FirstMedicare Direct  
 
FirstMedicare Direct HMO plans are rated 4 out of 5 Stars for calendar year 2020 by Centers for Medicare and Medicaid Services (CMS).
FirstMedicare Direct PPO plans are rated 3 ½ out of 5 Stars for calendar year 2020 by Centers of Medicare and Medicaid Services (CMS).
Click HERE for 2020 Stars information.
Click HERE for 2019 Stars information.

Pre-Enrollment Checklist

Before making an enrollment decision, it is important that you fully understand our benefits and rules. If you have any questions, you can call and speak to a customer service representative at 877-279-1732 (TTY USERS CALL 711) from 8am-8pm Eastern, seven days a week (except Thanksgiving and Christmas) from October 1 to March 31 and 8am-8pm Monday through Friday (except holidays) from April 1 through September 30.

Understanding the Benefits

  Review the full list of benefits found in the Evidence of Coverage (EOC), especially for those services that you routinely see a doctor. Visit www.FirstMedicare.com or call 877-279-1732 to view a copy of the EOC.
     
  Review the provider directory (or ask your doctor) to make sure the doctors you see now are in the network. If they are not listed, it means you will likely have to select a new doctor.
     
  Review the pharmacy directory to make sure the pharmacy you use for any prescription medicines is in the network. If the pharmacy is not listed, you will likely have to select a new pharmacy for your prescriptions.
     

Understanding Important Rules

  In addition to your monthly plan premium, you must continue to pay your Medicare Part B premium. This premium is normally taken out of your Social Security check each month.
     
  Benefits, premiums and/or copayments/co-insurance may change on January 1, 2020/2021.
     
  HMO Applicants: Except in emergency or urgent situations, we do not cover services by out-of-network providers (doctors who are not listed in the provider directory).
     
  PPO Applicants: Our plan allows you to see providers outside of our network (noncontracted providers). However, while we will pay for covered services provided by a non-contracted provider, the provider must agree to treat you. Except in an emergency or urgent situations, non-contracted providers may deny care. In addition, you will pay a higher co-pay for services received by non-contracted providers.
     
   

FirstCarolinaCare Insurance Company's FirstMedicare Direct plans are HMO and PPO plans with a Medicare contract. Enrollment in a FirstMedicare Direct plan depends on contract renewal.

FirstCarolinaCare Insurance Company’s FirstMedicare Direct plans are HMO and PPO plans with a Medicare contract. Enrollment in a FirstMedicare Direct plan depends on contract renewal.This is a required statement by CMS. FirstCarolinaCare has filed and been approved to offer an HMO and a PPO Medicare Advantage Prescription Drug plan for 2020.

 
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Page Last Updated:
Friday, October 2, 2020 11:14:46 AM