Advantage Point Health Alliance

Article provided by: PA Clinical Network

Advantage Point Health Alliance

The following Health Alliance Northwest plans offer Medicare Advantage Prescription Drug plan coverage. Medicare Advantage plans are an alternative way to get your Original Medicare. These plans help cover the costs of services provided by hospitals, doctors, lab tests, and some preventive screenings. These plans' prescription drug component helps cover medications. Even if a plan's monthly premium is $0, you would still pay the Original Medicare Part B premium, and Part A premium if applicable, to have medical coverage. Not all plans shown here will be available to you; enter your zip code to see some of the plans available in your area.

You can read about whether Medicare Advantage is right for you. If you only want plans with prescription drug coverage, browse Prescription Drug Plans.

What other important information should you know?

  • Every year, Medicare evaluates plans based on a 5-star rating system.
  • Benefits, premiums and copayments/co-insurance may change on January 1 of each year.
  • This information is not a complete description of benefits. Contact the plan for more information.
  • Limitations, copayments, and restrictions may apply.
  • You must continue to pay your Medicare Part B premium. The Part B premium may be covered through your State Medicaid Program.
  • The formula, pharmacy network, or provider network may change at any time. You will receive notice when necessary.
  • Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergencies. For a decision about whether the Plan will cover an out-of-network service, we encourage you or your provider to ask the Plan for a pre-service organization determination before you receive the service. Please call the Plan's customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
  • Medicare beneficiaries may also enroll in plans through the CMS Medicare Online Enrollment Center located at
  • MSA Plans: MSA Plans to combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. Medicare MSA Plans don’t cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate Medicare Prescription Drug Plan. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan for additional information.
  • PFFS Plans: A Private Fee-for-Service plan is not Medicare supplement insurance. Providers who do not contract with our plan are not required to see you except in an emergency.
  • SNP Plans: This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. This plan is available to anyone with Medicare, who has been diagnosed with HIV/AIDS. This plan is available to anyone who has both Medical Assistance from the State and Medicare. 

Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

  • For a complete list of medical plan

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Advantage Point Health Alliance

PA Clinical Network

Advantage Point Health Alliance

777 E Park Drive


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