Sterling Medicare SELECT

A Medicare Supplement Insurance Plan featuring a network of contracted facilities

Plan Overview

Sterling Medicare SELECT is a type of Medicare Supplement Insurance or "MediGap" product. The only difference is Sterling Medicare SELECT offers lower premiums in exchange for the policyholder's commitment to use Network Facilities, whenever inpatient hospital, outpatient hospital or ASC services are required. Exceptions to the network restrictions include emergency care when traveling outside of the Service Area or when required services are not offered at a Network Facility. Policyholders can choose their own physicians; however, when they need inpatient or outpatient services, their physician must have the ability to admit them to a Network Facility. Sterling Medicare Select is not available in all areas. A listing of Sterling's Network Facilities is available on this website by selecting "Network Hospital Map & Listing."

Advantages of a Sterling Medicare SELECT plan:

• This is not a Medicare Advantage plan, but a Medicare Supplement or "MediGap" plan.
• No physician network restrictions. Policyholders can choose their own physicians, including specialists. When policyholders need hospital or ASC services, their physician must have admitting privileges at a Network Facility, or be willing to refer them to a physician who does.
• No utilization review, but assistance is provided to locate a Network Facility that provides the necessary service. No referrals, pre-certifications, or pre-authorizations are required.
• Claims can be filed electronically and are usually paid within five business days of receipt from the Fiscal Intermediary or Carrier.
• No capitated payments. Payments are made under the Fee-for-Service system subsequent to payment by the primary payor, Medicare. In other words, you are paid for the services you provide.
• Most plans provide coverage to policyholders while they are traveling throughout the United States. Traveling means leaving the Service Area for purposes other than to receive services from a non-Network Facility.
• Lower premiums for policyholders in exchange for using a Network Facility.

Unique Benefits and Value-added programs for Sterling Medicare SELECT Supplement policyholders:

• Preeminent service featuring local sales agents and automated claims processing.
• Silver&Fit^® – exercise and healthy aging program specifically for Medicare beneficiaries¹
• Access to 24-hour Nurse Advice Line
• Sterling Rx Perks² prescription drug discount card with average savings of 31% on prescription drugs based on 2010 program savings data

¹ Silver&Fit^® is provided by American Specialty Health Systems, Inc., a subsidiary of American Specialty Health Incorporated (ASH).

² DISCOUNT ONLY – NOT INSURANCE. Discounts are available exclusively through participating pharmacies. You may cancel your registration at any time by contacting Customer Care. Administered by Medical Security Card Company, LLC.