Pharmacy Outreach Program The University of Rhode Island College of Pharmacy

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Pharmacy Outreach Program The University of Rhode Island College of Pharmacy"

Transcription

1 Pharmacy Outreach Program The University of Rhode Island College of Pharmacy Updated October 2014

2 Medicare provides health insurance for Aged 65 years or older Aged 65 years or less with certain disabilities All people with End-Stage Renal Disease (ESRD) All people with Lou Gehrig s Disease (ALS)

3 Part A Hospital insurance Part B Medical insurance Part C Medicare Advantage Plans Part D Prescription drug coverage

4 Covers: Inpatient hospital care Skilled nursing facilities (Under certain conditions) Usually doesn t require a monthly payment (Premium) Out-of-pocket deductible for hospital stays (in 2014): Days 1 60: $1,216 deductible Days 61 90: $304 coinsurance per day Days : $608 coinsurance per day Beyond day 151: patient pays all costs. For skilled nursing facilities: $152 per day for days 21 through 100 for each benefit period

5 Helps cover: Physician services Durable medical equipment Physical therapists Also covers other services and supplies: Glucose monitors Test strips Lancets Vaccines There is a monthly premium to enroll The standard Part B premium for 2014 is $ per month (income based) In general, automatically deducted from social security checks The Part B deductible is $147 Once deductible is paid enrollee generally pays a 20% co-payment for each service

6 Health insurance coverage, including preventative care PLUS prescription drug coverage in a single plan In exchange, typically must use a certain network of doctors, hospitals, and pharmacies (HMO, PPO)

7 9 plans available in Rhode Island with drug coverage 2 more plans without drug coverage If you already have a Medicare Advantage plan and you want to add drug coverage you MUST obtain it through your Medicare Advantage provider if they offer it. If you obtain an independent standalone drug plan instead, your health coverage under the Medicare Advantage plan will stop and you will return to Original Medicare.

8 Annual Enrollment Period in 2014 October 15-December 7, 2014 Can choose to leave current Medicare Advantage plan to switch to an Original Medicare plan Can add prescription coverage - Part D

9 Stand-alone prescription drug coverage Open to all people eligible for Medicare Open enrollment begins October 15, 2014 Enrollment for coverage of the year 2015 ends on December 7, 2014 Coverage Begins on January 1 st, 2015 Medicare Part D is VOLUNTARY!!

10 Re-enrollment begins October 15 th, 2014! Your new plan will take effect January 1 st, 2015 If you are happy with your current part D plan, you don t need to do anything during the re-enrollment period! Your Med D plan will automatically re-enroll you But be aware: your premiums, co-pays, formulary, or deductible may be changed for the new year!

11 NEW Open enrollment is from Oct 15 Dec 7 th of each year Coverage begins on January 1, 2015 If you become eligible for Medicare Part D after the enrollment period, you have a 7 month period to enroll without incurring a penalty 3 months before, the month of and 3 months after your 65 th birthday

12 People who are enrolled in a Med D plan right now but are thinking about switching to another plan next year You didn t sign up for a plan when eligible last time around but you re thinking of enrolling now Penalty: 1% increase in premium for every month not enrolled Enrolled in a Medicare Advantage Plan or Medigap Supplemental Insurance Plan but you want to add or change your drug coverage People who have major changes in the medications they take on a daily basis

13 If you have CREDITABLE Coverage: Creditable Coverage = a plan that provides a prescription drug benefit that is EQUIVALENT or better than Medicare Part D coverage You would have already been made aware of this by your insurance provider by mail KEEP THIS LETTER IN A SAFE PLACE** **If you are unsure if your coverage is creditable or not, ask your employer or union for it!**

14 If you did not enroll but were eligible to do so When you enroll now for coverage beginning on Jan.1, 2015 you will incur a penalty of a premium increase of 1% per month that you were eligible Will have to wait until 2015 enrollment period to join a Medicare drug plan if don t do so now! Average premium 2014 = $ % of $32.42 = $ months penalty= $3.89 rounded to nearest 0.10= 3.90 Therefore, $3.90 will be added on to your monthly premium every month forever!

15 You will not have this penalty enforced: If you were not previously eligible for Medicare Part D If you previously had creditable coverage

16 Those with Medicare Part D that have an annual income above a certain level will have an additional fee added to their monthly premium Penalty based on gross income reported on the income tax return from 2 years prior Paid directly to Medicare (aka the Federal government) It is not collected by Medicare Part D plans

17 The amount of an individual s IRMAA will be deducted from any government benefits (e.g. Social Security) If sufficient funds are not available, individuals will be billed directly from Medicare Medicare Part D beneficiaries will be contacted by the Social Security Administration if they are affected by the 2014 IRMAA

18 Beneficiaries who file individual tax returns with income that is: Less than or equal to $85,000 Greater than $85,000 and less than or equal to $107,000 Greater than $107,000 and less than or equal to $160,000 Greater than $160,000 and less than or equal to $214,000 Beneficiaries who file joint tax returns with income that is: Less than or equal to $170,000 Greater than $170,000 and less than or equal to $214,000 Greater than $214,000 and less than or equal to $320,000 Greater than $320,000 and less than or equal to $428,000 Medicare Part D Income Related Monthly Adjustment Amount $0.00 $0.00 $0.00 $12.30 $12.10 $11.60 $31.80 $31.10 $29.90 $51.30 $50.20 $48.10

19 Lower costs during donut hole : Patients pay 45% of brand name drugs Patients pay 65% of generic drugs Better Quality care: Bonus payments from the government will give incentives to Medicare Advantage plans with better quality care

20 Remember: this is just an explanation of the template used as a general basis for the plans-- there are options! STANDARD PLAN (2015) $31 per month premium $320 deductible (some plans don t have deductibles) 68% coverage until you ve paid $2,960 (copay varies by plan) Limited coverage until total of $4,700 spent Patient pays 45% of Brand Drugs and up to 65% of generic drugs This is called the coverage gap or Donut Hole 95% coverage beyond the coverage gap (% varies by plan)

21 HOW PART D WORKS Catastrophic Coverage > $4700 Donut hole - $2960 $4700 Medicare Pays 95% 45%-65% 5% Co-Insurance : $ % 25% 0 - $320 is your Deductible You Pay 100% New Change for Donut hole, will only spend 45% out of pocket for brand name and 65% maximum for generic drugs!!!

22 Step #1 The Deductible You pay 100% and plan pays 0% You receive $320 worth of medications Step #2 Co-insurance You pay 25% and plan pays 75% You receive $2,640 worth of medications (Total: Step 1 + Step 2 = $2960) Medicare Pays 95% 75% 25% You Pay 100% 45%-65% 5%

23 Step #3 The Donut Hole New changes let you pay 45% of brand drugs Max of 65% generics Total: Step 1 + Step 2 + Step 3 = $4700 New discounts! Step #4 Catastrophic Coverage You pay 5% and plan pays 95% You receive unlimited drugs for the remainder of calendar year Medicare Pays 95% 75% 25% You Pay 100% 45%-65% 5%

24 Even though you were enrolled in a program last year, you start from the Step #1 all over again on January 1, 2015 You will continue to pay the premium every month regardless of what step that you are on Even when in the donut hole a person still pays the monthly premium!

25 Must offer basic/standard drug benefit May offer enhanced benefit Some have no deductible Some have help during donut hole (coverage gap) The Premium depends on the enhancements Mail order options may save costs on maintenance medications (90 days)

26 A statement sent by your insurance company telling you which medical services were paid for by them. Includes: The service: date/place service provided Doctors fee and what was paid by them Remainder that the patient is responsible for To show you what portion the insurance is paying for and which portion you are.

27 Get a complete list of your medications Include all prescriptions-eye drops, creams, inhalers, patches, etc. Go to and click on Formulary Finder Follow the prompts and enter your medications Can also call MEDICARE ( ) Can enroll on line have your Medicare card ready CVS and Walgreens both have websites to condense your search of possible plans Rite Aid has plan finding software, just call your Rite Aid pharmacist and schedule a time to choose a plan

28

29

30

31

32

33

34

35 Rx Enrollment Check-Up: Cost Will your premium and costs change in 2015? Coverage Will you need more comprehensive coverage? Will your current meds be covered by your plan? Now that donut hole is partially covered, is switching a better option? Customer Service Are you satisfied with your service from your current plan?

36 If you decide that your current Med D plan will meet your needs in 2015 then you do not need to re-enroll Coverage will continue through 2015 starting from Step 1

37 Total of 26 prescription plans offered 11 plans available with NO deductible! Monthly premiums start at $15.60 Humana Walmart Rx Plan 9 Medicare advantage plans Lowest premiums have only a few brands covered All Medicare patients are eligible for a Medicare advantage plan

38 Formulary system Each plan selects certain drugs from each drug class that they will cover May have a tier system May have up to 5 tiers Generic drugs = cheapest (ex: $5) Preferred brand names = more expensive (ex: $28) Non-preferred brand names = most expensive (ex: $40) Certain injectable and specialty drugs= highest tiers (ex: $58)

39 Non-FDA approved drugs Weight loss or gain Erectile dysfunction Drugs for cosmetic purposes(hair growth) Non prescription drugs Cough & cold relief Fertility drugs Prescription vitamins, minerals Except prenatal vitamins and fluoride preparations

40 Generics: required to be covered by ALL plans Chemically identical to brand-name drugs and meet the same standards put forth by the FDA for: Safety, Purity, Effectiveness Generic drugs can be legally produced in the US if a patent has expired, or for drugs which have never been patented Prior authorization: may be needed for some medications Appeal process mandated by insurance company which includes paperwork by the Doctor explaining why you need the drug Step Therapy: may be required before certain medications will be covered ex: Motrin before Celebrex Quantity limits: may be enforced 30 day quantities retail vs. 90 day mail-order Some plans DO allow 90 day quantities of maintenance medicines at community pharmacies.

41

42 Medicare part D must cover all vaccines not covered by part B Ex: Zostavax (Shingles vaccine) Vaccines covered by part B Pneumococcal Influenza Hepatitis B Vaccines necessary to treat a disease or prevent one after direct exposure Ex: tetanus

43 You SHOULD keep your RIPAE! It will provide assistance with the deductible & coverage gap It is not creditable coverage You need a Medicare Part D Plan to apply RIPAE is only available for those enrolled in a Medicare part D plan Must send in copy of enrollment letter or card See your SHIP counselor or call The Point for RIPAE information

44 Provides extra benefit for those who don t qualify for extra help from Medicare Applicable to all expenses that person is 100% responsible for: Deductible Coverage gap ( Donut Hole ) Drugs not covered under your Part D Plan Only certain ones!

45 Eligible: Single, income less than $45,991 per year Married, income less than $52,561 per year The lower the financial category, the higher percentage RIPAE will pay More information: The Point Wrong phone number on Medicare & You 2008 Booklet! Talk to SHIP counselor

46 They are creditable coverage, letters have been sent in mail! Hold on to these letters! Contact your pension benefits manager or union if you have any questions

47 Will automatically be eligible for: No premium No deductible No donut hole Minimum co-payments ($2.65 generic & $6.60brand at most) Have been automatically enrolled in a plan & will be automatically re-enrolled in a plan Part D plan for 2015 won t necessarily be the same plan as 2014 Reassignment notices are being sent out Enrollment confirmations will follow If you are dually eligible, you can change your plan at any time during the year! Once per month!

48 Federal poverty limits determined by government each year Best to apply and be formally denied Many deductions, so apply! In order to be eligible, a person s resources must be no greater than the limits established Single* Married* Yearly Income <$17,505 <$23,595 Resources <$13,440 <$26,860 *Includes $1,500 per person burial expenses

49 Defined as those who had Low Income Subsidy (LIS) for 2014 & are not automatically eligible for 2015 Notifications being sent out with applications to re-enroll Does not mean that you are not eligible You need to reapply!!! Check with your SHIP counselor or The Point

50 Ask your doctor about generic and less expensive brand name drugs (therapeutic substitutions) Cheaper in the gap Less likely to hit the gap if avoid brand name medications from the beginning! Ask your doctor for samples Pharmaceutical Assistance Programs Available from the pharmaceutical manufacturers Contact the Partnership for Prescription Assistance

51 State Pharmaceutical Assistance Programs RIPAE Based on your income, RIPAE will pay 15%, 30%, or 60% of drug cost during coverage gap Apply for Extra Help If you have limited income and resources, you may qualify for extra help For more information go to or call

52 Changes in amount covered during the Coverage Gap! 45% for brand name prescriptions ( from 47.5%) 65% for generic prescriptions ( from 72%) Greater Coverage for preventive medical services Depression Cardiovascular Disease Alcohol Abuse Obesity

53 Options: Ask your pharmacist about therapeutic substitution Compare prescription vs. overthe-counter (OTC) options Celebrex $ Motrin OTC $10.99 Ibuprofen Rx- lowest cost or co-pay Always consult with your doctor regarding changes to your medications

54 Can still get these drugs but must pay the retail price ( cash ) and it does not count towards out-of-pocket expenses or total drug costs Examples: Drugs for weight loss, hair loss, and fertility Drugs covered under Medicare parts A and B Example: Drugs received while in the hospital, diabetic testing supplies

55 The vast majority of your health care providers are committed to providing you with high quality care However, there are some individuals who cheat the system out of millions of dollars, which results in higher premiums for its members. Be very cautious when dealing with your Medicare information, & never share it with a medical professional unless you are absolutely certain that they need it. Never share your Medicare information over the phone with someone else! Especially if you did not call them.

56

57 October 1- Compare and Prepare October 15- Open Enrollment Begins December 7- Open Enrollment Ends January 1, Coverage Begins

58 No single plan is best for everyone You must pick the plan that s right for YOU! Make sure to enroll between Oct 15 Dec 7 th, 2014 Yes, it is confusing! Don t be afraid to ask for help: The Point!!! (401) SHIP counselors at your local Senior Center Dept. of Elderly affairs (401) Ask a relative or friend to help you navigate the Web Social Security Administration Pharmacy Outreach Program

59 THANK YOU!

Medicare. Prescription Drug Plan Guide. Simple steps to help you choose the right prescription drug coverage

Medicare. Prescription Drug Plan Guide. Simple steps to help you choose the right prescription drug coverage Medicare Prescription Drug Plan Guide An educational resource developed by Simple steps to help you choose the right prescription drug coverage and published by Rite Aid Corporation. Rite Aid pharmacists

More information

Version 23. Medicare Prescription Drug Coverage and Medicare Plan Finder

Version 23. Medicare Prescription Drug Coverage and Medicare Plan Finder Version 23 Medicare Prescription Drug Coverage and Medicare Plan Finder What is Medicare? Health insurance for three groups of people 65 and older Under 65 with certain disabilities Any age with End-Stage

More information

Medicare. What you need to know. Choose the plan that s right for you GNHH2ZTHH_15

Medicare. What you need to know. Choose the plan that s right for you GNHH2ZTHH_15 Medicare What you need to know Choose the plan that s right for you GNHH2ZTHH_15 Choosing a Medicare plan is a lot like buying a car. There are lots of options to consider. And what s right for you may

More information

By Christina Crain, MSW. Director of Programs

By Christina Crain, MSW. Director of Programs By Christina Crain, MSW Director of Programs What we ll cover Medicare Eligibility Medicaid Eligibility Medicare Parts A, B, C and D New Improvements to Medicare under ACA The Medicare Savings Programs

More information

Prescription Drugs Medicare- Eligible Participants

Prescription Drugs Medicare- Eligible Participants State Retiree Health Benefits Program Fact Sheet #8A Prescription Drugs Medicare- Eligible Participants As a Medicare-eligible participant in the State Retiree Health Benefits Program, what are my choices

More information

1Will my Medicare Part D plan be

1Will my Medicare Part D plan be 2014 Medicare Prescription Drug Annual Open Enrollment Questions & Answers The Annual Open Enrollment for Medicare prescription drug (Part D) is October 15, 2013 December 7, 2013. Certain people with Medicare

More information

Contents. What s your current coverage? 13 What are my choices? 14 What to do and when to do it 16 Frequently asked questions 18 Glossary 21

Contents. What s your current coverage? 13 What are my choices? 14 What to do and when to do it 16 Frequently asked questions 18 Glossary 21 Show-Me Guide Introduction to Part D: Medicare s New Prescription Drug Coverage An educational resource developed and published by UnitedHealth Group Contents What are the big ideas? 2 Is a Part D plan

More information

On the next page are answers to some important questions that can help you during the Annual Open Enrollment.

On the next page are answers to some important questions that can help you during the Annual Open Enrollment. QA 2015 Medicare Prescription Drug Annual Open Enrollment The Annual Open Enrollment for Medicare prescription drug coverage (Part D) is October 15, 2014 December 7, 2014. Certain people with Medicare

More information

Making Sense of Medicare

Making Sense of Medicare Making Sense of Medicare Stephanie M. Turnbull Manager, Member Benefits 1 Highlights Medicare Eligibility Types of Medicare Coverage Medicare Part A Medicare Part B Medicare Part C Medicare Part D Medicare

More information

Using Medicare s Website to Choose a Medicare-Approved Drug Plan 2016. Prepared by Senior PharmAssist (rev 10.07.2015)

Using Medicare s Website to Choose a Medicare-Approved Drug Plan 2016. Prepared by Senior PharmAssist (rev 10.07.2015) TIPS AND HINTS: Using Medicare s Website to Choose a Medicare-Approved Drug Plan 2016 Prepared by Senior PharmAssist (rev 10.07.2015) IT PAYS TO COMPARE. The plan that was the cheapest for you in 2015

More information

New Medicare Prescription Drug Coverage: An Overview for Pharmacies in Oregon

New Medicare Prescription Drug Coverage: An Overview for Pharmacies in Oregon New Medicare Prescription Drug Coverage: An Overview for Pharmacies in Oregon Note: All material in this manual is intended for people with Medicare who live in Oregon. It is not indicative of what classes

More information

Essentials Rx 15 (HMO) Plan offered by PacificSource Medicare. Annual Notice of Changes for 2014

Essentials Rx 15 (HMO) Plan offered by PacificSource Medicare. Annual Notice of Changes for 2014 Essentials Rx 15 (HMO) Plan offered by PacificSource Medicare Annual Notice of Changes for 2014 You are currently enrolled as a member of Essentials Rx 15 (HMO) Plan. Next year, there will be some changes

More information

Your complimentary Medicare Guidebook

Your complimentary Medicare Guidebook Learn Protect Assess Enroll Your complimentary Medicare Guidebook About this Guidebook If you or someone you care for is new to Medicare or will be soon, this Guidebook will help make Medicare easier to

More information

Medicare Part D Prescription Drug Coverage

Medicare Part D Prescription Drug Coverage Medicare Part D Prescription Drug Coverage Part 3 Version 9.0 June 22, 2015 Terms and Conditions This training program is protected under United States Copyright laws, 17 U.S.C.A. 101, et seq. and international

More information

Prescription Drug Coverage

Prescription Drug Coverage CENTERS for MEDICARE & MEDICAID SERVICES Your Guide to Medicare Prescription Drug Coverage This official government booklet tells you: How your coverage works How to get Extra Help if you have limited

More information

Getting Started with Medicare Beginning Medicare Training

Getting Started with Medicare Beginning Medicare Training Getting Started with Medicare Beginning Medicare Training This Medicare Counselor Training program was developed under a grant from UnitedHealthcare through a joint project with the National Association

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Kaiser Permanente Senior Advantage Essential Plus plan (HMO) offered by Kaiser Foundation Health Plan, Inc., Hawaii Region Annual Notice of Changes for 2015 You are currently enrolled as a member of Kaiser

More information

BayCrest Insurance Services, 1275 S. Winchester Blvd., B, San Jose, CA 95128 Allan S. Eckmann. Medicare 2014

BayCrest Insurance Services, 1275 S. Winchester Blvd., B, San Jose, CA 95128 Allan S. Eckmann. Medicare 2014 BayCrest Insurance Services, 1275 S. Winchester Blvd., B, San Jose, CA 95128 Allan S. Eckmann What is Medicare? Medicare 2014 Medicare is a Health Insurance Program for: * People age 65 or older * People

More information

Guide to Medicare MEDICARE BASICS. Presented by

Guide to Medicare MEDICARE BASICS. Presented by Guide to Medicare MEDICARE BASICS Presented by 14 Medicare Basics What Is Medicare? Medicare is health insurance for the following: People 65 or older People under 65 with certain disabilities People of

More information

Things to think about when you compare Medicare drug coverage

Things to think about when you compare Medicare drug coverage Things to think about when you compare Medicare drug coverage Revised September 2015 There are 2 ways to get Medicare prescription drug coverage. You can join a Medicare Prescription Drug Plan and keep

More information

CENTERS FOR MEDICARE & MEDICAID SERVICES. Cost

CENTERS FOR MEDICARE & MEDICAID SERVICES. Cost CENTERS FOR MEDICARE & MEDICAID SERVICES Things to Think about when You Compare Medicare Drug Coverage You have two options to get Medicare coverage for your prescription drugs. If you have Original Medicare,

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Kaiser Permanente Senior Advantage Core (HMO) offered by Kaiser Foundation Health Plan of Colorado Annual Notice of Changes for 2016 You are currently enrolled as a member of Kaiser Permanente Senior Advantage

More information

Retiree Considerations Medicare 101. June 26, 2012

Retiree Considerations Medicare 101. June 26, 2012 Retiree Considerations Medicare 101 June 26, 2012 Agenda Goal: Present information regarding Medicare and related products to assist you in evaluating options Key Topics: Eligibility Rules Enrollment Rules

More information

Medicare Part D Prescription Drug Coverage

Medicare Part D Prescription Drug Coverage Medicare Part D Prescription Drug Coverage Part 3 Version 6.0 September 25, 2012 Terms and Conditions This training program is protected under United States Copyright laws, 17 U.S.C.A. 101, et seq. and

More information

Your complimentary Medicare Guidebook

Your complimentary Medicare Guidebook Learn Protect Assess Enroll Your complimentary Medicare Guidebook Learn Original Medicare... 4 Medicare Prescription Drug Coverage.............. 6 Medicare Supplement Insurance... 8 Medicare Advantage...

More information

Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc.

Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc. Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc. Annual Notice of Changes for 2015 You are currently enrolled as a member of Piedmont WellStar Medicare Choice HMO.

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 Advocare Spirit Rx (HMO-POS) offered by Security Health Plan of Wisconsin, Inc. Annual Notice of Changes for 2014 You are currently enrolled as a member of Advocare Spirit Rx (HMO-POS). Next year there

More information

CENTERS FOR MEDICARE & MEDICAID SERVICES

CENTERS FOR MEDICARE & MEDICAID SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Things to think about when you compare Medicare drug coverage There are 2 ways to get Medicare prescription drug coverage. You can join a Medicare Prescription

More information

Medicare At A Glance. State Health Insurance Assistance Program (SHIP)

Medicare At A Glance. State Health Insurance Assistance Program (SHIP) 2015 Medicare At A Glance Indiana 2015 State Health Insurance Assistance Program (SHIP) Who runs the Medicare Program? The Centers for Medicare & Medicaid Services (CMS) is the Federal agency that runs

More information

Medicare Part D and You for 2013. (Individuals and Families)

Medicare Part D and You for 2013. (Individuals and Families) Medicare Part D and You for 2013 (Individuals and Families) What is Medicare Part D? Drug coverage which helps you pay for the medicines you need if you do not have other prescription drug coverage Voluntary

More information

3How do I know what changes my plan is

3How do I know what changes my plan is 2012 Medicare Prescription Drug Annual Open Enrollment Questions & Answers The Annual Open Enrollment for Medicare prescription drug (Part D) is October 15, 2011 December 7, 2011. The Open Enrollment Period

More information

2014 Prescription Drug Schedule Humana Medicare Employer Plan

2014 Prescription Drug Schedule Humana Medicare Employer Plan 2014 Prescription Drug Schedule Humana Medicare Employer Plan Option 98 City of Newport News Y0040_GHHHEF3HH14 SECTION I - INTRODUCTION TO SUMMARY OF BENEFITS Thank you for your interest in the Humana

More information

Closing the Coverage Gap Medicare Prescription Drugs Are Becoming More Affordable

Closing the Coverage Gap Medicare Prescription Drugs Are Becoming More Affordable MEDICARE PRESCRIPTION DRUG COVERAGE Closing the Coverage Gap Medicare Prescription Drugs Are Becoming More Affordable The Affordable Care Act includes benefits to make your Medicare prescription drug coverage

More information

How Emeriti's Medical Plans Work With Medicare

How Emeriti's Medical Plans Work With Medicare POST65NATPCC 2015 Post-65 Medical and Rx Comparison Chart National Group Insurance Options Underwritten by Aetna Emeriti offers two types of medical plans aligning in different ways with Medicare Parts

More information

I wanted to understand the Medicare program basics. This presentation really helped.

I wanted to understand the Medicare program basics. This presentation really helped. Welcome to Medicare 101! I wanted to understand the Medicare program basics. This presentation really helped. What is Medicare? What benefits does Medicare cover? What benefits doesn t Medicare cover?

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 First Health Part D Value Plus (PDP) Plan offered by First Health Life & Health Insurance Company Annual Notice of Changes for 2015 You are currently enrolled as a member of First Health Part D Essentials

More information

Cabrillo College Retiree Benefits and Medicare Frequently Asked Questions

Cabrillo College Retiree Benefits and Medicare Frequently Asked Questions Cabrillo College Retiree Benefits and Medicare Frequently Asked Questions Table of Contents What is Medicare?... 3 What are the different parts of Medicare?... 4 What does Medicare help cover Part A?...

More information

UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan

UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan Annual Notice of Changes for 2016 You are currently enrolled as a member of UPMC for Life HMO Deductible with Rx. Next year, there

More information

Evidence of Coverage:

Evidence of Coverage: January 1 December 31, 2016 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Advantra Silver (HMO) This booklet gives you the details about

More information

What is Medicare? The Different Parts of Medicare

What is Medicare? The Different Parts of Medicare Medicare and You The Different Parts of Medicare A Medicare Part A Hospital Insurance Inpatient care at hospitals, skilled nursing facility*, hospice and home health care. What is Medicare? Medicare is

More information

How Medicare Works. Helping you make the most of Medicare. MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015

How Medicare Works. Helping you make the most of Medicare. MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015 How Medicare Works Helping you make the most of Medicare 2016 MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015 About Medicare Whether you re new to Medicare or want a refresher,

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Upper Peninsula Health Plan Advantage (HMO) offered by Upper Peninsula Health Plan, LLC Annual Notice of Changes for 2016 You are currently enrolled as a member of Upper Peninsula Health Plan Advantage

More information

Your 2014 Guide to. Medicare Part D. Have you done your yearly Medicare Part D Plan review?

Your 2014 Guide to. Medicare Part D. Have you done your yearly Medicare Part D Plan review? Your 2014 Guide to Medicare Part D Have you done your yearly Medicare Part D Plan review? The Fall Open Enrollment Period, during which people with Medicare can make unrestricted changes to their coverage

More information

PACE and MEDICARE PART D FREQUENTLY ASKED QUESTIONS 2015

PACE and MEDICARE PART D FREQUENTLY ASKED QUESTIONS 2015 The following Questions and Answers address program policies and procedures as they relate to how the PACE Program is working with Medicare Part D in 2015: 1. If I have PACE or PACENET, why should I enroll

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 ConnectiCare VIP Employer Group (HMO-POS) offered by ConnectiCare, Inc. Connecticut Business & Industry Association (CBIA) Annual Notice of Changes for 2014 You are currently enrolled as a member of ConnectiCare

More information

UAMS UnitedHealthcare Group Medicare Advantage (PPO) 2014 benefit plan Y0066_130717_100929

UAMS UnitedHealthcare Group Medicare Advantage (PPO) 2014 benefit plan Y0066_130717_100929 UAMS UnitedHealthcare Group Medicare Advantage (PPO) 2014 benefit plan Y0066_130717_100929 Welcome Why We re Here Medicare Basics Plan Benefits Questions & Answers How to Enroll Why UnitedHealthcare? UnitedHealthcare

More information

FREQUENTLY ASKED QUESTIONS REGARDING CHANGE TO MEDICARE ADVANTAGE PLAN

FREQUENTLY ASKED QUESTIONS REGARDING CHANGE TO MEDICARE ADVANTAGE PLAN FREQUENTLY ASKED QUESTIONS REGARDING CHANGE TO MEDICARE ADVANTAGE PLAN Q: What company administers the Medicare Advantage plan? A: The Medicare Advantage plan for the year of 2016 will be administered

More information

Overview of Health Insurance Options for Medicare-Eligible Members

Overview of Health Insurance Options for Medicare-Eligible Members Overview of Health Insurance Options for Medicare-Eligible Members The following pages offer general descriptions of the types of plans offered to CTPF retirees who are eligible for and maintain active

More information

Solutions for Today Flexibility for Tomorrow.

Solutions for Today Flexibility for Tomorrow. Solutions for Today Flexibility for Tomorrow. Medicare Products and Services For More Information call our Senior Care Specialist, Raun Lynch at 856.380.5079 Or visit us on the web at www.cbdi-inc.com

More information

Summary of benefits. 2009 idaho, utah. Health Net orange prescription drug plan

Summary of benefits. 2009 idaho, utah. Health Net orange prescription drug plan Health Net orange prescription drug plan Summary of benefits 2009 idaho, utah Benefits effective January 1, 2009 (S5678-064) PDP Option 1 (S5678-063) PDP Value Option 2 Section I INTRODUCTION TO SUMMARY

More information

THE A,B,C,D S OF MEDICARE

THE A,B,C,D S OF MEDICARE THE A,B,C,D S OF MEDICARE An important resource for understanding your healthcare in retirement What you need to know for 2014 How Medicare works What Medicare covers How much Medicare costs INTRODUCTION

More information

First Health Part D Value Plus (PDP) offered by First Health Life & Health Insurance Company

First Health Part D Value Plus (PDP) offered by First Health Life & Health Insurance Company First Health Part D Value Plus (PDP) offered by First Health Life & Health Insurance Company Annual Notice of Changes for 2016 You are currently enrolled as a member of First Health Part D Value Plus (PDP).

More information

Guide to Choosing a Medicare Prescription Drug Plan in Connecticut

Guide to Choosing a Medicare Prescription Drug Plan in Connecticut Medicare Prescription Drug - Choosing the Plan that s Right for You! Guide to Choosing a Medicare Prescription Drug Plan in Connecticut Medicare Prescription Drug, also called Part D or Medicare Rx, is

More information

Understanding your. Medicare options. Medicare Made Clear TM. Get Answers Series. Y0066_120629_084915 CMS Accepted

Understanding your. Medicare options. Medicare Made Clear TM. Get Answers Series. Y0066_120629_084915 CMS Accepted Understanding your Medicare options. Medicare Made Clear TM Get Answers Series Y0066_120629_084915 CMS Accepted learning about Medicare Choices. Eligibility Coverage options When to enroll Next steps and

More information

MEDICARE BASICS WHAT TO KNOW AND WHAT TO EXPECT WITH MEDICARE

MEDICARE BASICS WHAT TO KNOW AND WHAT TO EXPECT WITH MEDICARE MEDICARE BASICS WHAT TO KNOW AND WHAT TO EXPECT WITH MEDICARE AGENDA What is original Medicare? The A, B, C, and D s of Medicare Enrollment periods Medicare Advantage star rating system Where you can find

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna-HealthSpring Preferred Plus (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred Plus (HMO). Next year, there

More information

Let us help! WELCOME TO MEDICARE GUIDE. This brochure will help you understand the type of Medicare coverage that you need.

Let us help! WELCOME TO MEDICARE GUIDE. This brochure will help you understand the type of Medicare coverage that you need. WELCOME TO MEDICARE GUIDE Let us help! This brochure will help you understand the type of Medicare coverage that you need. Learn about the different parts of Medicare Decide how you want to receive your

More information

2016 Group Retiree Medicare Plans

2016 Group Retiree Medicare Plans 2016 Group Retiree Medicare Plans Blue Cross MedicareRx (PDP) Medicare Part D Prescription Drug Plans Anthem Blue Cross is a stand-alone prescription drug plan with a Medicare contract. Enrollment in Anthem

More information

Medicare Part D: Things People With Cancer May Want to Know

Medicare Part D: Things People With Cancer May Want to Know Medicare Part D: Things People With Cancer May Want to Know Medicare Part D prescription drug coverage This information is designed to help you decide whether to enroll in a Medicare Part D drug plan and

More information

MEDICARE PRESCRIPTION SAVINGS GUIDE

MEDICARE PRESCRIPTION SAVINGS GUIDE MEDICARE PRESCRIPTION SAVINGS GUIDE Since the beginning of Medicare Part D, we ve learned what s most important to you getting trusted information and lowering your prescription costs. We re here to help

More information

2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted

2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted 2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted Allegian Advantage is an HMO plan. We proudly serve Texas residents in Cameron, Hidalgo and Willacy counties, offering doctor, hospital

More information

You have from October 15 until December 7 to make changes to your Medicare coverage for next year.

You have from October 15 until December 7 to make changes to your Medicare coverage for next year. Advantra Gold (HMO) offered by HealthAmerica Pennsylvania, Inc. Annual Notice of Changes for You are currently enrolled as a member of Advantra Gold (HMO). Next year, there will be some changes to the

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Prescription Blue SM PDP, Option B, offered by Blue Cross Blue Shield of Michigan Annual Notice of Changes for 2015 You are currently enrolled as a member of Prescription Blue Option B. Next year, there

More information

Medicare Part D Prescription Drug Coverage

Medicare Part D Prescription Drug Coverage Medicare Part D Prescription Drug Coverage Part 3 Version 7.1 August 1, 2013 Terms and Conditions This training program is protected under United States Copyright laws, 17 U.S.C.A. 101, et seq. and international

More information

Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Molina Medicare Options Plus HMO SNP

Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Molina Medicare Options Plus HMO SNP January 1 December 31, 2015 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Molina Medicare Options Plus HMO SNP This booklet gives you the

More information

Medicare and Your Mental Health Benefits CENTERS FOR MEDICARE & MEDICAID SERVICES

Medicare and Your Mental Health Benefits CENTERS FOR MEDICARE & MEDICAID SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare and Your Mental Health Benefits This is the official government booklet about Medicare mental health benefits for people in the Original Medicare Plan.

More information

CENTERS FOR MEDICARE & MEDICAID SERVICES. Your Guide to Medicare. This official government booklet tells you the following:

CENTERS FOR MEDICARE & MEDICAID SERVICES. Your Guide to Medicare. This official government booklet tells you the following: CENTERS FOR MEDICARE & MEDICAID SERVICES Your Guide to Medicare Prescription Drug Coverage This official government booklet tells you the following: How it works How to get extra help paying for drug coverage

More information

Medicare doesn t have to be complicated. This guide is provided to help you better understand Medicare and how a Medicare Advantage plan may offer

Medicare doesn t have to be complicated. This guide is provided to help you better understand Medicare and how a Medicare Advantage plan may offer clarity YOUR GUIDE TO MEDicare AdvantaGE Medicare doesn t have to be complicated. This guide is provided to help you better understand Medicare and how a Medicare Advantage plan may offer the coverage

More information

Faculty Alabama State Health Insurance Assistance Program and Medicare 101

Faculty Alabama State Health Insurance Assistance Program and Medicare 101 Faculty Alabama State Health Insurance Assistance Program and Medicare 101 Susan Segrest Community Based Services Division Chief Central Alabama Aging Consortium A Training on Basic Medicare and the Alabama

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 True Blue Rx Option Il (HMO) offered by Blue Cross of Idaho Health Service, Inc. (Blue Cross of Idaho) Annual Notice of Changes for 2014 You are currently enrolled as a member of True Blue Rx Option Il

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 Blue Medicare HMO SM Standard offered by Blue Cross and Blue Shield of North Carolina (BCBSNC) Annual Notice of Changes for 2014 You are currently enrolled as a member of Blue Medicare HMO Standard. Next

More information

Allegian Advantage (HMO) H8554_001-2015 Accepted

Allegian Advantage (HMO) H8554_001-2015 Accepted Allegian Advantage (HMO) H8554_001-2015 Accepted IMPORTANT This presentation is for the exclusive use of Allegian Advantage (HMO) Allegian Health Plans is an HMO plan with a Medicare contract. Enrollment

More information

Summary of Benefits. (PDP), Blue MedicareRx Plus SM. (PDP) and Blue MedicareRx Premier SM

Summary of Benefits. (PDP), Blue MedicareRx Plus SM. (PDP) and Blue MedicareRx Premier SM Summary of Benefits for SM, Plus SM and Premier SM Available in Maine and New Hampshire A -approved Part D sponsor. Anthem Insurance Companies, Inc. (AICI) is the legal entity who has contracted with the

More information

Basic Reimbursement - Medicare Part D Specifics

Basic Reimbursement - Medicare Part D Specifics Basic Reimbursement - Medicare Part D Specifics 60889-R8-V1 (c) 2012 Amgen Inc. All rights reserved 2 This information is provided for your background education and is not intended to serve as guidance

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Healthy Advantage Plus HMO offered by Molina Healthcare of Utah Annual Notice of Changes for 2016 You are currently enrolled as a member of Healthy Advantage Plus HMO. Next year, there will be some changes

More information

It s Time for Medicare

It s Time for Medicare It s Time for Medicare med-waageinbook-1214 Medicare What you need to know. You re turning 65. Or you re already 65 and getting ready to retire and lose your healthcare coverage. You re almost ready for

More information

Harvard Pilgrim s Stride SM. (HMO) Medicare Advantage Plan. Value Rx Plus Annual Notice of Change

Harvard Pilgrim s Stride SM. (HMO) Medicare Advantage Plan. Value Rx Plus Annual Notice of Change HP15ANOCMNEPLUS 2015 Harvard Pilgrim s Stride SM (HMO) Medicare Advantage Plan Value Rx Plus Annual Notice of Change Maine Cumberland and York Y0098_15092 Accepted Harvard Pilgrim Stride Value RX Plus

More information

Prescription Drug Plan (PDP)

Prescription Drug Plan (PDP) Prescription Drug Plan (PDP) Blue Shield of California Medicare Rx Plan (PDP) Evidence of Coverage Effective January 1, 2015 Blue Shield of California is a PDP with a Medicare contract. Enrollment in Blue

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Express Scripts Medicare (PDP) for Consolidated Associations of Railroad Employees (CARE) Annual Notice of Changes for 2015 You are currently enrolled as a member of Express Scripts Medicare (PDP). The

More information

Get Ready! Get Set! Go! Medicare Part D in Minnesota

Get Ready! Get Set! Go! Medicare Part D in Minnesota Get Ready! Get Set! Go! Medicare Part D in Minnesota Videoconference Training For State Operated Services January 31, 2006 Kelli Jo Greiner, Minnesota Board on Aging and MN-DHS Continuing Care MMA: Overview

More information

Medicare Resource Guide

Medicare Resource Guide Medicare Resource Guide Patient Name Dear Patient, Please take the time to read the following sections of this brochure as noted by your healthcare provider. These different components of Medicare deal

More information

Medigap Insurance 54110-0306

Medigap Insurance 54110-0306 Medigap Insurance Overview A summary of the insurance policies to supplement and fill gaps in Medicare coverage. How to be a smart shopper for Medigap insurance Medigap policies Medigap and Medicare prescription

More information

DEVELOPED BY EQUIP FOR EQUALITY UNDER A GRANT PROVIDED BY THE ILLINOIS DEPARTMENT ON AGING

DEVELOPED BY EQUIP FOR EQUALITY UNDER A GRANT PROVIDED BY THE ILLINOIS DEPARTMENT ON AGING DEVELOPED BY EQUIP FOR EQUALITY UNDER A GRANT PROVIDED BY THE ILLINOIS DEPARTMENT ON AGING PUBLIC BENEFITS Medicare Overview This is an overview of the Medicare program. The information applies to people

More information

Understanding Medicare Part D & the Affordable Care Act. Bryan Padget Outreach Coordinator Senior Health Insurance Program (SHIP) 800-548-9034

Understanding Medicare Part D & the Affordable Care Act. Bryan Padget Outreach Coordinator Senior Health Insurance Program (SHIP) 800-548-9034 Understanding Medicare Part D & the Affordable Care Act Bryan Padget Outreach Coordinator Senior Health Insurance Program (SHIP) 800-548-9034 Topics What is SHIP? Medicare Part D Affordable Care Act Resource

More information

HARBOR ADVANTAGE (HMO) H7960-002-2015 Accepted

HARBOR ADVANTAGE (HMO) H7960-002-2015 Accepted HARBOR ADVANTAGE (HMO) H7960-002-2015 Accepted IMPORTANT This presentation is for the exclusive use of Authorized Plan Representatives of Harbor Advantage (HMO). Harbor Health Plan is an HMO plan with

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 True Blue Rx Option II (HMO) offered by Blue Cross of Idaho Health Service, Inc. (Blue Cross of Idaho) Annual Notice of Changes for 2014 You are currently enrolled as a member of True Blue Freedom (HMO).

More information

2015 Evidence of Coverage

2015 Evidence of Coverage Molina Medicare Options Plus HMO SNP Member Services Method Member Services Contact Information CALL (800) 665-1029 Calls to this number are free. 7 days a week, 8 a.m. to 8 p.m., local time. Member Services

More information

MEDICARE.GOV DRUG PLAN FINDER TOOL

MEDICARE.GOV DRUG PLAN FINDER TOOL MEDICARE.GOV DRUG PLAN FINDER TOOL Part 1 Part 2 A General Search is adequate for most people --The only required entry is your zip code Page 1 of 12 Part 3 Check the appropriate box under each section

More information

Choose the Medicare Advantage Plan That s Right for You

Choose the Medicare Advantage Plan That s Right for You Choose the Medicare Advantage Plan That s Right for You Indiana University Health Plans is a Medicare Advantage organization with a Medicare contract. Other pharmacies/physicians/providers are available

More information

Annual Notice of Changes for 2014 (This 2014 Annual Notice of Changes is effective October 1, 2013 December 31, 2014.)

Annual Notice of Changes for 2014 (This 2014 Annual Notice of Changes is effective October 1, 2013 December 31, 2014.) Blue Shield 65 Plus (HMO) offered by Blue Shield of California Annual Notice of Changes for 2014 (This 2014 Annual Notice of Changes is effective October 1, 2013 December 31, 2014.) You are currently enrolled

More information

Medicare Enrollment: What You Need to Know

Medicare Enrollment: What You Need to Know Medicare Enrollment: What You Need to Know September 18, 2014 Brandy Bauer National Council on Aging 1 National Council on Aging (NCOA) Who We Are: NCOA is the nation s leading nonprofit service and advocacy

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Cigna HealthSpring Premier (HMO POS) offered by Cigna HealthSpring Annual Notice of Changes for 2015 You are currently enrolled as a member of Cigna HealthSpring Premier (HMO POS). Next year, there will

More information

Helping you make the right Medicare decisions. Use. Choose. your benefits effectively. your health. care plan. Improve. and manage.

Helping you make the right Medicare decisions. Use. Choose. your benefits effectively. your health. care plan. Improve. and manage. Helping you make the right Medicare decisions Choose your health care plan Use your benefits effectively Improve and manage your health Your Guide to Selecting Medicare Coverage for 2015 What s Inside

More information

Medicare 101 Massachusetts Health Care Training Forum

Medicare 101 Massachusetts Health Care Training Forum Medicare 101 Massachusetts Health Care Training Forum What is Medicare? Health insurance for three groups of people 65 and older Under 65 with certain disabilities Any age with End-Stage Renal Disease

More information

Medicare Part D Prescription Drug Coverage

Medicare Part D Prescription Drug Coverage Medicare Part D Prescription Drug Coverage GENERAL INFORMATION Coverage Medicare Part D coverage is available to everyone enrolled in Medicare Drug plans are offered by insurance companies and other private

More information

PRESCRIPTION DRUG PLAN

PRESCRIPTION DRUG PLAN PRESCRIPTION DRUG PLAN The Plan Administrator will pay a portion of the cost of covered prescriptions. Maximum benefits are paid when prescriptions are filled through the CVS Caremark network pharmacies.

More information

Medicare Prescription Drug Benefit Part B vs Part D Home Infusion Perspective

Medicare Prescription Drug Benefit Part B vs Part D Home Infusion Perspective Medicare Prescription Drug Benefit Part B vs Part D Home Infusion Perspective Lucy Saldaña, Pharm.D Region IX Pharmacist Christina Leath, JD Health Insurance Specialist Consortium for Medicare Health Plans

More information

Evidence of Coverage. H8067_C_EOC_0915 CMS Accepted/File & Use 9/28/2015

Evidence of Coverage. H8067_C_EOC_0915 CMS Accepted/File & Use 9/28/2015 2016 Evidence of Coverage For more recent information or other questions, please contact Provider Partners Health Plan at 1-800-405-9681 or, for TTY users, 711, from 8 a.m. to 8 p.m. Monday through Friday,

More information

Geisinger Gold Preferred Complete Rx (PPO) offered by Geisinger Indemnity Insurance Company

Geisinger Gold Preferred Complete Rx (PPO) offered by Geisinger Indemnity Insurance Company Geisinger Gold Preferred Complete Rx (PPO) offered by Geisinger Indemnity Insurance Company Annual Notice of Changes for 2016 You are currently enrolled as a member of Geisinger Gold Preferred Complete

More information

2013 SUMMARY OF BENEFITS

2013 SUMMARY OF BENEFITS 22222 2013 SUMMARY OF BENEFITS Plus Prescription Drug Plans S5670 S5768 Y0022_PDP_2013_S5670_036_S5768_009_S5768_129SBa Accepted FH13SB06VP2 22 SECTION I INTRODUCTION TO SUMMARY OF BENEFITS Thank you for

More information