Member Frequently Asked Questions

You should receive your ID card no later than 10 calendar days from when you receive confirmation of your enrollment from the Centers for Medicare & Medicaid Services (CMS), or by the last day of the first month of your enrollment, whichever comes first.

Once your enrollment application is processed, you will receive an Acknowledgement Letter. This letter will inform you to begin using the plan on your Effective Date, which is typically the first day of the month following the date you submit your application. If you enroll in a 2013 plan during October 15, 2012 – December 7, 2012, your coverage will be effective on January 1, 2013.

You can make a premium payment in one of three ways:

1. You can arrange for an automatic bank withdrawal from your checking or savings account, or
2. We can send you a monthly bill, and you send us back a check or money order, or
3. You can sign up for automatic deduction from your Social Security check. This process can take up to 90 days to become effective, and you are responsible for paying any premiums during this time.

If you want to change how you pay your bill, we can accept a verbal request to change your method of payment over the phone for direct bill or Social Security Administration (SSA) deduction. You must submit a signed request in writing; either by sending a fax (1-713-558-7127) or a letter through the mail, if you are changing to automatic bank withdrawal from your bank account. You will need to submit a copy of a voided check.

If you choose to pay your bill monthly through a check or money order, you will receive a monthly premium notice, but you will not receive a coupon booklet. If you pay your premium by automatic bank withdrawal, you will not receive a monthly premium notice.

Our plan gives you the freedom to choose which doctors, specialists, and hospitals you visit, provided they participate in the Medicare program and accept the terms and conditions of our plan. With a Today's Options PFFS plan, you are not locked in to a network of doctors and hospitals. We do not require a referral to see a specialist, and there is no limit on covered office visits so you can see your doctor as often as you choose. However, a provider may at any time decide that he or she does not want to accept the Today's Options PFFS plan. If this happens, you will need to find another provider who will accept our plan. To make sure this doesn't happen, always verify in advance of receiving services that a particular provider is willing to see you.*

*A Private Fee-for-Service plan is not a Medicare supplement plan. Providers who do not contract with our plan are not required to see you except in an emergency. Providers can find the plan’s terms and conditions of payment on our website at: www.TodaysOptions.com.

You are not required to select a PCP in Today's Options PFFS, but we recommend it. The best way to meet your total healthcare needs is to have your care coordinated by one physician who knows you and your health history.

Your PCP acts as the manager of your healthcare and can assist you in finding the right specialists when necessary. He or she is available to patients 7 days a week, 24 hours a day through regularly scheduled appointments or by other doctors providing "on-call" back up coverage.

Your plan includes coverage for emergency services. You are covered anywhere in the United States. Simply go to the nearest Emergency Room or call 911 for assistance. If you are admitted to the hospital after an emergency, you'll need to contact us at the number on your ID card or contact your Primary Care Physician.

Your plan includes coverage for urgent care services. Urgently Needed Care is a non-emergency situation when you need medical care right away because of an illness, injury, or condition that you did not expect or anticipate, but your health is not in serious danger. You are covered anywhere in the United States.

If your specific medicine is not on our formulary, there may be a similar, high-quality medicine available that offers the same benefits. We'll work with you and your doctor to find a covered medicine that best suits your condition.

If you have questions about your prescription medicine, you should contact us at: 1-866-568-8921, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week.

Allegations can be reported to the Fraud, Waste, and Abuse hotline at 1-866-684-0595 or by email to Fraud@UniversalAmerican.com All calls and emails are confidential and may be anonymous. For more information please visit the Fraud, Waste, and Abuse section of the website.

In an effort to measure our member's level of satisfaction with Member Services, we place a call the day after a member contacts us to take a voluntary survey on his/her level of satisfaction. These calls help us monitor and improve the service we provide our members.