Medicare FAQs

Generally, you’re first eligible to sign up for Medicare starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)

A Medicare beneficiary is a person who has applied and been approved for Medicare benefits by the federal government.

A Medicare Advantage Plan is a comprehensive Medicare plan from a private insurance company that covers Parts A (hospital insurance) and Part B (medical insurance) and includes Part D, your prescription drug benefit, and often more services and benefits.

Original Medicare is managed by the federal government. It covers inpatient care in hospitals (Part A) and doctor’s visits (Part B). It does not cover prescription drugs; you’ll have to join a Medicare drug plan in addition to Original Medicare. It does not cover extra benefits like dental,
vision, or hearing.

Medicare Advantage Plans are offered by private insurance companies. They cover inpatient care in hospitals (Part A) and doctor’s visits (Part B) and, often, Part D (prescription drug coverage), PLUS extra benefits like dental, vision, hearing, fitness, and more – all in ONE plan. Community First Medicare Advantage Alamo Plan (HMO) also offers all the same rights and protections as Original Medicare.

Medicare Advantage Plans, including Community First Medicare Advantage Alamo Plan (HMO), covers health care services such as:

• Hospitalization
• Skilled Nursing Facilities, hospice, and home health care
• Medical services, including doctor visits and outpatient care
• Preventive services, including health screenings and vaccines
• Durable medical equipment like wheelchairs and walkers
• Prescription drugs
• Other medically necessary services

Community First Medicare Advantage Alamo Plan (HMO) also offers Members comprehensive coverage for things Original Medicare does not cover, including dental, vision, hearing, over-the-counter items, transportation to health care visits, fitness memberships, and more.

As a Community First Medicare Advantage Alamo Plan (HMO) Member, you will receive:

• Dental Coverage
• Vision Coverage
• Hearing Coverage
• Fitness Memberships
• Health & Wellness Programs
• 24/7 Nurse Advice Line
• Virtual Doctor Visits (Telehealth)
• Care Coordination (Organizing patient care and sharing information among the patient, family, doctors, and all concerned parties)
• Prepaid Card for Over-the-Counter Items
• Non-Emergency Transportation Services (NEMT)
• At-Home Meal Delivery Services
• Personal Emergency Response System
• Yearly Limit on Out-of-Pocket Costs
• Access to Nationally Recognized Specialists
• Access to a Level I Trauma Center
• Local, In-Person Member Services Support

To learn more, view our 2024 Extra Benefits Guide.

D-SNP stands for Dual Eligible Special Needs. If you are eligible for both Medicare and Medicaid, you may be eligible for Community First Medicare Advantage D-SNP (HMO).

Community First Medicare Advantage D-SNP (HMO) plan covers your Part A (Hospital Insurance), Part B (Medical Insurance), Part D (Prescription Drug Benefit), PLUS extra benefits, like:

• Dental Coverage
• Vision Coverage
• Hearing Coverage
• Fitness Memberships
• Health & Wellness Programs
• 24/7 Nurse Advice Line
• Virtual Doctor Visits (Telehealth)
• Care Coordination (Organizing patient care and sharing information among the patient, family, doctors, and all concerned parties)
• Prepaid Card for Over-the-Counter Items
• Non-Emergency Transportation Services (NEMT)
• At-Home Meal Delivery Services
• Personal Emergency Response System
• Yearly Limit on Out-of-Pocket Costs
• Access to Nationally Recognized Specialists
• Access to a Level I Trauma Center
• Local, In-Person Member Services Support

A Community First Medicare Advantage Alamo Plan (HMO) is an alternative to Original Medicare Part A and Part B. Also called Medicare Part C, Community First Medicare Advantage Plan (HMO) combine your Part A (hospital insurance) and Part B (Medicare insurance) into one plan and often include Part D (prescription drug coverage) plus extra benefits like hearing, vision, dental, and more.

D-SNP stands for Dual-Eligible Special Needs Plan and is a special Community First Medicare Advantage Plan (HMO) for those with both Medicare and Medicaid. D-SNPs combine your Medicare, Medicaid and extra health benefits – all in one easy plan that’s just right for you. D-SNPs often include coverage for Care Coordinators, D-SNP-specific benefits, and lower costs. 

Community First Medicare Advantage Alamo Plan is an HMO plan. This means you generally must get your care and services from providers in our network, except for:

• Emergency care
• Out-of-area urgent care
• Out-of-area dialysis

Medicare Open Enrollment is from October 15 through December 7 every year for coverage beginning January 1. During this enrollment period you can:

• Join, drop, or switch to another Medicare Advantage Plan
• Switch from Original Medicare to a Medicare Advantage Plan, like the Community First Medicare Advantage Alamo Plan (HMO).

Medicare Advantage Open Enrollment is from January 1 through March 31 every year. This enrollment period is only for individuals already in a Medicare Advantage Plan. During this enrollment period, you can switch to another Medicare Advantage Plan, like the Community First Medicare Advantage Alamo Plan (HMO). Your coverage will begin the first of the month after the plan gets your request.

If you are new to Medicare, you can enroll during the Initial Enrollment Period. This enrollment period starts 3 months before you get Medicare and ends 3 months after you get Medicare. During this time, you can join the Community First Medicare Advantage Alamo Plan (HMO), but you need both Part A (Hospital Insurance) and Part B (Medical Insurance) to join. If you request to join our plan before your Medicare starts, your plan coverage starts the same day as when your Medicare starts. If you request to join our plan after your Medicare starts, your plan coverage starts the first of the month after the plan gets your request.

Learn more about Medicare Enrollment Periods.

Enrolling in the Community First Medicare Advantage Alamo Plan (HMO) is simple.

Medicare beneficiaries may enroll in the Community First Medicare Advantage Alamo Plan (HMO) through the CMS Medicare Online Enrollment Center located at Medicare.gov. 

A  Spanish Enrollment Form is also available.

You can also call 1-833-434-2347 to speak with a licensed agent who can help enroll you today.

Yes, most prescription drugs are covered by Community First Medicare Advantage Alamo Plan (HMO). Our plan offers protection against high-cost prescription drugs through our offering of various levels of cost coverage for different “tiers” of drugs. For drugs that are not covered, your primary care doctor can submit a request for coverage.

Learn more about our prescription drug coverage.

Community First does not require a referral to see a specialist in our network. Some specialists may require a referral from your PCP in order to see you. Additionally, some services require preauthorization from Community First before you receive services. Your PCP will take care of this request for you.

Please see the Explanation of Coverage for your plan for more details.

Yes. For a list of primary care providers (PCP) in network, click “Find a Provider” at the top of this screen. If you’d like a printed copy, call Member Services at 1-833-434-2347, and we’ll mail you one at no cost within five business days.

If you do not select a PCP, we’ll choose one for you. You can find your PCP’s name and phone number on your Member ID card.

The Evidence of Coverage, Summary of Benefits, and Member Handbook are detailed plan documents that contain valuable information about our plan. You can view them here.