Hello Advantage At UnitedHealthcare, we want you to get the most from your Medicare coverage. Our simple, all-in-one Medicare Advantage plans are designed to offer you benefits, services and tools to help you live a healthier life. 2014 Medicare Advantage plans Overview 2 Plans 3 Timing 6 Tools 7
Benefits beyond Original Medicare. There are two steps to getting the coverage you may need. First, you must be signed up for Original Medicare and continue to pay your Medicare Part B premium, then you can choose to enroll in a Medicare Advantage plan offered by insurance companies like UnitedHealthcare. Medicare Choices Step 1 Enroll in Original Medicare when you become eligible. Original Medicare Covers hospital stays + Covers doctor and outpatient visits Government-provided Step 2 If you need more coverage, you have choices. Option 1 or Option 2 Keep Original Medicare and add: Medicare Supplement INSURANCE Covers some or all of the costs not covered by Parts A & B Offered by private companies and/or Medicare Part D Covers prescription drugs Offered by private companies Medicare Advantage (Part C) Combines Parts A & B Additional benefits Most plans cover prescription drugs Offered by private companies 2013 United HealthCare Services, Inc., Medicare Made Clear initiative 2
Benefits in a single plan. Medicare Advantage (Part C) plans are provided through private insurers like UnitedHealthcare. They include the same coverage you get with Original Medicare (Part A and Part B) and often include prescription drug coverage (Part D) and additional benefits all in one plan. The advantages of a single plan. + Hospital Overnight stays Skilled nursing Home health + Doctor Office visits Outpatient care Screenings and shots Lab tests + Additional benefits Emergency coverage Wellness programs Prescription drug coverage Included in many Medicare Advantage plans 3
10 things to know about Medicare Advantage. 1 Designed to fit your budget Many Medicare Advantage plans have low or $0 monthly premiums and deductibles. But you must continue to pay your Part B premium. 2 The extra advantage Medicare Advantage plans may offer extra coverage such as vision, hearing or dental services and fitness programs. 3 Medicare Advantage is still Medicare Even though Medicare Advantage plans are privately administered, you still have the same rights and protections as Original Medicare. 4 Medicare Advantage has you covered Medicare Advantage plans must cover all of the services that Original Medicare covers, except hospice care. But Original Medicare will cover hospice care when you re in a Medicare Advantage plan. 1 5 A built-in financial safety net Most plans have an annual out-of-pocket maximum, which will be your safety net that assures you ll never pay more than a certain amount out of pocket in any plan year for covered medical services. 6 The scoop on drug coverage Many Medicare Advantage plans include built-in drug coverage. If a Medicare Advantage plan isn t right for you, you can enroll in a stand-alone Medicare Part D plan. 7 Location, location, location Medicare Advantage plans vary based on where you live. To find the plans available in your area, talk to your local agent or go online. 8 Review your choices once a year Once you re enrolled in a Medicare Advantage plan, you can change plans each year during the Open (or Annual) Enrollment Period, October 15 through December 7. Or, if you move out of your plan s service area, you may qualify for a Special Enrollment Period. 9 Not all networks are created equal Each Medicare Advantage plan has its own network of providers, clinics and hospitals. Some Medicare Advantage plans let you receive services outside of the network, generally at a higher cost. 10 No underwriting exams You can join even if you have a pre existing condition, except for end stage renal disease. 4
The benefits of UnitedHealthcare Medicare Advantage plans. After you have enrolled, the benefits of membership go beyond the doctor s office. At UnitedHealthcare, we surround you with not only the coverage you may need, but the people, programs, resources and tools to help you live a healthier life. You re connected to care. Easy tools for finding providers or specialists Programs and resources for managing a chronic condition, like diabetes HouseCalls for an in-home clinical visit in the comfort of your home may apply to a plan in your area Emergency and urgent care Preventive services like an annual physical and immunizations You re connected to value. Many Medicare Advantage plans include built-in prescription drug coverage Prescriptions as low as $2 with Pharmacy Saver 2 Preferred Mail Service Pharmacy delivers convenience, as well as savings, to your mailbox You re connected to wellness. Health tips from our own team of medical professionals Innovative online tools, resources and incentive programs Wellness coaching for everything from eating well to helping to reduce stress GetMyUHCGuide.com 5
When you can enroll in a Medicare Advantage plan. You must be enrolled in Original Medicare before you can enroll in a Medicare Advantage plan. Most people can enroll in Medicare when they turn 65. If something changes. After you sign up for Original Medicare, you can enroll in a Medicare health plan three months before the month you turn 65, your birthday month, and the three months after If you have employer health coverage, you don t need to do anything until you retire or lose that coverage If you have retiree coverage, be sure to check with your plan administrator to see how your coverage works with Medicare If you retire or lose your employer coverage after your initial enrollment period, you ll have a two-month Special Election Period to enroll in a Medicare plan And if your needs change, you will always be able to choose a new Medicare plan at least once a year during the Open Enrollment Period Different life situations may affect your decision. Currently enrolled in Medicare: Make sure to review your coverage and budget needs at least once per year Review the Medicare plan choices in your area Eligible for Medicare and working: If you have employer-provided health insurance, check with your benefits administrator to see how Medicare might work with your current coverage If you don t have employer-provided insurance, review the Medicare plan choices in your area Eligible for Medicare and not working: Review the Medicare plan choices in your area If your family needs coverage but is not eligible for Medicare, advise them to explore the individual health plans in your area Eligible for Medicare and retiring soon or losing coverage: If you will have retiree benefits, talk to your benefits administrator to understand how Medicare might work with your retiree benefits If you re losing your employer provided coverage or if retiree coverage isn t available to you, review the Medicare plan choices in your area If your family or dependents are currently on your employer- or plan sponsored coverage and not yet eligible for Medicare, advise them to consider COBRA or the individual plans in your area 6
Medicare Advantage checklist. Make a confident choice. When choosing a Medicare Advantage plan, it s important to select one that fits your needs and your budget. Here are some important questions to think about as you focus on the big picture of your health coverage for the coming year. Use this simple checklist when considering a plan to help make sure it meets all of your needs. Yes No Does the plan meet your existing health care needs and conditions? Do the plan s costs fit within your budget? Be sure to include copays, premiums and any deductible. Does the plan s network include your preferred doctors, hospitals and clinics? If your preferred doctors aren t in-network, does the plan offer out-of-network choices that work for you? Are your prescription drugs covered by the plan? If your prescription drugs are covered, does the plan offer a mail order pharmacy? Does the plan include programs or networks for additional savings or perks? If you plan on traveling, does the plan meet your needs for coverage? Does the plan offer preventive services or wellness and fitness programs to help you live a healthier life? Does the plan cover vision, hearing or dental care? Is the company or organization that provides the plan trustworthy and strong? Does the company have convenient, friendly customer service? GetMyUHCGuide.com 7
We re here when you need us. GetMyUHCGuide.com 1 Original Medicare covers hospice care even if you re in a Medicare Advantage plan. 2 Drugs and prices may vary between pharmacies and are subject to change during the plan year. Prices are based on quantity filled at the pharmacy. Quantities may be limited by pharmacy based on their dispensing policy or by the plan based on Quantity Limit requirements; if prescription is in excess of a limit, copay amounts may be higher. You are not required to use OptumRx to obtain a 90-day supply of your maintenance medications, but you may pay more out-of-pocket compared to using OptumRx, your plan s Preferred Mail Service Pharmacy. New prescriptions should arrive within ten business days from the date the completed order is received by the Mail Service Pharmacy. Completed refill orders should arrive in about seven business days. OptumRx will contact you if there will be an extended delay in the delivery of your medications. OptumRx is an affiliate of UnitedHealthcare Insurance Company. Medicare Advantage plans are not available in all areas. You must live in the county or region where a specific plan is offered. Medicare Advantage plans must cover all of the services that Original Medicare covers except hospice care. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/ co-insurance may change on January 1 of each year. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan s contract renewal with Medicare. Y0066_130802_145630 Accepted SPRJ14413a