Frequently Asked Questions
Q: How can I reach Customer Service?
A: Customer Service can be reached by phone at 434-947-3671 or toll-free 1-877-210-1719 from 8:00 a.m. to 8:00 p.m., seven days a week from October 1 through March 31. From April 1 through September 30, Customer Service is available 8:00 a.m. to 8:00 p.m., Monday through Friday. TTY users should call 711. Walk-ins are welcome 8:30 a.m. to 5:00 p.m., Monday through Friday.
Q: If I enroll in Piedmont Medicare Advantage, do I still have to pay my part B premium?
A: Yes. You will continue to pay a premium each month for Medicare part B (Medical Insurance).
Q: Do I need a referral to see a doctor or specialist?
A: No. You can go to doctors, specialists, or hospitals in or out-of-network. You may have to pay more for the services you receive outside the network.
Q: Does Original Medicare cover all of my health care costs?
A: Medicare covers many services; however, you will still accumulate out-of-pocket costs including copays, deductibles and coinsurance. Piedmont Medicare Advantage (PPO) provides additional coverage resulting in less out-of-pocket costs.
Q: What premium payment options are available?
A: There are three ways to pay your premium:
- Premiums can be paid using a credit card in-person at our office location, by calling Customer Service, or by going online to the log-in portal. If you choose to pay online, you will need to set up an online account.
- You can pay your premium through deduction from your Social Security or Railroad Retirement benefits check.
- You may also pay your premium with a check or money order. With this option, you will receive a monthly bill prior to the due date as a reminder.
Q: Is vision included?
A: With a low copayment you will be able to receive one pair of eyeglasses or contact lenses after cataract surgery, and exams to diagnose and treat diseases and conditions of the eye, including an annual glaucoma screening for people at risk. For the 2019 benefit year, Piedmont Select Medicare Option One, Piedmont Select Medicare Option Two, and Piedmont Select Medicare Option Three will continue to include an annual routine eye exam. Piedmont Select Medicare Option One benefits include a $150 allowance every two years for eyeglasses (frames and lenses) from any provider.
Q: Do you offer any additional supplemental benefits?
A: Yes. For the 2019 benefit year, we will continue to offer the 24/7 Nurse Advice Line and SilverSneakers® Fitness program and Centra 24/7 (Remote Access Technology). For more information on these additional supplemental benefits, see Chapter 4 of the Evidence of Coverage or CLICK HERE.
Q: What immunizations are covered at 100%?
A: The Pneumonia vaccine, Influenza vaccine, Hepatitis B vaccine (if you are at high or intermediate risk) are all covered at 100%.
Q: Am I covered in case of an emergency if I am out of town or even out of the country?
A: Yes, for 2019, there is a $90 copay per emergency room visit within the United States and its territories. If you receive emergency care at an out-of-network hospital and need inpatient care after your emergency condition is stabilized, you must move to a network hospital in order to pay the in-network cost-sharing amount for the part of your stay after you are stabilized. If you stay at the out-of-network hospital, your stay will be covered but you will pay the out-of-network cost-sharing amount for the part of your stay after you are stabilized. Emergency care must be furnished by a provider that is qualified to provide emergency services and evaluate or stabilize an emergency medical condition. There is a $25,000 plan coverage limit for emergency services outside the U.S. every year.
Q: If I enroll in Piedmont Medicare Advantage, will I lose my Original Medicare coverage?
A: No, you still have Medicare. Once you join Piedmont Medicare Advantage, we will cover all the services that original Medicare covers with the exception of Hospice Care and Clinical Research studies.
Q: Do I have to re-enroll during the Annual Enrollment Period?
A: If you are a member of Piedmont Medicare Advantage and want to keep your current plan, your coverage will automatically renew. Please refer to your Annual Notice of Change or Evidence of Coverage for changes to your benefits in the upcoming year. If you would like to make a change you can do so during the Annual Enrollment Period (October 15 through December 7).
Piedmont Medicare Advantage is a PPO plan with a Medicare contract. Enrollment in Piedmont Medicare Advantage depends on contract renewal. This information is not a complete description of benefits. Call 434-947-3671 or toll-free 1-877-210-1719 (TTY-711) for more information. Out-of-network/non-contracted providers are under no obligation to treat Piedmont Medicare Advantage members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Tivity Health and SilverSneakers are registered trademarks or trademarks of Tivity Health, Inc., and/or its subsidiaries and/or affiliates in the USA and/or other countries. © 2018 Tivity Health, Inc. All rights reserved.
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Last Updated 10/01/2018