situations. If an Essence member obtains routine care from an out-of-network provider, without prior authorization from Essence, neither Medicare nor Essence will be responsible for the costs. In addition, Essence members must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, and quantity limitations and/or restrictions may apply.

Essence’s government contract is renewed annually and the availability of coverage beyond the end of 2011 is anticipated but not guaranteed. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2012.

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week. Or, call the Social Security Office at 1-800-772-1213 between 7 am and 7 pm, Monday through Friday. TTY users should call 1-800-325-0778. Or, contact your state Medicaid office.

The information presented on this site is available in alternate formats and languages, and may be obtained by calling the number(s) listed on this site. The people pictured and/or quoted on this site were Essence members as of 8/1/10.

The Essence Advantage® Diabetes SNP is only for Medicare beneficiaries with diabetes, and Essence is required to check and make sure SNP members have diabetes. People who join our SNP and do not have/no longer have diabetes must be disenrolled. (Please note that this plan is not offered in all areas.).

The Medicare program rates how well plans perform in different categories (for example, detecting and preventing illness, ratings from patients and customer service). If you have access to the web, you may use the web tools on www.medicare.gov and select “Compare Medicare Prescription Drug Plans” or “Compare Health Plans and Medigap Policies in Your Area” to compare the plan ratings for Medicare plans in your area. You can also contact us directly to obtain a copy of the plan ratings for the Essence plan(s) offered in your community.