2013 CIGNA MEDICARE RX (PDP) A MEDICARE PRESCRIPTION DRUG PLAN

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1 2013 CIGNA MEDICARE RX (PDP) A MEDICARE PRESCRIPTION DRUG PLAN i 08/12 S5617_5978i CMS Approved

2 TABLE OF CONTENTS page Medicare overview 3 Medicare Part D 5 Cigna Medicare Rx (PDP) plans 12 Additional information 25 2

3 Medicare and Medicare Part D Overview Position for optional photo 3

4 MEDICARE OVERVIEW The A, B, C and D s of Medicare Medicare Part A Medicare Part B Medicare Part C Medicare Part D 4

5 MEDICARE OVERVIEW Medicare Part D Prescription Drug Coverage Insurance that helps with drug costs Implemented January 1, 2006 Potential penalties for those who don t enroll during initial enrollment period (1% per month penalty), with some exceptions Voluntary program you must enroll to participate 5

6 MEDICARE PART D Eligibility and enrollment You are eligible to join a prescription drug plan if you: Are entitled to Medicare Part A and/or Are enrolled in Medicare Part B and Reside in the plan s service area Did you know? You can only be enrolled in one Part D plan at a time You may enroll in the plan only during specific times a year (in most instances) Cigna Medicare Rx (PDP) is available in all 50 states and the District of Columbia 6

7 2013 MEDICARE PART D STANDARD BENEFIT How it works If you are entitled to Medicare Part A and/or enrolled in Part B, and reside in the plan s service area, you can enroll in a Part D plan The standard Medicare Part D program works like this: Individual pays a monthly premium You pay 100% of your prescription costs until you meet your annual deductible (if applicable) After the deductible is met, you have initial coverage (the amount you pay is based on your plan) up to a predetermined limit based on what you (or others on your behalf) pay and what your Part D plan pays (i.e., total drug costs) After total drug costs reach this initial limit, there is a coverage gap In the coverage gap, you will receive a discount of approximately 50% for brandname drugs* and pay no more than 79% of generic drug costs (if you receive Extra Help, these discounts are not applicable) You will remain in the coverage gap until your total out-of-pocket costs reach another predetermined limit, at which time you hit the catastrophic level *Dispensing fees and vaccine administration fees are not eligible for the brand manufacturer discount 7

8 THE FOUR STAGES OF STANDARD MEDICARE PART D 2013 minimum plan requirements Standard Medicare Part D plans consist of four stages: Deductible Initial coverage Coverage gap Catastrophic coverage End of year Our focus here will be on Medicare Part D s coverage gap stage. Coverage gap standard discount Catastrophic coverage Generic drugs Brand drugs Initial coverage up to limit 5% 95% 79% 21% 47.5% 2.5% 50% 25% 75% $4,750 in total out-of-pocket costs $2,970 in total drug costs $325 deductible Beginning of year Customer pays Part D (Medicare and/or Plan) pays Manufacturer discount 8

9 UNDERSTANDING THE COVERAGE GAP 1 Post-health care reform timeline highlights A 50% manufacturer discount on the contracted price (excluding any applicable dispensing fees or vaccine administration fees) became available for brandname drugs. 1 Individuals paid no more than 86% of generic drug costs. Individuals will continue to receive a 50% manufacturer discount on the contracted price 2 for brand-name drugs and will be responsible for 47.5% of the remaining 50% and 47.5% of the dispensing and vaccine administration fees. Individuals will pay no more than 79% of generic drug costs. By 2020, individuals with standard Part D gap coverage will ultimately be responsible for only 25% of the contracted cost of their brand-name and generic drugs. Plan Two provides full coverage through the coverage gap: $0 for all Tier 1 drugs! 1. This program is not available if you receive Extra Help from the government since you already have coverage through the coverage gap. 2. Dispensing fees and vaccine administration fees are not eligible for the brand manufacturer discount. 9

10 2013 MEDICARE PART D Extra Help/low-income subsidy If you are experiencing financial difficulty you may be able to get Extra Help (also called low-income subsidy (LIS)) to pay for your Part D prescription expenses If you have limited income and assets, you may be eligible for Extra Help through the Social Security Administration (the amount of Extra Help you receive is based on your income and resources) The government provides Extra Help paying Medicare Part D prescription drug plan costs (e.g., monthly premiums, annual deductibles, copays and coinsurance) Did you know? There are four levels of LIS: 1, 2, 3 and 4 Within each of the four levels, a qualifying customer will be assigned a percentage premium subsidy coverage: 25%, 50%, 75% or 100% Cost share for each subsidy level is defined by Centers for Medicare and Medicare Services (CMS) 10

11 2013 MEDICARE PART D When to enroll Initial enrollment period (IEP): If you re just turning 65, you can enroll in a Part D plan during the month of your 65 th birthday, as well as three months before and after. Annual election period (AEP): 2013 AEP occurs from October 15 through December 7, You can make as many changes as desired during the AEP, but the last election made during the AEP is the one that becomes effective on January 1, Special election periods (SEP): SEP exists for those to make changes to their current Medicare benefit plan outside of the normal enrollment periods. SEPs are only allowed under certain circumstances (e.g., moving into a new service area, losing employer group coverage or a benefit plan termination by CMS). SEPs exist year round for dual-eligible and LIS individuals or Chronic Care Special Needs Plans. 11

12 2013 Cigna Medicare Rx (PDP) A plan to save you money on your prescriptions 12

13 PLAN FEATURES plan one coverage in all states plan two expanded coverage in some states 1 Lower premium pharmacy plan with a $0 copay for some drugs and very low copays for most other drugs. - $0 copay for all Tier 1 drugs including high cholesterol, hypertension and diabetes medications - Very low copays for most other drugs - Broad drug coverage - Standard gap coverage 2 $0 deductible generics For those living in DE, DC, GA, ID, MD, ME, MS, NH, SC, UT, WI: $0 deductible for Tiers 1-2 drugs $325 deductible for Tiers 3-5 drugs Moderate premium plan with a $0 copay for some drugs, including a $0 copay through the coverage gap. - No deductible - $0 copay for all Tier 1 drugs including high blood pressure, diabetes, high cholesterol, glaucoma and thyroid therapy medications - Standard gap coverage 2 plus $0 copay for all Tier 1 drugs in the coverage gap - Low copays for other generics and preferred brand drugs - Expanded drug coverage 1. Plan Two is available in AL, AR, AZ, CT, FL, IA, IL, IN, KY, MA, MI, MN, MO, MT, NC, ND, NE, OH, PA, RI, SC, SD, TN, TX, VA, VT, WV, WY. 2. The Health Care Reform mandated gap coverage provides you with a discount of approximately 50% on brand-name drugs and you pay 79% of generic drug costs (does not apply if you are receiving Extra Help). 13

14 PLAN AVAILABLITY Plan One coverage available in all 50 States and the District of Columbia Plan Two expanded coverage available in 28 States shown in dark blue Plan One only Plan One and Plan Two 14

15 AT A GLANCE 2013 Cigna Medicare Part D plans Annual deductible Initial coverage: Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 Standard coverage gap 3 (health care reform) Additional coverage gap (Plan Two only) Catastrophic coverage: After out-of-pocket drug costs reach $4,750 Plan One $0/$325 for residents of DE, DC, GA, ID, MD, ME, MS, NH, SC, UT, WI $325 for all other states Copay 1 $0 $8 $22-$37 $52-$ % After your yearly drug costs reach $2,970, you receive a discount on brand-name drugs and pay 79% of generic drug costs. Plan Two* * Plan Two is available in AL, AR, AZ, CT, FL, IA, IL, IN, KY, MA, MI, MN, MO, MT, NC, ND, NE, OH, PA, RI, SC, SD, TN, TX, VA, VT, WV, WY. 1. Copays are for a 30-day supply at an in-network retail pharmacy. For a 90-day supply at retail, the copay is 3 times the above levels. For a 90-day supply at our preferred mail-service pharmacy, the copay is 2.5 times the 30-day levels. 2. Ranges are state variations. 3. The Health Care Reform mandated gap coverage provides you with a discount of approximately 50% on brand-name drugs and you pay 79% of generic drug costs (does not apply if you are receiving Extra Help). 4. Higher of 5% coinsurance or $2.65 (generic or brands treated as generic) and $6.60 (for all other drugs). 5. Benefits, formulary pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments and restrictions may apply. 15 $0 Copay 1 $0 $10 $45 $90 33% After your yearly drug costs reach $2,970, you receive a discount on brand-name drugs and pay 79% of generic drug costs and $0 copay coverage on all Tier 1 drugs. You pay 5% of covered drug costs. 4 You pay 5% of covered drug costs. 4

16 STATE-BY-STATE PREMIUMS AND DEDUCTIBLES State Monthly premium 2 Plan One Plan Two 1 Annual deductible Monthly premium 2 Annual deductible AK $43.20 $325 N/A N/A AL $33.50 $325 $74.00 $0 AR $33.50 $325 $70.30 $0 AZ $42.90 $325 $81.10 $0 CA $55.80 $325 N/A N/A CO $51.00 $325 N/A N/A CT $34.00 $325 $76.50 $0 DE $35.40 $0/$325* N/A N/A DC $35.40 $0/$325* N/A N/A FL $45.80 $325 $78.70 $0 GA $33.50 $0/$325* N/A N/A HI $33.50 $325 N/A N/A IA $35.40 $325 $80.60 $0 ID $44.80 $0/$325* N/A N/A IL $31.30 $325 $79.20 $0 IN $36.30 $325 $76.90 $0 KS $37.60 $325 N/A N/A KY $36.30 $325 $76.90 $0 LA $37.50 $325 N/A N/A MA $34.00 $325 $76.50 $0 MD $35.40 $0/$325* N/A N/A ME $32.80 $0/$325* N/A N/A MI $35.20 $325 $66.30 $0 MN $35.40 $325 $80.60 $0 MO $34.50 $325 $75.90 $0 * $0 deductible generics for: DE, DC, GA, ID, MD, ME, MS, NH, SC, UT, WI: $0 deductible for Tiers 1-2 drugs $325 deductible for Tiers 3-5 drugs 1. Plan Two is available in AL, AR, AZ, CT, FL, IA, IL, IN, KY, MA, MI, MN, MO, MT, NC, ND, NE, OH, PA, RI, SC, SD, TN, TX, VA, VT, WV, WY. 2. You must continue to pay your Medicare Part B premium. 16

17 STATE-BY-STATE PREMIUMS AND DEDUCTIBLES State Monthly premium 2 Plan One Plan Two 1 Annual deductible Monthly premium 2 Annual deductible MS $34.30 $325 n/a N/A MT $35.40 $325 $80.60 $0 NC $33.10 $325 $72.10 $0 ND $35.40 $325 $80.60 $0 NE $35.40 $325 $80.60 $0 NH $32.80 $0/$325* N/A N/A NJ $47.00 $325 N/A N/A NM $25.50 $325 N/A N/A NV $46.70 $325 N/A N/A NY $42.30 $325 N/A N/A OH $38.30 $325 $72.20 $0 OK $34.00 $325 N/A N/A OR $49.00 $325 N/A N/A PA $36.10 $325 $76.00 $0 RI $34.00 $325 $76.50 $0 SC $37.10 $0/$325* $71.70 $0 SD $35.40 $325 $80.60 $0 TN $33.50 $325 $74.00 $0 TX $31.80 $325 $79.10 $0 UT $44.80 $0/$325* N/A N/A VA $31.40 $325 $71.40 $0 VT $34.00 $325 $76.50 $0 WA $49.00 $325 N/A N/A WI $38.00 $0/$325* N/A N/A WV $36.10 $325 $76.00 $0 WY $35.40 $325 $80.60 $0 1. Plan Two is available in AL, AR, AZ, CT, FL, IA, IL, IN, KY, MA, MI, MN, MO, MT, NC, ND, NE, OH, PA, RI, SC, SD, TN, TX, VA, VT, WV, WY. 2. You must continue to pay your Medicare Part B premium. * $0 deductible generics for: DE, DC, GA, ID, MD, ME, MS, NH, SC, UT, WI: $0 deductible for Tiers 1-2 drugs $325 deductible for Tiers 3-5 drugs 17

18 STATE-BY-STATE MONTHLY LIS PREMIUMS Plan One Plan Two 1 Subsidized Part D low-income premium (by % covered) customer pays: Subsidized Part D low-income premium (by % covered) customer pays: State 100% 75% 50% 25% 100% 75% 50% 25% AK $8.50 $17.20 $25.80 $34.50 N/A N/A N/A N/A AL $0.00 $8.40 $16.70 $25.10 $40.30 $48.70 $57.20 $65.60 AR $0.00 $8.40 $16.70 $25.10 $36.10 $44.70 $53.20 $61.80 AZ $13.50 $20.80 $28.20 $35.50 $51.70 $59.00 $66.40 $73.70 CA $25.90 $33.40 $40.90 $48.30 N/A N/A N/A N/A CO $19.10 $27.10 $35.00 $43.00 N/A N/A N/A N/A CT $2.60 $10.50 $18.30 $26.20 $45.10 $53.00 $60.80 $68.70 DE $0.00 $9.20 $17.90 $26.70 N/A N/A N/A N/A DC $0.00 $9.20 $17.90 $26.70 N/A N/A N/A N/A FL $21.00 $27.20 $33.40 $39.60 $53.90 $60.10 $66.30 $72.50 GA $0.00 $8.40 $16.70 $25.10 N/A N/A N/A N/A HI $0.20 $8.50 $16.80 $25.20 N/A N/A N/A N/A IA $0.00 $9.40 $18.10 $26.70 $46.00 $54.60 $63.30 $71.90 ID $2.60 $13.20 $23.70 $34.30 N/A N/A N/A N/A IL $0.00 $8.10 $15.80 $23.60 $48.30 $56.00 $63.70 $71.50 IN $0.00 $9.10 $18.10 $27.20 $39.70 $49.00 $58.30 $67.60 KS $0.00 $10.60 $19.60 $28.60 N/A N/A N/A N/A KY $0.00 $9.10 $18.10 $27.20 $39.70 $49.00 $58.30 $67.60 LA $0.00 $9.50 $18.80 $28.20 N/A N/A N/A N/A MA $2.60 $10.50 $18.30 $26.20 $45.10 $53.00 $60.80 $68.70 MD $0.00 $9.20 $17.90 $26.70 N/A N/A N/A N/A ME $0.00 $8.20 $16.40 $24.60 N/A N/A N/A N/A MI $0.00 $9.60 $18.10 $26.70 $32.10 $40.70 $49.20 $57.80 MN $0.00 $9.40 $18.10 $26.70 $46.00 $54.60 $63.30 $71.90 MO $0.00 $8.60 $17.20 $25.90 $41.30 $50.00 $58.60 $67.30 This chart does not include any Medicare Part B premium you may have to pay. 1. Plan Two is available in AL, AR, AZ, CT, FL, IA, IL, IN, KY, MA, MI, MN, MO, MT, NC, ND, NE, OH, PA, RI, SC, SD, TN, TX, VA, VT, WV, WY. 18

19 STATE-BY-STATE MONTHLY LIS PREMIUMS Plan One Plan Two 1 Subsidized Part D low-income premium (by % covered) customer pays: Subsidized Part D low-income premium (by % covered) customer pays: State 100% 75% 50% 25% 100% 75% 50% 25% MS $0.00 $8.60 $17.10 $25.70 N/A N/A N/A N/A MT $0.00 $9.40 $18.10 $26.70 $46.00 $54.60 $63.30 $71.90 NC $0.00 $9.10 $17.10 $25.10 $40.10 $48.10 $56.10 $64.10 ND $0.00 $9.40 $18.10 $26.70 $46.00 $54.60 $63.30 $71.90 NE $0.00 $9.40 $18.10 $26.70 $46.00 $54.60 $63.30 $71.90 NH $0.00 $8.20 $16.40 $24.60 N/A N/A N/A N/A NJ $10.00 $19.20 $28.50 $37.70 N/A N/A N/A N/A NM $3.00 $8.60 $14.20 $19.90 N/A N/A N/A N/A NV $26.30 $31.40 $36.50 $41.60 N/A N/A N/A N/A NY $0.00 $10.60 $21.10 $31.70 N/A N/A N/A N/A OH $8.40 $15.90 $23.40 $30.80 $42.30 $49.80 $57.30 $64.70 OK $0.00 $9.40 $17.60 $25.80 N/A N/A N/A N/A OR $11.50 $20.90 $30.30 $39.60 N/A N/A N/A N/A PA $0.00 $9.00 $18.00 $27.10 $39.40 $48.60 $57.70 $66.90 RI $2.60 $10.50 $18.30 $26.20 $45.10 $53.00 $60.80 $68.70 SC $0.00 $9.30 $18.50 $27.80 $32.90 $42.60 $52.30 $62.00 SD $0.00 $9.40 $18.10 $26.70 $46.00 $54.60 $63.30 $71.90 TN $0.00 $8.40 $16.70 $25.10 $40.30 $48.70 $57.20 $65.60 TX $0.00 $7.90 $15.90 $23.80 $47.30 $55.20 $63.20 $71.10 UT $2.60 $13.20 $23.70 $34.30 N/A N/A N/A N/A VA $0.00 $8.90 $16.40 $23.90 $41.30 $48.90 $56.40 $63.90 VT $2.60 $10.50 $18.30 $26.20 $45.10 $53.00 $60.80 $68.70 WA $11.50 $20.90 $30.30 $39.60 N/A N/A N/A N/A WI $0.00 $9.50 $19.00 $28.50 N/A N/A N/A N/A WV $0.00 $9.00 $18.00 $27.10 $39.40 $48.60 $57.70 $66.90 WY $0.00 $9.40 $18.10 $26.70 $46.00 $54.60 $63.30 $71.90 This chart does not include any Medicare Part B premium you may have to pay. 1. Plan Two is available in AL, AR, AZ, CT, FL, IA, IL, IN, KY, MA, MI, MN, MO, MT, NC, ND, NE, OH, PA, RI, SC, SD, TN, TX, VA, VT, WV, WY. 19

20 DRUG OVERVIEW Our Part D plan covers over 6,000 medications and Plan Two covers 96% of the most commonly used drugs by Medicare individuals 1 We provide a separate drug list/formulary for Plan One and for Plan Two Formulary Tier descriptions for both plans are as follows: Tier 1: Preferred generic drugs Includes preferred generic drugs and may include preferred brand-name drugs. This grouping of prescription drugs represents the lowest cost-sharing. Tier 2: Non-preferred generic drugs Includes non-preferred generic drugs and may include preferred brand-name drugs. Tier 3: Preferred brand drugs Includes preferred brand drugs and may include non-preferred generic drugs. Tier 4: Non-preferred brand drugs Includes non-preferred brand drugs and may include non-preferred generic drugs. Tier 5: Specialty tier Includes generic and brand-name drugs that meet certain criteria defined by Medicare. This grouping of prescription drugs represents the highest cost-sharing. Search our full drug list on cignamedicarerx.com 1. Based on the top 100 Part D prescription drugs used by Medicare-eligible customers. The four percent of drugs not covered are brand-name drugs with a covered generic equivalent available. 20

21 CIGNA HEALTHY REWARDS Discounts on products and programs Through Healthy Rewards,* customers get access to a range of health and wellness programs and services, including: Hearing aids and exams Deeply discounted pricing on hearing aids plus free batteries for 2 years Vision exams and eyewear Discounts for routine vision services, exams and eyeglasses Chiropractic/acupuncture/massage therapy Save up to 25% off usual and customary fees for services Weight and nutrition Save up to 25% off weight and nutrition programs Fitness clubs Save at least 10% off initiation and/or monthly dues * The products and services described for Healthy Rewards are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Cigna Medicare Rx grievance process. Some Healthy Rewards programs are not available in all states. If their Cigna plan includes coverage for any of these services, this program is in addition to, not instead of, your plan benefits. A discount program is NOT insurance and you must pay the entire discounted charge. 21

22 CIGNA HOME DELIVERY PHARMACY We make it easy Cigna Home Delivery Pharmacy delivers prescription drugs right to your mailbox, often at lower prices than your pharmacy 1 and provides: Free and quick delivery of all your prescriptions 2 Refill reminders to help ensure you don t miss a dose FDA-approved medications Confidential, tamper-resistant packaging Pharmacists available day or night to answer your questions and put you at ease Cigna Home Delivery Pharmacy has a dedicated phone number for you to call 24 hours a day/seven days a week: (TTY/TDD users can call: ) You could pay less with Cigna Home Delivery Pharmacy, for example: If a customer pays $30 copay today for a monthly prescription with Cigna Home Delivery Pharmacy, they could pay only $75 for a 90-day supply possible savings of 17% 3 1. Results may vary based on where you are in the Medicare Part D Coverage phases. 2. Free standard shipping extra costs apply for rush delivery. 3. This example is for the initial coverage phase for Medicare Part D customers. Results will be different for those in the deductible phase, or coverage gap phase. Your copay may vary from the $30 used in the example. 22

23 CIGNA MEDICARE RX (PDP) A plan to save you money Medicare Rx Plans: Can save you money on hearing and vision programs; including hearing aids and eyeglasses Have a broad, national network of over 64,000 pharmacies, including our convenient Cigna Home Delivery Pharmacy where you can get your drugs delivered right to your door Cover over 6,000 medications and Plan Two even covers 96% of the most commonly used drugs 1 Plan One $0 deductible generics if you reside in DC, DE, GA, ID, MD, ME, MS, NH, SC. UT, WI: you ll pay no deductible for Tiers 1-2 drugs and the standard $325 deductible applies for Tiers 3-5 drugs $0 copay for all Tier 1 drugs (including high cholesterol, hypertension and diabetes medications) and only $8 for all Tier 2 drugs Plan Two No deductible $0 copay for all Tier 1 drugs & $0 copay for Tier 1 drugs all the way through the coverage gap (including high blood pressure, diabetes, high cholesterol, glaucoma and thyroid therapy medications) 1. Based on the top 100 Part D prescription drugs used by Medicare-eligible customers. The four percent of drugs not covered are brand-name drugs with a covered generic equivalent available. 23

24 Enroll Today! Four simple ways to enroll: 1. Call your broker or Cigna Medicare Rx at Online through your broker s website or by visiting the Cigna Medicare Rx website at 3. Mail your enrollment form to: Cigna Medicare Rx (PDP) P.O. Box Weston, FL Fax your completed form to: After you enroll, you will receive a call from the Cigna Medicare Rx customer service team to confirm your intent to enroll in the plan. 24

25 Additional information 25

26 ADDITIONAL INFORMATION Income related Medicare adjustment amount Most individuals will pay the standard monthly Part D premium; however, some have to pay an extra amount because of their annual income For singles or married individuals filing separately with income above $85,000 and married couples with income above $170,000, an extra Part D premium will be charged If you need to pay more, the Social Security Administration will send you a letter with instructions on how to pay the extra amount The extra amount must be paid separately and cannot be paid with your monthly plan premium to their Part D plan 26

27 ADDITIONAL INFORMATION Income related Medicare adjustment amounts If you filed an individual tax return and your income in 2012 was: If you were married but filed a separate tax return and your income in 2012 was: If you filed a joint tax return and your income in 2012 was: This is the monthly cost of your extra Part D amount (to be paid in addition to your plan premium): Equal to or less than $85,000 Equal to or less than $85,000 Equal to or less than $170,000 $0 Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000 $11.60 Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000 $29.90 Greater than $160,000 and less than or equal to $214,000 Greater than $85,000 and less than or equal to $129,000 Greater than $320,000 and less than or equal to $428,000 $48.30 Greater than $214,000 Greater than $129,000 Greater than $428,000 $

28 ADDITIONAL INFORMATION Late enrollment penalty 1 An amount (late enrollment penalty (LEP)) added to your monthly premium if you do not enroll in a Medicare Part D plan when you first become eligible: if you go without creditable coverage (i.e., coverage at least as good as Medicare s) for a continuous period of 63 days or more LEP is added to your monthly premium (considered part of your premium); if you do not pay your LEP, you could be disenrolled for failure to pay premium If you are under 65 and are currently receiving Medicare benefits, the LEP will reset when you turn 65; after age 65, your LEP will be based only on the months you don t have coverage after your initial enrollment period for aging into Medicare To calculate your LEP: Count the number of full months you delayed enrolling in a Medicare drug plan (after you were eligible to enroll) or count the number of full months you did not have creditable prescription drug coverage (if the break in overage was 63 days or more) The penalty is 1% for every month you did not have creditable coverage (e.g., if they go 14 months without coverage, the penalty will be 14%) 1. If you are eligible for LIS and receive Extra Help from the government, you are not subject to late enrollment penalties. 28

29 MEDICARE RESOURCES Cigna Medicare Rx (PDP) Information (TTY/TTD users call ) - 8am-8pm local time, 7 days a week - Medicare MEDICARE (TTY/TDD users call ) - 24 hours a day, 7 days a week - Social Security Administration for Extra Help (TTY/TDD users call ) - 7am-7pm, Monday-Friday

30 Cigna, "Cigna Medicare Services" and "Cigna Medicare Rx" (PDP) are registered service marks, and the "Tree of Life" logo, GO YOU, Healthy Rewards and Cigna Home Delivery Pharmacy are service marks, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, including Connecticut General Life Insurance Company (CGLIC), and not by Cigna Corporation. CGLIC is a Medicare approved Part D sponsor. All models are used for illustrative purposes only i 08/ Cigna. Some content provided under license.

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