GroupHealth Medicare Advantage Plans Calling 1.800.884.2343 will direct you to a licensed insurance agent

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GroupHealth Medicare Advantage Plans
Group Health Clear Care Benefits
Helpful Information
GroupHealth Customer Support

Existing Customers

1-888-901-4600
TTY: 711.
Hours: 8 a.m.-8 p.m.
Extended hours Oct. 1-Feb. 14
7 days a week, 8 a.m.-8 p.m.

2015 GroupHealth Medicare Advantage Plans

Basic (HMO MA)
Optimal (HMO MAPD)
Vital
(HMO MAPD)
Essential
(HMO MAPD)
Harbor (HMO MAPD)
Haven (HMO MAPD)
Columbia (HMO MAPD)
Prestige (PPO MAPD)

GroupHealth Plan List
Plan Name Plan Type Plan Details Application Premium
Basic HMO MA Benefit Summary Apply online
Download app
$50
Available in: Island, San Juan, Skagit, and Whatcom Counties
Basic HMO MA Benefit Summary Apply online
Download app
$50
Available in: King, Kitsap, Lewis, Pierce, Snohomish, Thurston, Grays Harbor* (98541, 98557, 98559, 98568), Mason* (98524, 98528, 98546, 98548, 98555, 98584, 98588, 98592) Counties
Basic HMO MA Benefit Summary Apply online
Download app
$50
Available in: Spokane County
Vital HMO MAPD Benefit Summary Apply online
Download app
$27
Available in: King, Kitsap, Lewis, Pierce, Snohomish, Thurston, Grays Harbor* (98541, 98557, 98559, 98568), Mason* (98524, 98528, 98546, 98548, 98555, 98584, 98588, 98592) Counties
Essential HMO MAPD Benefit Summary Apply online
Download app
$113
Available in: King, Kitsap, Lewis, Pierce, Snohomish, Thurston, Grays Harbor* (98541, 98557, 98559, 98568), Mason* (98524, 98528, 98546, 98548, 98555, 98584, 98588, 98592) Counties
Optimal HMO MAPD Benefit Summary Apply online
Download app
$253
Available in: King, Kitsap, Lewis, Pierce, Snohomish, Thurston, Grays Harbor* (98541, 98557, 98559, 98568), Mason* (98524, 98528, 98546, 98548, 98555, 98584, 98588, 98592) Counties
Harbor HMO MAPD Benefit Summary Apply online
Download app
$37
Available in: Island, San Juan, Skagit, and Whatcom Counties
Haven HMO MAPD Benefit Summary Apply online
Download app
$197
Available in: Island, San Juan, Skagit, and Whatcom Counties
Columbia HMO MAPD Benefit Summary Apply online
Download app
$163
Available in: Spokane County
Prestige PPO MAPD Benefit Summary Apply online
Download app
$175
Available in: Parts of Clallam* (ZIP codes 98362, 98363, 98382) and Jefferson* (ZIP codes 98325, 98339, 98358, 98368) Counties

Medicare Disclaimers

  • If you need help, please call 1-800-884-2343 Mon - Fri, 9am - 4pm PT for Customer Service Representatives and licensed insurance agents who can assist with finding information on available Medicare Advantage.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.
  • You must be enrolled in both Medicare Part A and Medicare Part B and live in the plan's service area to be eligible for these plans.
  • You must continue to pay your Medicare Part B premium in addition to any plan premium shown below.
  • Estimated annual savings is determined by subtracting a plan's annual cost estimate of the medications entered from the medications' average retail prices. The annual cost estimate for a plan includes covered annual monthly premiums and any annual cost sharing expenses that you must pay out-of-pocket for the medications entered. This number can only be calculated if the consumer enters medication information.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.

Important details and dates

  • You are first eligible during the 7–month Initial Coverage Enrollment Period (ICEP), the 3 months before your 65th birthday, the month of, and 3 months after. CAUTION: You only have one choice so take your time, ask for help and choose wisely.
  • You are also eligible during the Annual Election Period (AEP) which is from Oct.15 to Dec.7. You can change as many times as you want. The last change received by CMS prevails.
  • You have an opportunity to disenroll from your plan and return to Original Medicare and purchase a Part D Prescription Drug Plan during the new Annual Disenrollment Period from Jan 1 to Feb 14.
  • You may be eligible for a Special Enrollment Period (SEP) if you reside in a nursing home, join a Special Needs Plan (SNP), move outside the plan's service area, the plan leaves your area, or other special situations.
  • This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consultwww.medicare.gov.
  • For plans with Part D Coverage: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult¬†www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your Medicaid Office.
  • A Medicare Advantage Plan Health plan sold by an insurance company with a Medicare contract.
  • Award-winning* Group Health Physicians
  • Self-refer to Group Health specialists
  • 24-Hour Consulting Nurse service
  • Coordinated services all under one roof**
  • Medication refills by phone or online with free delivery
  • E-mail your doctor, schedule appointments, check labs and benefits online**
  • Optional dental
  • Fitness programs

We offer HMO plans in these counties:

King, Kitsap, Lewis, Pierce, Snohomish, Thurston, Grays Harbor* (98541, 98557, 98559, 98568), Mason* (98524, 98528, 98546, 98548, 98555, 98584, 98588, 98592), Spokane, Island, San Juan, Skagit, and Whatcom Counties. Service Area Map (PDF)

We offer PPO plans in these counties:

Prestige PPO
Prescription drug coverage with lower monthly premiums.

Service area for our PPO plans in these counties:
Clallam* (ZIP codes 98362, 98363, 98382) and Jefferson* (ZIP codes 98325, 98339, 98358, 98368).
Service Area Map (PDF)

Coverage provided by Group Health Cooperative

* Source: www.ghc.org/topdocs
** When you receive care at Group Health Medical Centers.

Group Health is a Medicare Advantage organization with a Medicare contract. Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B premium.

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