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

Member Rights & Responsibilities


Please read through the rights and responsibilities that you have as a member of Vibra Health Plan.

As a member of Vibra Health Plan, you have the right to:

  • Have your health information handled in a confidential and private manner in accordance with state and federal law. See notice of privacy practices for a description of how Vibra Health Plan protects your personal health information.
  • Be understood and treated with respect and dignity by Vibra Health Plan personnel, network providers, pharmacies and other health care professionals, regardless of race, national origin, religion, physical handicap, or source of payment.
  • Receive information in a language and method you are able to comprehend and understand.
  • Receive information that helps you select a qualified practitioner, including disclosure of their qualifications and presence of malpractice insurance.
  • Designate and/or authorize another party to act on your behalf.
  • Choose an Advance Directive to designate the kind of care you wish to receive should you become unable to express your wishes.
  • Access to physicians, health care professionals and health care facilities.
  • Know about access to after-hours and 24-hour emergency care.
  • Take part in decisions about your health care treatment, including services and care you receive, except when such participation is contraindicated for medical reasons.
  • Candidly discuss with your provider the appropriate and medically necessary treatment options, including alternatives, available to you for your condition(s), regardless of costs and/or benefit coverage.
  • Be informed about, and refuse to participate in, any experimental treatment.
  • Receive, upon request and prior to treatment, a reasonable estimate of charges for medical care.
  • Have coverage decisions and claims processed according to regulatory standards and/or medical policy.
  • Register a complaint and/or appeal concerning your health plan and/or services you received.
  • Ask a question, express a concern or file a complaint without hesitation, and receive a timely response.
  • Have claims paid accurately and promptly.
  • Ask for and receive a copy of your medical records and request a change/correction in any of your medical record, as required by law.
  • Receive, upon request, full information and necessary counseling on the availability of known financial resources for your care.
  • Make recommendations regarding the organization’s rights and responsibilities.

As a member of Vibra Health Plan, you have the responsibility to:

  • Read and understand the information in and the terms of your Evidence of Coverage (EOC) and call Vibra Health Plan’s Member Services if you have questions.
  • Know and understand your benefits.
  • Contact an appropriate health care professional when you have a medical need or concern.
  • Show your health plan ID card before receiving health care services.
  • Talk openly with your health care professional and build a provider-patient relationship built on mutual trust and cooperation.
  • Understand your health issue(s) and/or ask questions of your health care provider(s) to obtain the information needed to understand your health issues.
  • Share your health information to support delivery of health care services.
  • Develop mutually agreed upon treatment goals with your health care provider and follow the established treatment plan and related instructions.
  • Make your required co-payment/co-insurance at the time you receive treatment.
  • Use emergency room services only for injury and illness that, in the judgment of a reasonable person, require immediate treatment to avoid jeopardy to life or health.
  • Keep scheduled appointments and when you are unable to do so, notify your provider in advance if able.
  • Log in to vibrahealthplan.com or call Member Services when you have a question about your eligibility, benefits, claims and more.
  • Log in to vibrahealthplan.com or call Member Services to verify that your physician or health care professional participates in the network.
  • Inform Vibra Health Plan and your doctors if you changed your address.
  • Prevent the illegal use of your Member ID card.
  • Inform your doctor and the plan about any other insurance you have.
  • Conduct yourself in a manner that is respectful of all health care providers and staff, as well as other members.
  • Follow health care facility rules and regulations affecting your care and conduct.
  • Fulfill your financial obligations related to non-covered services.
  • Be accountable for your own actions if you refuse treatment or you do not follow your health care provider recommendations.
  • Inform your provider about any living will, medical power of attorney or Advanced Directives that could affect your care.
  • Call or write within 60 days of service if you wish to request a review of service provided and/or appeal a Vibra Health Plan decision.
  • Live a healthy lifestyle and prevent injury and disease.

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Preferred method of contact

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.

Your location

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

Required field

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

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)

8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)

Previous

View Plan Options

Please select one of our coverage options below.

Your options
Plan Monthly Premium Primary Care Copay Out-of-pocket Max Select
Essential Coverage PPO$0In $10 | Out $35$6,700
Enhanced Coverage PPO$49.50In $5 | Out $25$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.

Previous

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('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('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 Phone Applications (please call to speak with a licensed agent)
Phone: 1-844-324-0691 (TTY 711)
Phone: 1-800-MEDICARE (1-800-633-4227)
Hours: 8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)
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 Nov. 11th, 2016 (H9408_17_49134_Webenroll Approved)

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.

Your location

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

Required field

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

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)

8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)

Previous

Almost there.

Thank you for adding some of your information. You can now download our enrollment application.

We are unable to accept online enrollments at this time. Please check back on October 15, or feel free to download the paper application. Applications should be mailed to:

PO Box 60250,
Harrisburg, PA 17106
Fax: 1-844-260-7923

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


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 Phone Applications (please call to speak with a licensed agent)
Phone: 1-844-324-0691 (TTY 711)
Phone: 1-800-MEDICARE (1-800-633-4227)
Hours: 8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)
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 Nov. 11th, 2016 (H9408_17_49134_Webenroll Approved)