Annual Notice of Changes for 2016

Transcription

1 Blue Cross Community MMAI offered by Blue Cross and Blue Shield of Illinois Annual Notice of Changes for 2016 You are currently enrolled as a member of the Blue Cross Community MMAI Plan. Next year, there will be some changes to the plan s benefits. This Annual Notice of Changes tells you about the changes. You can end your membership in Blue Cross Community MMAI at any time. Medicare-Medicaid Plan provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Enrollment in HCSC s plan depends on contract renewal. representative will return your call no later than the next business day. The call is free. For more H0927_BEN_IL_ANOC16a Accepted

2 Additional Resources You can get this document in Spanish, or speak with someone about this information in other languages for free. Call (TTY/TDD 711). The call is free. Puede obtener este documento en español o hablar con alguien sobre esta información en otros idiomas de forma gratuita. Llame al (TTY/TDD 711). La llamada es gratuita. You can get this Annual Notice of Changes for free in other formats, such as large print, Braille or audio. Call Member Services at (TTY/TTD 711), 8:00 a.m. until 8:00 p.m. Central time, seven (7) days a week. On weekends and Federal holidays, voice messaging is available. If you leave a voice message, a Member Services representative will return your call no later than the next business day. The call is free. About Blue Cross Community MMAI Blue Cross Community MMAI is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. This Blue Cross Community MMAI plan is offered by Blue Cross and Blue Shield of Illinois. When this Annual Notice of Changes says we, us, or our, it means Blue Cross and Blue Shield of Illinois. When it says the plan or our plan, it means Blue Cross Community MMAI. 2

3 Disclaimers Blue Cross Community MMAI is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. It is for people with both Medicare and Medicaid. Limitations and restrictions may apply. For more information, call Blue Cross Community MMAI Member Services or read the Blue Cross Community MMAI Member Handbook. This means that you may have to pay for some services and that you need to follow certain rules to have Blue Cross Community MMAI pay for your services. The List of Covered Drugs, and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you. Benefits may change on January 1 of each year. *SilverSneakers is a registered mark of Healthways, Inc. Healthways SilverSneakers Fitness Program is a wellness program owned and operated by Healthways, Inc., an independent company. Blue Cross, Blue Shield and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Think about your Medicare and Medicaid coverage for next year It is important to review your coverage now to make sure it will still meet your needs next year. If it does not meet your needs, you can leave the plan at any time. If you leave our plan, you will still be in the Medicare and Medicaid programs. You will have a choice about how to get your Medicare benefits (go to page 11 to see your options). You will get your Medicaid benefits through fee-for-service or remain in our plan to get your Medicaid long term services and supports benefits (go to page 12 for more information). 3

4 Important things to do: Check if there are any changes to our benefits that may affect you. Are there any changes that affect the services you use? It is important to review benefit changes to make sure they will work for you next year. Look in sections B and C for information about benefit changes for our plan. Check if there are any changes to our prescription drug coverage that may affect you. Will your drugs be covered? Are they in a different tier? Can you continue to use the same pharmacies? It is important to review the changes to make sure our drug coverage will work for you next year. Look in section B for information about changes to our drug coverage. Check to see if your providers and pharmacies will be in our network next year. Are your doctors in our network? What about your pharmacy? What about the hospitals or other providers you use? Look in section A for information about our Provider and Pharmacy Directory. Think about whether you are happy with our plan. If you decide to stay with Blue Cross Community MMAI: If you want to stay with us next year, it s easy you don t need to do anything. If you don t make a change, you will automatically stay enrolled in our plan. If you decide to change plans: If you decide other coverage will better meet your needs, you can switch plans at any time. If you enroll in a new plan, your new coverage will begin on the first day of the following month. Look in section D to learn more about your choices. 4

5 Table of Contents Disclaimers... 3 Think about your Medicare and Medicaid coverage for next year... 3 A. Changes to the network providers and pharmacies... 6 B. Changes to benefits for next year... 6 Changes to benefits for medical services... 6 Changes to prescription drug coverage... 7 C. Other Changes D. Deciding which plan to choose If you want to stay in Blue Cross Community MMAI If you want to join a different Medicare-Medicaid Plan If you don t want to join a different Medicare-Medicaid Plan E. Getting help Getting help from Blue Cross Community MMAI Getting help from Illinois Client Enrollment Services Getting help from the Illinois Long Term Care Ombudsman Program Getting help from the Senior Health Insurance Program (SHIP) Getting help from Medicare Getting help from Medicaid

6 A. Changes to the network providers and pharmacies Our network of providers and pharmacies has changed for next year. An updated Provider and Pharmacy Directory is located on our website at You may also call Member Services at (TTY/TDD 711) for updated provider information or to ask us to mail you a Provider and Pharmacy Directory. It is important that you know that we may also make changes to our network during the year. If your provider does leave the plan, you have certain rights and protections. For more information, see Chapter 3 of your Member Handbook. B. Changes to benefits for next year Changes to benefits for medical services We are changing our coverage for certain medical services next year. The table below describes these changes (this year) 2016 (next year) Fitness program None Membership in the SilverSneakers Fitness Program Over-the-counter items Preventative dental $25 (plus $5 shipping) allowance per quarter; requires pre-approval Two oral exams each year, two preventative cleanings each year, one set of X-rays each year $30 (plus $5 shipping) allowance per quarter; requires pre-approval Two oral exams each year, two preventative cleanings each year, one fluoride treatment each year 6

7 Changes to prescription drug coverage Changes to our Drug List We sent you a copy of our 2016 List of Covered Drugs in this envelope. The List of Covered Drugs is also called the Drug List. We made changes to our Drug List, including changes to the drugs we cover and changes to the restrictions that apply to our coverage for certain drugs. Review the Drug List to make sure your drugs will be covered next year and to see if there will be any restrictions. If you are affected by a change in drug coverage, we encourage you to: Work with your doctor (or other prescriber) to find a different drug that we cover. You can call Member Services at (TTY/TDD 711) to ask for a list of covered drugs that treat the same condition. This list can help your provider find a covered drug that might work for you. Work with your doctor (or other prescriber) and ask the plan to make an exception to cover the drug. You can ask for an exception before next year and we will give you an answer within 72 hours after we receive your request (or your prescriber s supporting statement). To learn what you must do to ask for an exception, see Chapter 9 of the 2016 Member Handbook or call Member Services at (TTY/TDD 711). If you need help asking for an exception, you can contact Member Services or your care coordinator. Ask the plan to cover a temporary supply of the drug. In some situations, we will cover a one-time, temporary supply of the drug during the first 90 days for Medicare Part D drugs or 180 days for Medicaid drugs of the plan year. (To learn more about when you can get a temporary supply and how to ask for one, see Chapter 5 of the Member Handbook. When you get a temporary supply of a drug, you should talk with your doctor to decide what to do when your temporary supply runs out. You can either switch to a different drug covered by the plan or ask the plan to make an exception for you and cover your current drug. A new pharmacy benefit will be offered for the Blue Cross Community MMAI for Members can now receive up to a 90-day supply of drugs at retail and mail order (this year) 2016 (next year) A 90-day supply of drug (retail and mail order). Not offered New benefit 7

8 Drug List Changes Drugs Added to List or Lowered Tier Drug 2015 (this year) 2016 (next year) cromolyn sodium oral conc 100 mg/5ml on drug list Changed to Tier 1 ergoloid mesylates tab 1 mg on drug list Changed to Tier 1 zaleplon cap 10 mg on drug list Changed to Tier 1 zaleplon cap 5 mg on drug list Changed to Tier 1 ELIQUIS on drug list Changed to Tier 1 ELLA on drug list Changed to Tier 1 GAMUNEX-C on drug list Changed to Tier 1 ISENTRESS on drug list Changed to Tier 1 MIGRANAL on drug list Changed to Tier 1 Tier 1 Generic Drugs Tier 2 Brand Name Drugs Tier 3 Over the Counter Drug 8

9 Drugs Removed From List or Raised Tier Drug 2015 (this year) 2016 (next year) acetaminophen dispersible tab 80 mg On drug list Removed from drug list amcinonide cream 0.1% On drug list Removed from drug list bacitracin-polymyxin b oint On drug list Removed from drug list calcium carbonate chew tab 420 mg On drug list Removed from drug list calcium carbonate-cholecalciferol tab 600 mg-400 unit calcium carbonate-vitamin d tab 500 mg-200 unit On drug list On drug list Removed from drug list Removed from drug list cefotaxime sodium for inj 10 gm On drug list Removed from drug list cetirizine hcl chew tab 10 mg On drug list Removed from drug list cetirizine hcl chew tab 5 mg On drug list Removed from drug list cetirizine hcl syrup 1 mg/ml (5 mg/5ml) On drug list Removed from drug list chlorpheniramine & phenylephrine liquid mg/ml On drug list Removed from drug list ciprofloxacin hcl tab 100 mg On drug list Removed from drug list cromolyn sodium soln nebu 20 mg/2ml On drug list Removed from drug list cyanocobalamin orally disintegrating tab 1500 mcg On drug list Removed from drug list dantrolene sodium cap 100 mg On drug list Removed from drug list daunorubicin hcl for inj 20 mg On drug list Removed from drug list diflorasone diacetate oint 0.05% On drug list Removed from drug list electrolyte-m in d5w soln On drug list Removed from drug list eprosartan mesylate tab 600 mg On drug list Removed from drug list 9

10 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) esomeprazole sodium for intravenous soln 20 mg On drug list Removed from drug list fexofenadine hcl tab 180 mg On drug list Removed from drug list fexofenadine hcl tab 60 mg On drug list Removed from drug list galantamine hydrobromide oral soln 4 mg/ml On drug list Removed from drug list glyburide micronized tab 1.5 mg On drug list Removed from drug list glyburide micronized tab 3 mg On drug list Removed from drug list glyburide micronized tab 6 mg On drug list Removed from drug list glyburide tab 1.25 mg On drug list Removed from drug list glyburide tab 2.5 mg On drug list Removed from drug list glyburide tab 5 mg On drug list Removed from drug list glyburide-metformin tab mg On drug list Removed from drug list glyburide-metformin tab mg On drug list Removed from drug list glyburide-metformin tab mg On drug list Removed from drug list glycerin suppos 2.1 gm On drug list Removed from drug list ketorolac tromethamine tab 10 mg On drug list Removed from drug list leucovorin calcium for inj 50 mg On drug list Removed from drug list methylcellulose powder laxative On drug list Removed from drug list mitomycin for iv soln 5 mg On drug list Removed from drug list morphine sulfate cap sr 24hr 10 mg On drug list Removed from drug list naloxone hcl inj 1 mg/ml On drug list Removed from drug list neomycin-bacitracin-polymyxin oint On drug list Removed from drug list 10

11 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) ofloxacin tab 300 mg On drug list Removed from drug list ofloxacin tab 400 mg On drug list Removed from drug list phenobarbital sodium inj 130 mg/ml On drug list Removed from drug list simethicone susp 40 mg/0.6ml On drug list Removed from drug list skin protectants misc - cream On drug list Removed from drug list trimipramine maleate cap 100 mg On drug list Removed from drug list trimipramine maleate cap 25 mg On drug list Removed from drug list trimipramine maleate cap 50 mg On drug list Removed from drug list white petrolatum-mineral oil ophth ointment On drug list Removed from drug list ABILIFY On drug list Removed from drug list ABILIFY DISCMELT On drug list Removed from drug list ACYCLOVIR SODIUM On drug list Removed from drug list ASTEPRO On drug list Removed from drug list ATELVIA On drug list Removed from drug list AVODART On drug list Removed from drug list AZOR On drug list Removed from drug list BARACLUDE On drug list Removed from drug list BENADRYL ALLERGY CHILDREN On drug list Removed from drug list BENICAR On drug list Removed from drug list BENICAR HCT On drug list Removed from drug list BETADINE SKIN CLEANSER On drug list Removed from drug list 11

12 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) BROVEX PEB On drug list Removed from drug list BYSTOLIC On drug list Removed from drug list CELEBREX On drug list Removed from drug list CELLCEPT On drug list Removed from drug list COMBIVENT On drug list Removed from drug list CORTIFOAM On drug list Removed from drug list DOCEFREZ On drug list Removed from drug list DOXIL On drug list Removed from drug list EPIVIR On drug list Removed from drug list ERYTHROCIN LACTOBIONATE On drug list Removed from drug list EXFORGE On drug list Removed from drug list EXFORGE HCT On drug list Removed from drug list FLUCONAZOLE IN NACL On drug list Removed from drug list FLUDARABINE PHOSPHATE On drug list Removed from drug list FOSCARNET SODIUM On drug list Removed from drug list GAS-X On drug list Removed from drug list GLYBURIDE On drug list Removed from drug list HUMULIN N U-100 PEN On drug list Removed from drug list HUMULIN 70/30 PEN On drug list Removed from drug list IFOSFAMIDE On drug list Removed from drug list INSULIN SYRINGE/NEEDLE On drug list Removed from drug list ISOSORBIDE DINITRATE On drug list Removed from drug list 12

13 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) JALYN On drug list Removed from drug list KANAMYCIN SULFATE On drug list Removed from drug list LAMICTAL ODT On drug list Removed from drug list LEVOBUNOLOL HCL On drug list Removed from drug list LOTRIMIN AF On drug list Removed from drug list LOTRONEX On drug list Removed from drug list NEXIUM On drug list Removed from drug list NICORETTE On drug list Removed from drug list OCEAN NASAL SPRAY On drug list Removed from drug list OPANA ER (CRUSH RESISTANT) On drug list Removed from drug list OXYCONTIN On drug list Removed from drug list PATANASE On drug list Removed from drug list REFRESH LIQUIGEL On drug list Removed from drug list REYATAZ On drug list Removed from drug list SANCUSO On drug list Removed from drug list SEROMYCIN On drug list Removed from drug list STROMECTOL On drug list Removed from drug list SUBSYS On drug list Removed from drug list SYLATRON On drug list Removed from drug list SYSTANE PRESERVATIVE FREE On drug list Removed from drug list TASMAR On drug list Removed from drug list TEKAMLO On drug list Removed from drug list 13

14 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) TETANUS TOXOID ADSORBED On drug list Removed from drug list TRIBENZOR On drug list Removed from drug list U-CORT On drug list Removed from drug list VALCYTE On drug list Removed from drug list VECTICAL On drug list Removed from drug list ZYVOX On drug list Removed from drug list butorphanol tartrate inj 1 mg/ml butorphanol tartrate inj 2 mg/ml butorphanol tartrate nasal soln 10 mg/ml fentanyl td patch 72hr 100 mcg/hr fentanyl td patch 72hr 12 mcg/hr fentanyl td patch 72hr 25 mcg/hr fentanyl td patch 72hr 50 mcg/hr fentanyl td patch 72hr 75 mcg/hr hydrocodone-acetaminophen soln mg/15ml hydrocodone-acetaminophen tab mg hydrocodone-acetaminophen tab mg hydrocodone-acetaminophen tab mg hydrocodone-acetaminophen tab mg 14

15 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) hydrocodone-acetaminophen tab mg hydrocodone-acetaminophen tab mg hydrocodone-ibuprofen tab mg hydrocodone-ibuprofen tab mg hydrocodone-ibuprofen tab mg hydrocodone-ibuprofen tab mg hydromorphone hcl preservative free (pf) inj 10 mg/ml hydromorphone hcl tab 2 mg hydromorphone hcl tab 4 mg hydromorphone hcl tab 8 mg morphine sulfate (concentrate) oral soln 20 mg/ml morphine sulfate inj pf 0.5 mg/ml morphine sulfate inj pf 1 mg/ml morphine sulfate oral soln 10 mg/5ml morphine sulfate oral soln 20 mg/5ml morphine sulfate tab cr 100 mg morphine sulfate tab cr 15 mg morphine sulfate tab cr 200 mg morphine sulfate tab cr 30 mg morphine sulfate tab cr 60 mg 15

16 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) oxycodone hcl tab 10 mg oxycodone hcl tab 15 mg oxycodone hcl tab 20 mg oxycodone hcl tab 30 mg oxycodone hcl tab 5 mg oxycodone w/ acetaminophen tab mg oxycodone w/ acetaminophen tab mg oxycodone w/ acetaminophen tab mg oxycodone w/ acetaminophen tab mg oxycodone-aspirin tab mg ARANESP ALBUMIN FREE ARZERRA CUPRIMINE EMEND NEXIUM PRADAXA SELZENTRY SUPREP BOWEL PREP SUSTIVA THALOMID 16

17 Drugs Removed From List or Raised Tier (continued) Drug 2015 (this year) 2016 (next year) TIVICAY TYKERB VELCADE VOLTAREN WELCHOL XIFAXAN hydrocortisone cream 1% On drug list Changed to Tier 3 17

18 C. Other Changes The table below explains changes in prior authorization requirements (this year) 2016 (next year) Diabetic self-management training, services, and supplies Hearing services Kidney disease services and supplies Non-emergency transportation Outpatient mental health care Outpatient substance abuse services Partial hospitalization services Podiatry services Prosthetic devices and related supplies Custodial nursing facility care Dental services Prior authorization NOT required Prior authorization NOT required Prior authorization NOT required in Prior authorization NOT required in Prior authorization NOT required in Prior authorization NOT required in Prior authorization NOT required in Prior authorization NOT required in Prior authorization NOT required in Prior authorization NOT required in Prior authorization NOT required in 2016; however, prosthetic devices that cost more than $2,500 require prior authorization. Care in skilled nursing facilities requires prior authorization. Treatment for Dental Trauma and Anesthesia needs prior authorization. 18

19 2015 (this year) 2016 (next year) Medical equipment and related supplies Nursing facility care and skilled nursing facility care Outpatient diagnostic tests and therapeutic services Outpatient hospital services Outpatient rehabilitation services Outpatient surgery Prior authorization NOT required Equipment and prostheses that costs more than $2500, power wheelchairs, specialty hospital beds, diapers and underpads, and orthotics that cost more than $1,000 require prior authorization. Care received in an Acute SNF requires prior authorization. CT scans, PET scans, MRIs and genetic testing require prior authorization. CT scans, PET scans, MRIs and genetic testing require prior authorization. The plan will cover physical therapy, occupational therapy, and speech therapy. These services require prior authorization. Some surgeries require prior authorization. 19

20 D. Deciding which plan to choose If you want to stay in Blue Cross Community MMAI We hope to keep you as a member next year. To stay in our plan you don t need to do anything. If you do not sign up for a different Medicare-Medicaid Plan, change to a Medicare Advantage Plan, or change to Original Medicare, you will automatically stay enrolled as a member of our plan for If you want to join a different Medicare-Medicaid Plan If you want to keep getting your Medicare and Medicaid benefits together from a single plan, you can join a different Medicare-Medicaid Plan. You can enroll in the new Medicare-Medicaid Plan by calling Illinois Client Enrollment Services at , from 8 a.m. to 7 p.m. Monday through Friday and 9 a.m. to 3 p.m. on Saturday. TTY users should call If you don t want to join a different Medicare-Medicaid Plan If you do not want to enroll in a different Medicare-Medicaid Plan after you leave Blue Cross Community MMAI, you will go back to getting your Medicare and Medicaid services separately. 20

21 How you will get Medicare services You will have three options for getting your Medicare services. By choosing one of these options, you will automatically end your membership in our Medicare-Medicaid Plan: 1. You can change to: A Medicare health plan (such as a Medicare Advantage Plan or Programs of All-inclusive Care for the Elderly (PACE)) Here is what to do: Call Medicare at MEDICARE ( ), 24 hours a day/seven days a week. TTY users should call If you need help or more information: Call the Senior Health Insurance Program (SHIP) at You will automatically be disenrolled from Blue Cross Community MMAI when your new plan s coverage begins. 2. You can change to: Original Medicare with a separate Medicare prescription drug plan Here is what to do: Call Medicare at MEDICARE ( ), 24 hours a day/seven days a week. TTY users should call If you need help or more information: Call the Senior Health Insurance Program (SHIP) at You will automatically be disenrolled from Blue Cross Community MMAI when your Original Medicare coverage begins. 21

22 3. You can change to: Original Medicare without a separate Medicare prescription drug plan NOTE: If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you tell Medicare you don t want to join. You should only drop prescription drug coverage if you get drug coverage from an employer, union or other source. If you have questions about whether you need drug coverage, call the Senior Health Insurance Program at Here is what to do: Call Medicare at MEDICARE ( ), 24 hours a day/seven days a week. TTY users should call If you need help or more information: Call the Senior Health Insurance Program (SHIP) at You will automatically be disenrolled from Blue Cross Community MMAI when your Original Medicare coverage begins. How you will get Medicaid services If you do not join a different Medicare-Medicaid Plan, you will get your Medicaid services through fee-for-service, with the following exception: If you are in a nursing facility or are enrolled in a Home and Community Based Service (HCBS) waiver, you will remain in our plan to get your Medicaid services. You will have 90 days to switch to another Medicaid-only health plan. If you are not in a nursing facility or enrolled in a HCBS waiver, you will be in Medicaid fee for service. This is how you received your Medicaid services before joining our plan. You can see any provider that accepts Medicaid and new patients. 22

23 E. Getting help Getting help from Blue Cross Community MMAI Questions? We are here to help. Please call Member Services at (TTY/TTD 711). We are open 8:00 a.m. until 8:00 p.m. Central time, seven (7) days a week. On weekends and representative will return your call no later than the next business day. The call is free. Read your 2016 Member Handbook The 2016 Member Handbook is the legal, detailed description of your plan benefits. It has details about next year s benefits. It explains your rights and the rules you need to follow to get covered services and prescription drugs. An up-to-date copy of the 2016 Member Handbook is always available on our website at You may also call Member Services at (TTY/TDD 711) to ask us to mail you a 2016 Member Handbook. Visit our website You can also visit our website at As a reminder, our website has the most up-to-date information about our provider and pharmacy network (Provider and Pharmacy Directory) and our Drug List (List of Covered Drugs). Getting help from Illinois Client Enrollment Services Illinois Client Enrollment Services can help you find other plans in your area as well as help you enroll or disenroll in a plan. You can call Illinois Client Enrollment Services at , from 8 a.m. to 7 p.m. Monday through Friday and 9 a.m. to 3 p.m. on Saturday. TTY users should call Getting help from the Illinois Long Term Care Ombudsman Program The Illinois Long Term Care Ombudsman Program can help you if you are having a problem with Blue Cross Community MMAI. The Illinois Long Term Care Ombudsman Program is not connected with us or with any insurance company or health plan. The phone number for the Illinois Long Term Care Ombudsman Program is TTY users should call The services are free. 23

24 Getting help from the Senior Health Insurance Program (SHIP) You can also call the Senior Health Insurance Program (SHIP). The SHIP counselors can help you understand your Medicare-Medicaid Plan choices and answer questions about switching plans. The SHIP is not connected with us or with any insurance company or health plan. The SHIP s services are free. The SHIP phone number is TTY users should call Getting help from Medicare To get information directly from Medicare: Call MEDICARE ( ). You can call MEDICARE ( ), 24 hours a day/seven (7) days a week. TTY users should call Visit the Medicare Website You can visit the Medicare website ( If you choose to disenroll from your Medicare-Medicaid Plan and enroll in a Medicare Advantage plan, the Medicare website has information about costs, coverage, and quality ratings to help you compare Medicare Advantage plans. You can find information about Medicare Advantage plans available in your area by using the Medicare Plan Finder on the Medicare website. (To view the information about plans, go to and click on Find health & drug plans. ) Read Medicare & You 2016 You can read Medicare & You 2016 Handbook. Every year in the fall, this booklet is mailed to people with Medicare. It has a summary of Medicare benefits, rights and protections, and answers to the most frequently asked questions about Medicare. If you don t have a copy of this booklet, you can get it at the Medicare website ( or by calling MEDICARE ( ), 24 hours a day/seven days a week. TTY users should call

25 Getting help from Medicaid If you have questions about your Medicaid eligibility, you can contact the Illinois Department of Human Services: Call Visit You can also call the Quality Improvement Organization (QIO). In Illinois, this is Telligen QIO, at , TTY/TDD 711. This is a group of doctors and other health care providers who help improve the quality of care for people with Medicare. It is not connected with our plan. 25

26 . TTY/TDD: 711. We are open 8:00 a.m. until 8:00 p.m. Central time, seven (7) days a week. On weekends and Federal holidays, voice messaging is available. If you leave a voice message, a Member Services representative will return your call no later than the next business day. The call is free. For questions about enrolling call: Illinois Client Enrollment Services (TTY: ).