Exploring your medicare options?

Liberty Health Advantage HMO is offering two Medicare Advantage Plans, one for beneficiaries with Medicare and one for beneficiaries with Medicare and Medicaid. Both plans include prescription drug coverage.

If you are exploring your Medicare options you can review our plans in more detail by selecting a plan from the drop-down menu listed above.

New For 2017:

Medicare With
Part D Prescription Drug
Coverage
Medicare & Medicaid With
Part D Prescription Drug
Coverage
Preferred Choice* Dual Power**

$0 Monthly Premium in addition to your monthly Medicare Part B Premium.

$0 Copay for PCP Visits
$0 Copay for 24 one-way trips to
      plan-approved locations every year.

Pharmacy Copays for One Month (31 day) Supply:

Tier 1 (Preferred Generics): $0
Tier 2 (Non-Preferred Generics): $10
Tier 3 (Preferred Brand): $47
Tier 4 (Non-Preferred Brand): 30%
Tier 5 (Specialty): $33%

Pharmacy copay may be reduced if you have Low Income Subsidy (LIS).

$0 Monthly Premium in addition to your monthly Medicare Part B Premium.

$0 Copay for PCP Visits
$0 Copay for Hospital Stays

Pharmacy Copays for One Month (31 day) Supply.

Generics: $0; $1.20 or $3.30
For all other drugs: $0; $3.70 or $8.25

Premiums, copays and coinsurance may vary based on the level of Extra Help you receive.

Geographic Coverage: Bronx, Kings, Nassau, New York, Queens and Richmond Counties in New York State.

* To enroll in the Liberty Preferred Choice Plan you must have active Medicare Part A and PArt B and you must live in the service area. You must continue to pay your Part B Premium.

** To enroll in the Liberty Dual Power Plan you must have active Medicare Part A and Part B, and also active New York State Medicaid and you must live in the service area. Your Medicare Part B Premium will be paid by the State on your behalf.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information, contact the plan.

Limitations, copayments and restrictions may apply.

Benefits, formulary, pharmacy network, premiums and/or co-payments/coinsurance may change on January 1 of each year.

Liberty Health Advantage, Inc. is an HMO plan with a Medicare contract and a contract with the New York State Medicaid program. Enrollment in Liberty Health Advantage depends on contract renewal.

Becoming a Liberty member is as easy as A...B...C. Please click one of the buttons below.

Contact Information

Member and Provider Services

Sales Representative

Hours: 8:00AM to 8:00PM
Monday through Sunday

From February 15th through September 30th, hours are Monday - Friday only

Enrollment

Download an Enrollment Form

You may download, complete, sign and date an enrollment form. Application Instructions

Once you have completed the form please fax it to:

1-631-227-3484

Or mail it to:

Liberty Health Advantage
1 Huntington Quadrangle
Suite 3N01
Melville, NY 11747

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Liberty Health Advantage HMO is an HMO Plan with a Medicare Advantage contract and a contract with the New York State Medicaid program. Enrollment in Liberty Health Advantage HMO depends on contract renewal.

H3337 2017 Website Pending

Last Modified: Wed, September 30, 2015 13:30:36