To speak with a licensed agent call 1-844-324-0691 (TTY 711)

2017 Enrollment


During these next couple of months you can enroll for the current calendar year if you need coverage between now and the beginning of the next calendar year. Below is more information along with downloadable documents for you to use to determine what the best coverage is for you!

All Plans Include:

  • The same Extensive Preferred Pharmacy Network including Giant, Walmart, and many independent locations with copays as low as $0
  • Optional supplemental dental coverage
  • With Vibra Health Plan, you will have access to a large and growing network of over 9,400 providers, including professional providers and hospitals
  • Dedicated member services line is staffed by representative in Harrisburg, PA who answer your call directly with no automated menus involved
  • Vision coverage
  • The same drug formulary
  • All members will be partnered with a Member Advocate who will
    • Assist with your health care needs
    • Navigate the health care systems with you
    • Coordinate services related to your care & well-being
  • Under our out-of-network coverage rules, your share of the cost may be higher for an out-of-network provider than for an in-network provider.

Questions? Call the sales department at 1-844-324-0691 (TTY 711) to speak with a licensed agent.

Essential Coverage PPO

This plan is a Medicare Advantage plan, also known as Medicare Part C. It covers all of your Medicare Part A and Part B healthcare costs, and your Part D prescription drug costs—all in one plan! In many cases, these plans also include additional benefits beyond what original Medicare covers. View plan details, with premium, deductible, and your pay limits for covered services.
BenefitEssential Coverage PPO
Monthly Premium Help $0
Medical Deductible $0
Primary Care Copay In $10 | Out $35
Specialist Copay In $50 | Out $70
Preferred Pharmacy Initial Coverage (tiered coverage 1/2/3/4/5/6) Help $0 | $15 | $42 | $95 | 33% | $0
Standard Pharmacy Initial Coverage (tiered coverage 1/2/3/4/5/6) Help $15 | $20 | $47 | $100 | 33% | $5
Coverage Gap Coverage Tiers 1 and 6
Out-of-pocket Max Help $6,700
Monthly Dental Premium (Optional) Help $33.30

For more details, please review the

Summary of Benefits

Enhanced Coverage PPO

This plan is a Medicare Advantage plan, also known as Medicare Part C. It covers all of your Medicare Part A and Part B healthcare costs, and your Part D prescription drug costs—all in one plan! In many cases, these plans also include additional benefits beyond what original Medicare covers. View plan details, with premium, deductible, and your pay limits for covered services.
BenefitEnhanced Coverage PPO
Monthly Premium Help $49.50
Medical Deductible $0
Primary Care Copay In $5 | Out $25
Specialist Copay In $40 | Out $60
Preferred Pharmacy Initial Coverage (tiered coverage 1/2/3/4/5/6) Help $0 | $10 | $35 | $90 | 33% | $0
Standard Pharmacy Initial Coverage (tiered coverage 1/2/3/4/5/6) Help $10 | $15 | $40 | $95 | 33% | $5
Coverage Gap Coverage Tiers 1, 2 and 6
Out-of-pocket Max Help $4,800
Monthly Dental Premium (Optional) Help $28.00

For more details, please review the

Summary of Benefits

When you receive care covered by your benefit plan from a provider outside of our network, you are only responsible for paying your share of the cost, not the entire cost.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

You must continue to pay your Medicare Part B premium.

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We want to make sure that you know you are exiting our site and going to an external website.

Tell us where you live.

Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov.

To view your coverage options, enter your zip code and county below.

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We're sorry, but you have either entered an incorrect zip code or you are out of our service area.

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Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

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Before you enroll

To make sure you are eligible we'll need a few more pieces of information.

Before your enroll

You must have Medicare Part A and Part B to join a Medicare Advantage Plan.

Generally you are not eligible to enroll in our plan if you have been medically determined to have ESRD. If you have had a successful kidney transplant and/or you don’t need regular dialysis any more, you are eligible to enroll, we will need to contact you to obtain additional information.

Are you new to Medicare?

Are you already entitled to Part A and enrolled in Part B?

Do you have end-stage renal disease ESRD?

If you have had a successful kidney transplant and/or you don't need regular dialysis any more, please mail a note or records from your doctor showing you have had a successful kidney transplant or you don't need dialysis, otherwise we may need to contact you to obtain additional information.

Vibra Health Plan, Inc.

4000 Crums Mill Rd.

Suite 201

Harrisburg, PA 17112
To speak with a licensed agent call 1-844-324-0691 (TTY 711)
Monday through Friday, 8:00 a.m. to 8:00 p.m., with extended hours from October 1 through February 14.

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View Plan Options

Please select one of our coverage options below.

Your options
Plan Monthly Premium Primary Care Copay Out-of-pocket Max Select
$0In $10 | Out $35$6,700
$49.50In $5 | Out $25$4,800
$0In $5 | Out $35$5,900
$55.00In $5 | Out 30%$4,800

Do you want to add optional dental coverage?

Your monthly rate will increase by $33.30.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

Your monthly rate will increase by $28.00.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

Your monthly rate will increase by $33.30.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

Your monthly rate will increase by $28.00.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

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Ready to Enroll?

It looks like you are interested in the plan outlined below. By clicking the “Enroll Now” button, you are confirming your intent to complete an actual enrollment request to join Vibra Health Plan.

You will want to have your Medicare card available to help complete the application.

If you need assistance during this process, our contact information is listed below.

Plan Breakdown

  • Primary Care Copay In $10 | Out $35
  • Out-of-pocket Max $6,700

Estimated monthly payment:

  • Monthly Premium $0
  • Monthly Dental Premium (Optional) $33.30

  • Monthly Total ${[{ mec.formatMonthlyTotal('2017_Essential_Coverage_PPO') }]}
  • Primary Care Copay In $5 | Out $25
  • Out-of-pocket Max $4,800
  • Monthly Premium $49.50
  • Monthly Dental Premium (Optional) $28.00

  • Monthly Total ${[{ mec.formatMonthlyTotal('2017_Enhanced_Coverage_PPO') }]}
  • Primary Care Copay In $5 | Out $35
  • Out-of-pocket Max $5,900
  • Monthly Premium $0
  • Monthly Dental Premium (Optional) $33.30

  • Monthly Total ${[{ mec.formatMonthlyTotal('2018_Essential_Coverage_PPO') }]}
  • Primary Care Copay In $5 | Out 30%
  • Out-of-pocket Max $4,800
  • Monthly Premium $55.00
  • Monthly Dental Premium (Optional) $28.00

  • Monthly Total ${[{ mec.formatMonthlyTotal('2018_Enhanced_Coverage_PPO') }]}
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Important Information

You may enroll in only one Medicare Advantage Plan at a time.

You may join or leave that plan only at certain times of the year or in special circumstances.

The Annual Election Period occurs October 15 through December 7. During this time, eligible individuals may enroll in or change Medicare Advantage Plans. Coverage will begin January 1.

Other Enrollment Methods

Fax: 1-844-260-7923
For Submitting Applications by Phone (please call to speak with a licensed agent)
Dial: 1-844-324-0691 (TTY 711)
To contact Medicare, Dial: 1-800-MEDICARE (1-800-633-4227)
Hours: Monday through Friday, 8:00 a.m. to 8:00 p.m., with extended hours from October 1 through February 14.
Online: Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

Note

You must continue to pay your Medicare Part B premium.

Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.


Last Updated Sep. 30th, 2017 (H9408_18_47546 Pending)