12.1.                           Mercy MedicareADVANTAGE Eligibility Criteria

Mercy MedicareADVANTAGE offers Medicare recipients an excellent alternative in the marketplace with a comprehensive benefit package that covers more than traditional Medicare. MHP’s Medicare Advantage products are Mercy MedicareADVANTAGE HMO and PPO.

Members may select HMO or PPO benefits plans. All plans are easy to use and affordable. Each is offered with the Part D prescription drug benefit.

There are no pre-existing condition clauses. Mercy MedicareADVANTAGE accepts all members regardless of their medical condition. MHP maintains eligibility information on all covered members, regardless of plan type.

For Mercy MedicareADVANTAGE, providers may obtain the most up-to-date eligibility information by calling MHP Provider Relations at 314-214-8137 or 800-596-4315, Monday through Friday from 8 a.m. - 5 p.m. Providers may also access eligibility information through MHP’s provider portal, Provider Connection, 24 hours a day, seven days a week, once a provider key has been obtained from Provider Relations.

Mercy MedicareADVANTAGE membership is effective for as long as the member meets the eligibility requirements or elects another Medicare Advantage plan or original Medicare.