Sterling offers a range of Medicare Supplement SELECT plans, featuring a network of contracted hospitals and inpatient facilities. This section provides details on the SELECT plans and specific advantages and features available through Sterling to both providers and customers.
Sterling Medicare SELECT is a type of Medicare Supplement Insurance or "Medigap" product. The only difference from standard plans is Sterling Medicare SELECT offers lower premiums in exchange for the policyholder's commitment to use Network Facilities, whenever inpatient hospital, outpatient hospital or ambulatory surgery center (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.
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.
Preeminent service featuring local sales agents and automated claims processing.
Value-added programs included with Sterling Medicare SELECT Medicare Supplement policies:
The Silver&Fit® Exercise and Healthy Aging Program specifically for Medicare beneficiaries1
Access to 24-hour Nurse Advice Line
Sterling Rx Perks2 prescription savings card with average savings of 38% on prescription drugs and potential savings up to 75%
Value-added programs are considered member services and are not insurance benefits. Programs are subject to change or can be discontinued at any time. Silver&Fit and Nurse Advice Line are not offered by Sterling in the state of Illinois.
1The Silver&Fit® program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH Fitness). Silver&Fit is a federally registered trademark of ASH and is used with permission herein.
2DISCOUNT 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.