2014 Medicare Advantage Plans s y a Tod

2014 Medicare Advantage Plans s ’ y a Tod Ø Introduction Ø Eligibility Ø Basics of M edicare: 4 Pa rts: ü Original Me dicare basics (Parts A and limitation B) s s ü Medicare Adv c i p o antage – Part T C ü Medicare p rescription dr ug – Part D Ø Enrollment periods Ø Plan specif ic information

Original Medicare: Eligibility You are eligible to join if one of these three items applies to you: • You are 65 or older, or • You are under 65 with certain disabilities, or • You are any age with end-stage renal disease – permanent kidney failure requiring dialysis or kidney transplant • Must be entitled to Part A and enrolled in Part B, and permanently reside in the plan’s service area.

Original Medicare: (Continued) Eligibility And, both of these items describe you: 1. You or your spouse worked and paid Social Security taxes for at least 10 years. 2. You are a permanent resident of the U. S. or a legal citizen who has lived in the U. S. for five years in a row.

The Basics : s t r a p 4 s a h e r a ic Med Part A & üOriginal Medicare: üPart C Part B ge ra e v o c g ru d n o ti p ri c s üPart D – pre

Medicare Part A is hospital coverage that helps cover the costs for: • Inpatient care in hospitals and skilled nursing facilities (not custodial or long-term care). • Hospice and some health care services. *Late enrollment penalty may apply.

Medicare Part B is medical care coverage that helps cover the costs for: • Doctors’ services, hospital outpatient care and home health care services, as well as lab tests and durable medical equipment. • Most preventive services, including a yearly wellness exam. *Late enrollment penalty may apply.

Replace Medicare Parts A and B with Medicare Part C, also called Medicare Advantage. Medicare Part C: • Is offered by private insurers that have been approved by Medicare. • Offers similar coverage to Part A (hospital) and Part B (medical), and typically offers additional benefits. * • Some plans may include prescription drug coverage, vision, dental, and fitness and wellness programs. * Some of these additional benefits may require an additional fee.

HMO LPPO RPPO ased h c r u p e b n a lans c p e s plan, e e h t n f lo o a t s d o n a M t • PO or s P , O M H fits e n n a e b l a t n e either as supplem d d a o t n io t with an op fee. * ly h t n o m l a n for an additio dicare e M r u o y y a e to p u in t n o c t s u You m m. iu m e r p B t r Pa Part C (M edicare Advanta ge) Plan Op tions

. s v O M H PPO Health Maintenance Organization (HMO) • Must receive all routine care from network providers (except for emergency and urgent care) • Monthly premiums generally lower than other plan types • Set copays for most covered services • Most plans include Part D prescription drug coverage

ued) (contin . s v HMO PPO Preferred Provider Organization (PPO) • Local Preferred Provider Organization (LPPO) ü Use network providers for savings ü Freedom to see out-of-network providers (may cost more unless it’s an emergency) • Regional Preferred Provider Organization (RPPO) ü See network and out-ofnetwork providers ü Larger service area than an LPPO

e r a c i d Me : C t r a P Annual 1 ble Deducti ntage a v d A e edicar 1 Not all M uctible. d e d a clude Plans in • For plans offering deductibles, the deductible will only need to be met once during the year. • The deductible may be met through any qualifying expenses. • The plan deductible does not apply to the following services: – Doctor office visits (PCP and Specialist) – Basic lab services – Basic X-rays – Preventive services 2 (e. g. , mammogram screening, Pap/pelvic exam, prostate cancer screening, colorectal screening, immunization, etc. ) 2 These services are $0 cost to a member and will not apply to the deductible.

Medicare Part D is prescription drug coverage Medicare Part D is only offered by private insurers approved by Medicare. These plans: • Help pay for many brand-name and generic prescribed drugs. • Give you access to retail drugstores across the country and mail-order options. *Late enrollment penalty may apply.

2014 Medicare Standard Part D Coverage 1 $310 Deductible: plan May vary by Initial 2 Up to $2, 850 Plan pays: 75% Gap 2 – $4, 5503 0 5 $2, 8 % of the price , you pay 47. 5 gs During this stage r brand-name dru fo ) e fe g n si n e p (plus the dis for generic drugs. ce ri p e th f o % 2 7 and Catastrophic 3 50 More than $4, 5 ter of: You pay grea $6. 35 other d n a c ri e n e g y • $2. 55 copa ce • 5% coinsuran 1 Base coverage on a Part D plan; minimum set by Medicare 2 Includes total cost of insured’s prescription drugs in the calendar year 3 Includes insured’s out-of-pocket cost for prescription drugs in the calendar year

Medicare Basics OR Original Medicare Plan Part A Inpatient Hospital + Piecing the “Parts” together: Medicare Advantage Plans Part C Combines Parts A and B, and sometimes Part D Part B Medical Part D + Part D Prescription Drug: can be combined with Part C; can be stand-alone if combined with PFFS or MSA* Requires three ID Cards Requires only one ID card Stand-alone Prescription Drug Medicare Supplement (Medigap) * Stand-alone Part D with Private Fee For Service (PFFS) or Medicare Medical Savings Account (MSA) requires separate ID cards.

Enrollme nt – When can I enroll? – Timing matters!

n o i t c e l E s d o i Per d rt A an ently a P o t an tled be enti t B, and perm a t s u M e r * vice ar d in Pa enrolle the plan’s ser in reside Initial enrollment period: * 7 months surrounding your Medicare eligibility: This is the 3 months before you turn 65, the month when you turn 65, and the 3 months after.

ued) (contin n o i t c e l E s d o Peri d rt A an ently a P o t an tled be enti t B, and perm a t s u M e r * vice ar d in Pa enrolle the plan’s ser in reside Annual election period: * • October 15 to December 7, 2013. The period you can enroll in or change your M A or MAPD plan. • This is also the period yo u can enroll in, change or disenroll from a Part D pla n. • You may also switch to Original Medicare. New coverage will begin Janua ry 1, 2014.

ued) (contin n o i t Elec s d o i r e P n rolled i n e d n Aa to Part eside in the d e l t i t ntly r be en * Must and permane Part B, rvice area se plan’s Special enrollment period: * • A common SEP is for those covered under their employer’s health plans who retire after 65. • In this case, you can enroll with no penalty during the three months before your Part B takes effect.

Additional Information You may only be enrolled in one prescription drug plan at a time. If enrolled in a Medicare Advantage coordinated care (HMO or PPO) plan or an MA PFFS plan that includes Medicare prescription drugs, you may not enroll in a stand-alone prescription drug plan unless you disenroll from the HMO, PPO or Medicare Advantage PFFS plan.

Additional Information • Limitations, copayments, and restrictions may apply. • Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year.

We renew our contract with Medicare annually. Additional Informatio n Anthem Blue Cross renews its contract with Medicare (the federal government) each year on January 1. Premiums and benefits may change at that time, but not during the year, unless the change is to your advantage. In addition, the plan may reduce its service area and no longer offer services in the area where the beneficiary resides. If we do not renew our contract, we’ll tell you at least 90 days in advance. You may then switch to a standard Medigap plan (A, B, C, F, K or L) that won’t deny coverage because of a pre-existing condition. It will normally go into effect the day after your Medicare Advantage membership ends.

Medicare Advantage 2014 Let’s examine some benefits The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.

Let’s fill out the enrollment form M SA E PL

Additional Information 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. Anthem Blue Cross is a PPO plan, an HMO plan and a PDP with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ®ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Y 0071_14_18365_R_001 CMS Approved 9/30/2013 41241 WPSENMUB_001 BROKER