1 Medicare Part D Prescription Drug Coverage Part 3 Version 6.0 September 25, 2012
2 Terms and Conditions This training program is protected under United States Copyright laws, 17 U.S.C.A. 101, et seq. and international treaties. Except as provided below, the training program may not be reproduced (in whole or in part) in hard paper copy, electronically, or posted on any web site or intranet without the prior written consent of AHIP. Any AHIP member company in good standing sponsoring a Medicare Advantage or Part D plan may reproduce the training program for the limited purpose of providing training and education to the company s own employees and contractors on the subject matter contained in the training program. Employees or contractors participating in such training may not further reproduce (in whole or in part) the training program. No changes of any kind may be made to the training program and any reproduction must include AHIP's copyright notice. This limited license is terminable at will by AHIP. The training program is intended to provide guidance only in identifying factors for consideration in the basic rules and regulations governing coverage, eligibility, marketing, and enrollment for Medicare, Medicare supplement insurance, Medicare health plans, and Part D prescription drug plans and is not intended as legal advice. While all reasonable efforts have been made to ensure the accuracy of the information contained in this document, AHIP shall not be liable for reliance by any individual upon the contents of the training program.
3 Learning Objectives After reviewing Part 3 - Medicare Part D Prescription Drug Coverage you will be able to explain: What Part D plans are; Who is eligible for a Part D plan; Part D standard and alternate benefits; Part D management tools, covered drugs, and formulary requirements; Part D True Out-of-Pocket (TrOOP) costs and help for beneficiaries with limited income; Late enrollment penalty and premiums; and How Part D works with other coverage.
4 Medicare Part D Prescription Drug Program Basics Program began January 1, Coverage of Medicare Part D benefits is provided by private companies. Medicare pays a share of the program costs. The types of Part D plans are: Stand-alone Prescription Drug Plan (PDP) to work with Original Medicare Medicare Advantage-Prescription Drug (MA-PD) Plan: An MA health plan that also covers Part D prescription drugs. Cost-PD Plan A Medicare health plan that covers Part D prescription drugs as an optional supplemental benefit.
5 Medicare Part D Eligibility Individuals entitled to Part A and/or enrolled under Part B are eligible to enroll in Part D plans. The beneficiary must live in the plan s service area. Part D plan coverage is provided through network pharmacies in the Part D plan s service area, except that PFFS plans are not required to use a pharmacy network. Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited circumstances in the case of MA-PD plans under MA program rules (e.g., beneficiaries with ESRD or who do not meet the eligibility criteria of a chronic care SNP).
6 Part D Plan Benefits Standard Part D plans must cover at least the Part D standard benefit or its actuarial equivalent. For 2013, the standard benefit requires the beneficiary to pay: $325 deductible 25% of prescription drug costs between $325 and $2,970 = $ Part of the costs in the Coverage Gap - After total spending on drugs by the beneficiary and the plan reaches $2,970 the beneficiary pays for 79% of generic drug costs and 47.5% of brand name drug undiscounted costs. Drug manufacturers provide a 50% discount on brand name drug costs. A new law enacted in 2010 eliminates the coverage gap by 2020 by reducing the amount beneficiaries pay while in the coverage gap by a small percentage each year until 2020 when they will be responsible for only 25% of brand and generic drug costs. Nominal costs under catastrophic coverage: Once beneficiary expenditures (including drug manufacturer discounts) reach a total of $4,750, the beneficiary is through the coverage gap and reaches catastrophic coverage. On any future prescriptions the beneficiary pays either a co-pay of $2.65 for generic drugs or $6.60 for brand name drugs or a co-insurance of 5%, whichever is greater.
7 Part D Plan Benefits Standard for 2013 (Updated Annually) Total Drug Expenditures $6, $ (Varies depending on mix of brand-name and generic drugs.) Plan Contributions Drug Manufacturer Discount Enrollee Out-of-Pocket Expenditures $2,970 $325 $0 Plan Payment 21% for generic drugs and 2.5% for brandname drugs Catastrophic Coverage 95% Plan Contribution Drug Manufacturer Discount 50% for brand name drugs: Plan Contribution 75% ($1,983.75) Enrollee Deductible $325 Copay or 5% Coverage Gap - Enrollee pays 79% of cost of generic drugs and 47.5% of cost of brand-name drugs Coinsurance 25% ($661.25) Enrollee Out-of-Pocket Expenditures $4,750 - Annual out-ofpocket threshold (The amount of the drug manufacturer discount for brand name drugs is counted as an enrollee out-of-pocket expenditure.) $ Initial Coverage Limit (Coverage Gap begins) $325 $0
8 Part D Plan Benefits Alternative Part D plan benefits may differ from the standard benefit under specific Medicare rules. In all cases the value of Part D benefits must be at least as good as the standard coverage. Some Part D plans may also include enhanced coverage for an additional monthly premium.
9 Part D Pharmacy Networks Enrollees may fill prescriptions for covered drugs at network pharmacies that contract with plans. Network pharmacies include retail pharmacies and may also include mail order pharmacies. Part D plans may designate preferred pharmacies that offer lower levels of cost-sharing than apply at non-preferred pharmacies. Under certain circumstances, enrollees may fill prescriptions for covered drugs at non-network pharmacies, but likely at higher cost to enrollees. For example: Illness or losing a drug during travel Circumstances resulting in limited access to a drug through innetwork pharmacies
10 Part D Drug Management Tools Part D plans commonly use a variety of prescription drug benefit management tools, including: A formulary: A list of drugs covered by the plan Co-pay tiers: Drugs grouped together by amount of co-pay are in a tier with a set amount for each prescription. Many plans group drugs into 3 or 4 tiers with lower tiers costing less than higher tiers, for example: - Tier 1: Generic drugs - Tier 2: Preferred brand-name drugs - Tier 3: Non-preferred brand-name drugs - Tier 4: High-cost drugs
11 Part D Drug Management Tools, cont d. Part D plans commonly use a variety of prescription drug benefit management tools, including: Step therapy: One or more similar lower cost drugs must be tried before other more costly drugs are tried, if necessary. Prior authorization: Requires the doctor to contact the plan before the plan will cover these prescriptions. The doctor must show the drug is medically necessary for it to be covered.
12 Covered Part D Drugs By law, Part D plans are permitted to cover any prescription drugs and biologicals that: Must be covered by states that provide Medicaid prescription drug benefits Many Part D plans do not cover all of these drugs because in some cases several similar drugs are available to treat the same medical condition. Part D plans include the drugs they will cover on formularies that are developed by pharmacists, doctors, and other experts. Part D plan formularies must include: At least two drugs in each therapeutic category Generic and brand-name drugs.
13 Drugs Excluded from Part D Coverage By law, Part D plans are not permitted to include the following under their Part D covered benefits: Drugs for weight loss or gain, fertility, cosmetic purposes, symptomatic relief of cough and colds Vitamins Barbiturates (except when used in treatment of epilepsy, cancer, or chronic mental health disorder) Erectile dysfunction drugs (when used for sexual dysfunction) Non-prescription drugs Some off label use drugs Part B covered drugs Part D plans are permitted to offer supplemental benefits that cover certain drugs not covered under Part D.
14 Mid-year Formulary Changes Formulary changes must be approved by CMS Part D plans cannot make any formulary changes during the first 60 days of the contract year, unless it is in response to a drug s removal from the market. After March 1st, Part D plans may make some midyear formulary changes including: Removal of a drug that is being withdrawn from the market by the FDA or manufacturer; Replacing brand name with new generic drugs, but only following 60 days notice to affected enrollees; and Other changes only if the enrollees currently taking the affected drug are exempted for the remainder of the year.
15 Transition Requirements Enrollees initially enrolling in Part D, those switching plans, and current enrollees affected by formulary changes must receive coverage of a single 30-day fill of their non-formulary drugs during the first 90 days after their enrollment, the plan switch, or the formulary change. Enrollees who reside in a long-term care facility must receive coverage for fills of at least 91 days for their non-formulary drugs, as necessary, following enrollment under the Part D plan. During the transition period: The Part D plan does not apply prior authorization or step therapy rules. The enrollee and his/her physician can request an exception to the Part D plan s formulary to continue coverage of the nonformulary drug or can transition to a formulary drug.
16 Requesting Exceptions for Drugs Enrollees have the right to request a formulary exception for coverage either of non-formulary drugs or of formulary drugs at a less costly formulary tier. If a doctor thinks an enrollee needs a drug that is not on the list, the enrollee or the doctor can apply for a formulary exception. To facilitate their request, a standard form is available on Part D plan websites for enrollees to request a coverage determination, including a formulary exception. Provide access via a secure website or secure address on the website for enrollees to quickly request a coverage determination or appeal a decision; and Require network pharmacies to provide enrollees with a printed notice with the plan s toll-free number and website for requesting a coverage determination.
17 Part D Enrollee Costs: True Out-of-Pocket Costs (TrOOP) Part D True Out-of-Pocket costs or TrOOP are out-of-pocket costs enrollees incur that count towards the annual out-ofpocket threshold to move into catastrophic coverage. Calculated on an annual basis. Generally, includes payments for Part D prescription drugs: For the annual deductible, cost-sharing above the deductible and up to the initial coverage limit, and above the initial coverage limit up to the annual out-of-pocket threshold After the initial coverage period, a drug manufacturer s discount for brand name drugs counts toward the true out-ofpocket costs. Generally drugs must be on the plan s formulary and purchased at a plan s participating network pharmacy Beginning January 1, 2011 amounts paid or borne by AIDS drug assistance programs and the Indian Health Service count toward TrOOP.
18 Part D Enrollee Costs: True Out-of- Pocket Costs (TrOOP), cont d. Some costs do not count toward the Part D true outof-pocket (TrOOP) cost total including: Costs for drugs not on a Part D plan s formulary, unless the beneficiary receives an exception under which the plan covers the drug; Costs for over the counter and other non-part D drugs; Costs for covered Part D drugs obtained out-of-network (unless the plan s out-of-network policy applies); Costs paid for or reimbursed to an enrollee by insurance, a group health plan, most government-funded health programs (such as Medicaid), or another third party; Costs for drugs purchased outside the United States.
19 Help for Individuals with Limited Income and Limited Resources If a beneficiary has limited income and resources, he/she may qualify for the low-income subsidy (LIS) and receive extra help from Medicare to cover all or part of the Part D plan premium and cost-sharing. To qualify for extra help, beneficiary income may not exceed 150% of the Federal Poverty Level (FPL). The 150% FPL varies geographically as follows: 48 states - $16,755 (individual)/$22,695 (couple) in Alaska - $20,955 (individual)/$28,380 (couple) in Hawaii - $19,290 (individual)/$26,115 (couple) in Assets up to $13,070 (individual)/$26,120 (couple) in Note: Typically these figures are updated annually.
20 Encourage Individuals with Limited Income/ Resources to Apply to the State Medicaid Office Beneficiaries with limited income and resources should be encouraged to apply for the low income subsidy (LIS) also called extra help through the State Medicaid office or the Social Security Administration (SSA). Beneficiaries may apply at any time. Tell beneficiaries to call MEDICARE ( ) and say Medicaid for the State Medicaid office phone number. If beneficiaries apply to the State Medicaid office for Part D help, the State Medicaid office also will check for eligibility for other low-income assistance programs. Or call SSA at or apply online at: to apply for help with Part D costs. After SSA or the State approves an application for extra help, it is effective the first day of the month in which the individual applied.
21 Other Help For Low-Income Pharmaceutical Assistance Programs Some pharmaceutical manufacturers operate programs directly or indirectly that assist low income individuals in obtaining drugs at reduced or no costs. Some states have assistance programs designed specifically for their residents. Some programs are qualified State Pharmaceutical Assistance Programs or SPAPs that count towards TrOOP and some do not count towards TrOOP. Becoming familiar with your state s programs may help a beneficiary address cost-sharing for prescriptions, particularly in the coverage gap.
22 Assistance Programs What Counts toward TrOOP? Enrollees may receive assistance for Part D costs, but costs paid by many assistance programs do not count toward the true out-of-pocket (TrOOP) cost. Included entities costs do count towards TrOOP for: Qualified State Pharmaceutical Assistance Programs (SPAPs), most charities, non-government and Indian Health Service funded tribal coverage, AIDS Drug Assistance Programs, health savings accounts, flexible spending accounts, and medical savings accounts. Excluded entities costs do not count towards TrOOP for: Medicaid, State Children s Health Insurance Program (CHIP), Federally Qualified Health Centers, Rural Health Clinics, Patient Assistance Programs (PAPs) outside the Part D benefit, TRICARE, Federal Employees Health Benefits Program (FEHBP), Black Lung Funds, and health reimbursement arrangements.
23 Part D Late Enrollment Penalty If a beneficiary does not enroll when first eligible or there is a subsequent gap in Part D coverage of more than 63 continuous days, he/she may pay a penalty to join a Part D plan later. If there has been a period of at least 63 continuous days following his/her initial enrollment period for Part D during which the beneficiary did not have either Part D or any other prescription drug coverage that was creditable (coverage that expects to pay, on average, at least as much as Medicare s standard Part D coverage expects to pay), when the beneficiary joins a Part D plan, generally the premium will go up by 1% of the national average beneficiary premium for each month he/she did not have such coverage.
24 Late Enrollment Penalty, cont d. In general, the penalty is in effect as long as the beneficiary has Medicare prescription drug coverage. Beneficiaries who qualify for the low-income subsidy are not subject to the late enrollment penalty as long as they are not disenrolled from their Part D or other creditable drug coverage for 63 days or longer.
25 Part D Premium Payment Part D enrollees have three options for paying their Part D premium. (1) Automatic electronic monthly mechanism, such as withdrawal from their checking or savings bank account or automatic deduction from their credit or debit card; (2) Direct monthly billing from the plan; or (3) Automatic deduction from their monthly Social Security Administration (SSA) benefit check. Typically it takes 2-3 months for SSA withholding to begin or end. When withholding begins, it will be for the 2-3 months of premiums owed. If a beneficiary is considering this option, he/she should call the plan first. Generally the beneficiary must stay with the premium payment option for the entire year.
26 Employer/Union Coverage of Drugs Employer or Union Coverage: Employers/unions will tell their employees whether their prescription drug coverage is creditable (coverage that, on average, equals at least as much as Medicare s standard Part D coverage expects to pay). If coverage is creditable and the beneficiary keeps it, he/she will not incur a premium penalty if he/she later loses or drops the employer coverage and joins a Part D plan. If coverage is not creditable, the beneficiary will need to enroll in Medicare Part D during his/her initial eligibility period to avoid the late enrollment penalty. If a beneficiary has creditable drug coverage through TriCare, the VA, or the FEHBP, he/she can compare that coverage with available Part D plans to decide whether to enroll in Part D.
27 Employer Coverage of Drugs, cont d. The beneficiary should check with the employer or union benefits administrator before making any change. If a beneficiary drops employer/union prescription drug coverage, he/she may not be able to get it back and also may lose health coverage. If the beneficiary retires or otherwise loses employer/union creditable coverage and joins a Medicare Part D plan or otherwise obtains creditable drug coverage within 63 days, there will not be a late enrollment penalty.
28 Beneficiaries in Original Medicare with Medigap Drug Coverage Medigap plans H, I, and J with drug coverage could no longer be sold as of January 1, Some beneficiaries may have decided to keep their Medigap policy with the drug coverage they had before January 1, Insurers are required to notify beneficiaries annually whether or not the prescription drug coverage they have is creditable (coverage that expects to pay, on average, at least as much as Medicare s standard Part D coverage expects to pay).
29 Beneficiaries in Original Medicare with Medigap Drug Coverage, cont d. For beneficiaries who decided to keep their Medigap policy with the drug coverage they had before January 1, They may continue to keep the Medigap policy with drug coverage; OR They may keep their Medigap coverage with the drug portion of the coverage removed and enroll in a Part D PDP plan; OR They may drop their Medigap coverage and enroll in a MA-PD plan or other health plan with a PDP. If these beneficiaries choose a Part D plan now, they must pay a Part D late enrollment penalty unless their Medigap coverage was creditable. Note: See Part 1, Medicare Program Basics, for more information on Original Medicare and Medigap (Medicare supplement insurance).
30 Medicaid Drug Coverage Most prescription drugs that were previously covered by Medicaid are now covered under Medicare Part D. When a Medicaid beneficiary becomes eligible for Medicare, then Medicare, instead of Medicaid, covers the Part D drugs once the beneficiary is enrolled in a Part D plan. Medicaid beneficiaries can compare plans and choose a Medicare Part D plan. If they don t choose a plan, Medicare will select one for them. Medicaid beneficiaries can change Part D plans throughout the year.
31 For Additional Information Medicare s site on Part D prescription drug coverage for beneficiaries. Medicare s information site on Part D prescription drug coverage for Part D sponsoring organizations. Medicare & You Handbook.
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
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
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
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
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
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
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
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
Prescription Drug Coverage for Medicare Beneficiaries: A Summary of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Prepared by Health Policy Alternatives, Inc. for The Henry
Prescription Drug Coverage Presented by: Medigap Part D & Prescription Drug Helpline Board on Aging & Long Term Care A Wisconsin SHIP Medicare Part A Prescription Drug Coverage Part A generally pays for
2013 SUMMARY OF BENEFITS Plus Prescription Drug Plans S5670 S5768 Y0022_PDP_2013_S5670_138_S5768_119_S5768_150_SBb Accepted FH13SB935 SECTION I INTRODUCTION TO SUMMARY OF BENEFITS Thank you for your interest
f Your Medicare Health Benefits and Services as a Member of Health Net Value Orange Option 2 This mailing gives you the details about your Medicare health coverage from January 1 December 31, 2009, and
THE BASICS Participation is voluntary. The income level and assets of beneficiaries determine the level of prescription assistance they will receive. Beneficiaries with incomes over 150% of the Federal
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
PO Box 350 Willimantic, Connecticut 06226 (860)456-7790 (800)262-4414 1025 Connecticut Ave, NW Suite 709 Washington, DC 20036 (202)293-5760 MEDICARE PART D PRESCRIPTION DRUG COVERAGE 2016 Se habla español
Enrollment Guidance Medicare Advantage and Part D Plans Part 5 Version 6.0 September 26, 2012 Terms and Conditions This training program is protected under United States Copyright laws, 17 U.S.C.A. 101,
Frequently Asked Questions: Medicare Supplement & Medicare Advantage Who is eligible for CBIA s Medicare program? A CBIA Health Connections participant is eligible for either plan if they are qualified
Medicare Part D: 2010 Presented by: Howard Houghton Virginia Insurance Counseling & Assistance Program (VICAP) 1 The Basics Medicare Part D is available to all Medicare beneficiaries regardless of their
Medicare Part D & Ryan White HIV/AIDS Program As of November 2008 The below discussion can guide Ryan White HIV/AIDS programs in understanding implications of the Medicare Part D prescription drug benefit
ISSUE BRIEF VOL. 5, NO. 10, 2005 This ongoing series provides information on how to develop programs to educate Medicare beneficiaries and their families. Additional information about this and other projects
For more information, please call the Emeriti Service Center at 1-866-EMERITI (1-866-363-7484) 2016POST65NATPCC Emeriti Retirement Health Plan 2016 Post-65 Medical & Rx Comparison Chart Group Insurance
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
SCOPE OF SALES APPOINTMENT CONFIRMATION FORM To be completed by person with Medicare. Please initial below in the box beside the plan type that you want the agent to discuss with you. If you do not want
Medicare Part D Frequently Asked Questions: Eligibility & Enrollment This list of Frequently Asked Questions regarding eligibility and enrollment issues in the new Medicare Part D prescription drug benefit
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
DRAFT: 4B World Bank Group RMIP DATE: 9/08/15 FAQS for Pre-pre-enrollment mailing Sept 2015 FREQUENTLY ASKED QUESTIONS (FAQs) About Your New Retiree Prescription Drug Plan On January 1, 2016, SilverScript
Part D payment system paymentbasics Revised: October 204 This document does not reflect proposed legislation or regulatory actions. 425 I Street, NW Suite 70 Washington, DC 2000 ph: 202-220-3700 fax: 202-220-3759
2015 National Training Program Module 9 Medicare Part D Prescription Drug Coverage Session Objectives This session should help you Differentiate Medicare Part A, Part B, and Part D drug coverage Summarize
2 Medicare Part D Agenda Medicare Overview Medicare Part B Drug Coverage Medicare Part D: Background Benefits of Medicare Part D Enrollment Coverage Specialty Medications Part D Costs How to Find and Compare
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
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
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
Retiree prescription drug program: time to move to an Employer Group Waiver Plan (EGWP)? Gail Levenson and Rich Stover Today s areas of focus Overview of Medicare Part D plan Impact of health care reform
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
UPREHS PRIME MEDICARE PART D PRESCRIPTION DRUG PLAN (EMPLOYER PDP) BENEFIT GUIDE Your Medicare Prescription Drug coverage as a Member of the UPREHS Prime Medicare Part D Plan 2015 A $9 copayment gets you
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
Medicare Prescription Drug Coverage: An Overview for Oregonians Table of Contents Who is Eligible?...3 Prescription Drug Plans and Medicare Advantage Plans...4 Medicare Supplement Insurance Plans (Medigap)...5
An Important Message on Medicare Prescription Drug Plans Coming to the U.S. Virgin Islands in 2006 What are Medicare Prescription Drug Plans? Beginning January 1, 2006, Medicare Prescription Drug Plans
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).
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
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
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
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,
2014 Benefits THE EMERITI PROGRAM in your retirement years Helping you achieve healthcare security in retirement This presentation is copyrighted exclusively by Emeriti 1 2 TODAY S AGENDA What s new in
Choosing a Medicare prescription drug plan. Medicare Made Clear TM Get Answers Series Look inside to: Learn about Part D prescription drug coverage options Find out what you need to know about the Part
2015 This is the official U.S. government Medicare handbook. What s important in 2015 (page 12) What Medicare covers (page 35) CENTERS FOR MEDICARE & MEDICAID SERVICES Section 7 Get Information about Prescription
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
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
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
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
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
Pharmacy Outreach Program The University of Rhode Island College of Pharmacy Updated October 2014 Medicare provides health insurance for Aged 65 years or older Aged 65 years or less with certain disabilities
Prescription Drug Benefits This insert will accompany the Medicare- Coordinating Plans Member Handbook for enrollees who are eligible for and have elected these benefits. Important Notice... 1 Using Your
800.334.1330 254.773.1330 fax 254.774.7652 4912 Midway Drive Post Office Box 6130 Temple, TX 76503-6130 www.carehealthplan.com A. PLEASE INDICATE WHICH PLAN YOU WISH TO ENROLL IN: Plan #4000 - Supplement
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
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,
Dual Eligibility in Pennsylvania: What Happens When I Am Newly Eligible for Medicare and Medicaid? Each month through our Helpline, PHLP talks to individuals (or to their family members, advocates or providers)
2015 Medicare Low-Income Subsidy (LIS), or Extra Help Extra Help with Prescription Drug Costs Medicare LIS Overview Patient Eligibility and Application Process How LIS Affects Patient Responsibility for
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
2011 SUMMARY OF BENEFITS First Health Part D Prescription Drug Plan (PDP) S5768 S5674 Y0022_2011_1001_046_25 CMS Approval Date: 09/23/2010 FH11SB25 Section I Introduction to Summary of Benefits Thank you
Express Scripts Medicare Prescription Drug Plan (PDP) 2014 Benefit Overview For TRS-Care 3 or Aetna Medicare Advantage Care 3 Participants Becoming Eligible for Medicare Welcome to Express Scripts Medicare
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
Private Wealth Management Products & Services A Guide to Understanding Medicare Benefits Medicare is a social insurance program created under the Social Security Act of 1965 as signed by President Lyndon
Medicare 2014 What s Important in 2014 Medicare 101 Agenda What is Medicare? How do I enroll? When can I sign up? What if I am still working? What does Medicare cost? Let s talk about Medicare Coverage
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
BlueRx (PDP) Local Government Health Insurance Plan (LGHIP) Prescription Drug Coverage for Medicare Members offered by Blue Cross and Blue Shield of Alabama Annual Notice of Changes for 2015 You are currently
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
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
November 2014 What s New with Medicare in 2015 Audio Portion: 1-866-740-1260 Web Portion: www.readytalk.com Code: 4796976 1 What we ll cover today 2015 Medicare cost sharing Part D in 2015 What s the big
Understanding Medicare Part D Cynthia Tudor, Ph.D. Acting Director, Medicare Drug Benefit Group Medicare Modernization Act Prescription Drug Coverage The Medicare Modernization Act (MMA) of 2003 provides
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
Making the most of Medicare S5743_102714_K04_RE Internal Approval 10/27/2014 Today s Topics What is Medicare Who s eligible Medicare coverage Options to fill coverage gaps When you can enroll Finding the
MODULE 16: MEDICARE AND THE HEALTH INSURANCE MARKETPLACES Objective This module will educate HIICAP counselors about how Medicare is affected (and not affected) by the health insurance Marketplaces. What
Medicare Made Clear Quick Reference Guide Helping your employees and volunteers understand Medicare. Medicare helps nearly 50 million older and disabled Americans save on their health care expenses. But
PEACE-OF-MIND IN RETIREMENT Income Security + Healthcare Security = Retirement Readiness 1 What s New In 2015 The Traditional Choice Plan will be discontinued A new, significantly enhanced Medicare Advantage
EVIDENCE OF COVERAGE A complete explanation of your plan Health Net Orange Option 1 (PDP) January 1, 2010 December 31, 2010 Important benefit information please read S5678_2010_0463 CMS F&U (09/09) January
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
SMART Humana Group Medicare Group Medicare GHHHNYFEN 0813 Overview of Humana Medicare Medicare is the largest government-sponsored health insurance program in the United States, serving more than 49 million
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
First Health Part D Premier Plus (PDP) offered by Cambridge Life Insurance Company Annual Notice of Changes for 2014 Dear Member, You are currently enrolled as a member of First Health Part D Premier Plus
Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange The Affordable Care Act (ACA) makes health insurance available to nearly all Americans and the law requires
MEDICARE SUPPLEMENT PLANS PLUS PRESCRIPTION COVERAGE FOR EMPLOYER GROUPS 2015 Toll-free 1-800-851-3379 ext. 8024 TTY/TDD 711 HealthAlliance.org mkt-grpmspdpbro-1014 Group Medicare Plans-Coverage for real
Medicare and Medicaid: What You Need to Know This program is sponsored by the Nevada Aging and Disability Services Division and is presented by the Access to Healthcare Network and Nevada Geriatric Education
2931 AND LOW INCOME SUBSIDY POLICY STATEMENT Beginning January 1, 2006, a new Medicare program will provide prescription drug coverage for Medicare recipients. This program is a part of the Medicare Prescription