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Member FAQ

Find answers to some of the most common questions for new GoHealth members below. If you don’t see your question listed or need more information, call us at 1-855-456-3980 (TTY 771).

Coverage and Costs
Benefit Activation
General Questions
GoHealth Partners

Coverage and Costs

We’re here to help you understand what to expect from the coverage, benefits, and costs on your new Medicare Advantage plan.

You can access these details in a few ways:
  • If you enrolled with GoHealth, you should have received an email from us with the subject line, “Thanks, Your Name! Your Medicare plan application is complete.” In that email, you will find a link to your personal landing page, which contains information about your monthly premiums, deductibles, and out-of-pocket costs.
  • Refer to your Summary of Benefits and Evidence of Coverage documents, which you should receive in the mail from your plan.
  • You can always call us! 1-855-456-3980 (TTY 771)
You can access your benefit information in a few ways:
  • Visit your health plan’s online portal.
  • Refer to your Summary of Benefits and Evidence of Coverage documents, which you should receive in the mail from your plan.
  • You can always call us! 1-855-456-3980 (TTY 771)

Benefit Activation

Your new plan will be active soon. Here’s how to get started on making the most of your benefits.

Your new plan becomes active on January 1, 2025. Here’s how you can get ready to make the most of your new coverage and benefits:

  • Start scheduling appointments with your healthcare providers for the coming year.
  • Complete Health Risk Assessments, which may make you eligible for incentives from your plan.

If you enroll during the Annual Enrollment Period (10/15-12/7), then your plan ID card is typically delivered by mid-December. If you enroll outside of that window, you should expect your ID card in 7-10 business days.

You can also access your ID card through your carrier’s online portal. Find instructions on how to access the online portal and your digital ID card in the welcome letter from your carrier or by visiting your carrier’s website. If you need help, give us a call at 1-855-456-3980 (TTY 771)

If your plan is already active and you have not received your card, please call us: 1-855-456-3980 (TTY 771)

You can submit an OTC order online, through your plan carrier’s mobile app (if available), over the phone with a live agent, or by visiting a participating retailer.

If you have not received a catalog of OTC items, contact your plan to request one.

Check your plan materials or contact your plan’s carrier to confirm that you’re eligible for fitness benefits.

You can enroll in a fitness program by visiting a participating location near you or join an online program.

Check your plan materials or contact your plan’s carrier to confirm that you’re eligible for the mail order pharmacy program.

Ask your doctor’s office to transfer your prescription information to the mail order pharmacy. If you need assistance, please call 1-855-456-3980 (TTY 771)

General Medicare Advantage Plan Questions

There are important differences between Medicare Advantage plans and Original Medicare. We’ll help you understand how to access the services you need.

Your plan covers, at minimum, all the preventive services that are included under Original Medicare and may offer more. Refer to your Summary of Benefits for a complete list.

Contact your healthcare provider’s office to schedule an appointment or vaccination. If you need help, you can also call our Member Services team: 1-855-456-3980 (TTY 771).

For HMO plans, you will need a referral from your Primary Care Provider to see a specialist. Some specialists may request a referral regardless of plan type. Contact the specialist’s office to confirm.

Plan carriers offer online member portals or apps for plan management.

Visit your carrier’s website for details.

Contact our Member Services team if you need assistance: 1-855-456-3980 (TTY 771).

Check your plan’s Summary of Benefits for travel coverage details.

Typically, benefits are restricted to a specific service area.

In emergencies, you are covered anywhere in the U.S.

A VCC form is a Verification of Chronic Condition. Your carrier will require you to complete this form if you enroll in a Chronic Condition Special Needs Plan (C-SNP), a type of Medicare Advantage plan designed for people with a specific chronic condition.

You and your doctor must both complete the VCC within 60 days of enrollment. Otherwise, your chronic condition plan will be terminated.

If you aren’t sure whether you enrolled in a chronic condition plan, check your plan documentation, contact your plan carrier, or call our Member Services team for assistance: 1-855-456-3980 (TTY 771).

GoHealth Partners

GoHealth partners with a variety of trusted organizations to connect you with helpful services that can make a difference in your life.

ExactCare is a pharmacy that offers free shipping for timestamped, presorted medications. ExactCare can help you manage a complicated prescription drug regimen, delivering medications right to your door.

To be eligible for ExactCare, you must:

  • Be a member of special needs plan (SNP), excluding plans from Anthem, Humana, or Kaiser.
  • Have active prescriptions for six or more medications.
  • To contact ExactCare, call (216) 260-2854

Charlie is a banking tool specifically designed for older adults. With a Charlie direct deposit account, you can get early access to Social Security Income, plus comprehensive fraud protection.

To be eligible, you must be at least 62 years old, receive Social Security payment, and have both an email account and a mobile phone.

To contact Charlie, call (404) 912-4769 or visit  https://www.charlie.com/p/plus/go-health.