It depends on when you enrolled in the US Family Health Plan.
If you enrolled in the US Family Health Plan at Martin’s Point on or after October 1, 2012 (Non-Grandfathered Status), you will be disenrolled from the US Family Health Plan. Your disenrollment will be effective on the last day of the month prior to the month you turn 65. TRICARE For Life (TFL) will be your TRICARE® option. You must enroll in Medicare Part B to maintain your TRICARE eligibility. To be covered by TFL, you must enroll in Medicare Part A and Part B (Original Medicare).
If you enrolled in the US Family Health Plan at Martin’s Point before October 1, 2012 (Grandfathered Status), you have the option of staying enrolled with the US Family Health Plan or disenrolling and using TRICARE For Life (TFL).
If you are unsure whether you are grandfathered or non-grandfathered, please contact your local Health Benefits Specialist from the list below.
If you are continuing your membership with the US Family Health Plan, you are not required to enroll in Medicare Part B. However, we strongly recommend you consider enrolling in Medicare Part B as soon as you are eligible for the following reasons:
Martin’s Point US Family Health Plan | TRICARE For Life (TFL) | |
Who administers my health plan? | Martin’s Point Health Care Portland, Maine |
Medicare and Wisconsin Physician Services (WPS) Madison, Wisconsin |
Who covers my medical expenses? |
Martin’s Point US Family Health Plan pays 100% *for services covered by the US Family Health Plan |
Medicare pays 80% TRICARE pays 20% *for services covered by both Medicare and TRICARE |
What are my costs for care? |
*Martin’s Point waives your US Family Health Plan enrollment fees and copayments, other than prescription copayments |
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Where do I get my prescriptions? |
Retail: US Family Health Plan network pharmacy (such as CVS, Rite Aid, Wegmans, Walgreens, Walmart, etc.) Maintenance: Martin’s Point mail-order pharmacy |
Retail: TRICARE network pharmacy Maintenance: Express Scripts mail-order pharmacy |
Name | Area | Phone | Address |
---|---|---|---|
Lori Theriault | Serving: Northern and Down East Maine. |
Office: 207-498-7020 |
25 Sweden Street, Suite B Caribou, ME 04736 |
Kimberly MacDonald | Serving: Central, Southern, and Western Maine. | Office: 207-253-6190 Email: [email protected] |
891 Washington Avenue Portland, ME 04103 |
Denise Luck | Serving: The Claremont and Lebanon areas of New Hampshire, Northern and Central Vermont and Northeastern New York. |
Office:866-740-2623 |
905 Roosevelt Highway, Suite 250A Colchester, VT 05446 |
John Reed | Serving: The State of New Hampshire, excluding the Claremont and Lebanon areas. | Office: 603-430-5057 Mobile: 603-651-7112 Email: [email protected] |
61 Corporate Drive Portsmouth, NH 03801 |
Keith Prairie | Serving: Southern Vermont and Eastern Upstate New York, including the Capital District | Office: 518-588-4441 Mobile: 518-588-4441 Email: [email protected]
|
800 Route 146 Bld 400 Suite 476 Clifton Park, NY 12065 |
Tim Dunnigan | Serving: Central New York and the Southern Tier and the Bradford and Susquehanna Counties and the Borough of Sayre in Pennsylvania. | Office: 866-876-7377 Mobile: 315 263-1406 Email: [email protected] |
101 Old Cove Road, Suite 112 Liverpool, NY 13090 |
Ralf Sosnowski | Serving: Western New York and the Erie, PA area. | Office: 716-839-0285 Mobile: 585-732-0417 Email: [email protected] |
141 Sully’s Trail, Suite 4, Pittsford, NY 14534 |
Melissa Strader | Serving: Fort Drum and the Watertown, NY area. | Office: 315-785-5467 Mobile: 518-339-8787 Email: [email protected] |
26121 US Route 11, Suite 3 Evans Mills, NY 13637 |