Disclaimers and Policies

• Martin’s Point Generations Advantage is a health plan with a Medicare contract offering HMO, HMO-POS, and Local PPO products. Enrollment in a Martin’s Point Generations Advantage plan depends on contract renewal.

• Martin’s Point Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

• Premiums vary by plan and county. You must continue to pay your Medicare Part B premium. 

• This information is not a complete description of benefits. Contact the plan for more information.

• Limitations, copayments, and restrictions may apply. Benefits, formulary, provider and pharmacy network, premium, copayments, and coinsurance may change on January 1 of each year.

• The formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary.

• Martin’s Point Generation Advantage’s pharmacy network includes limited lower-cost, preferred pharmacies in suburban areas in Maine and New Hampshire. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-866-544-7504 (TTY:711) or consult the online pharmacy directory.

• Other pharmacies/physicians/providers are available in network.

• This is not a complete list of all formulary alternatives covered by the Part D sponsor for the drug you have selected.

• This is not a complete list of drugs covered by our plan. For a complete listing, please call 1-866-544-7504 (TTY:711) or, for your coverage, see your plan page formulary.

• Plan selection information from Medicare Advantage/Part D Contract and Enrollment Data reports available at www.cms.gov.

• Medicare beneficiaries may also enroll in Martin's Point Generations Advantage through the CMS Medicare Online Enrollment Center at http://www.medicare.gov.

• The Generations Advantage Focus DC (HMO-SNP) plan is available (in Cumberland County only) to anyone with Medicare who has been diagnosed with diabetes.

• Out-of-network/non-contracted providers are under no obligation to treat Generations Advantage plan members, except in emergency situations. Please call our Member Service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

• A salesperson will be present at seminars with information and applications. For accommodation of persons with special needs at meetings, call 1-888-640-4423 (TTY: 711).

• Member Services 866-544-7504 (TTY:711) is available 8 am-8 pm, seven days a week from October 1 to March 31; and Monday through Friday the rest of the year.

Each year the federal agency that administers Medicare—the Centers for Medicare & Medicaid Services—rates all Medicare Advantage plans on quality and performance. A 5-star rating is the highest rating possible from Medicare.

These ratings help our members and other Medicare beneficiaries know how good a job our plan is doing. You can use these Star Ratings to compare our plans' performance to other plans' performance using the Medicare Plan Finder tool.  

For the 2023 Plan Year

HMO PLAN - OVERALL RATING   

For 2023, our Generations Advantage Prime (HMO-POS), Value Plus (HMO), Alliance (HMO), and Focus DC (HMO SNP) plans received a 5-Star Overall Rating from Medicare. In New Hampshire, these are the only plans to receive 5 Stars!¹

LPPO PLAN - OVERALL RATING  

For 2023, our Generations Advantage Select (LPPO) plan earned a 4.5-Star Overall Rating from Medicare.¹

For more rating information on the Generations Advantage Prime, Value Plus, Alliance, and Focus DC plans, see our CMS Plan Ratings Sheet for the Prime, Value Plus, Alliance, and Focus DC plans.

For rating information on the Generations Advantage Select plan, please see our CMS Plan Ratings Sheet for the Select plan.

¹ 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.

HMO Contract #H5591 (Generations Advantage Prime, Value Plus, Alliance, and Focus DC) earned 5 stars in 2022. LPPO Contract #H1365 (Generations Advantage Select) earned 5 stars in 2022.  

At Martin’s Point, we are committed to providing our members a fair and timely process for resolving any complaints or disputes. We encourage Martin’s Point Generations Advantage members to contact us with questions, concerns, or problems related to any benefits or service.

Please call us at 1-866-544-7504 (TTY: 711), 8 am to 8 pm, seven days a week from October 1–March 31, and Monday through Friday the rest of the year, to discuss your concerns.