1. Humana Prescription Drug Plan
Hi, my name is ____________ and I’m here to talk with you today about a subject lots of people are talking about: Medicare Part D prescription drug coverage.
Doctors have come to rely on prescription drugs to treat many conditions, and the cost of drugs keeps going up … so it’s likely you’re spending more on medications than ever before.
In fact, most people with Medicare currently need, or will come to need, prescription drugs to stay healthy.
Medicare Part D prescription drug coverage can help protect them – and you – from high out-of-pocket costs.

2. What You Need To Know . . .
. . . about 2011 Medicare Changes and Humana Prescription Drug Plans
1. Medicare Part D prescription drug plans
2. How to get your drug coverage
3. Humana prescription drug coverage
4. Important dates to remember
5. Where to find information
To take advantage of Medicare prescription drug coverage, you’ll need to weigh your options as related to your needs, and then choose a plan you’re comfortable with.
You’ll probably still need more details after today’s presentation, but I hope you’ll have an understanding of how Medicare’s prescription drug coverage works, and what you need to do to join.
Here’s what we’ll cover today:
First, I’ll give you the basics on Medicare’s prescription drug coverage
Then we’ll talk about the various ways you can get coverage – and how your current situation might affect your options
We’ll discuss the plans Humana will offer in 2011
And then we’ll talk about some important dates you need to know
And finally, I’ll tell you where you can find more information 2

3. Medicare Part D Prescription Drug Coverage
For 2011
To help you save money on your prescription medications, Medicare will continue prescription drug coverage (Medicare Part D) in 2011.
Prescription drug coverage is an option available to all individuals entitled to Medicare Part A and/or enrolled in Part B.
Humana and other private insurance companies approved by Medicare will continue to offer Medicare Part D plans for 2011.
You can get Medicare Part D coverage even if you haven’t had prescription drug coverage in the past.
So, let’s get into the basics:
Additional comments
The Medicare prescription drug plans are available only from private insurance companies approved by Medicare to offer them.
You can enroll in a Part D plan even if you haven’t had prescription drug coverage in the past. If you haven’t enrolled in a prescription drug plan, you may be subject to pay a penalty for late enrollment – and the longer you wait, the higher the penalty. So even if you missed the deadline of May 15, 2006, or when you were first eligible for Medicare (if after 5/15/2006) you can still save money by enrolling now. The penalty keeps increasing as time goes by. 3

4. New Prescription Drug Plans
To get Medicare prescription drug coverage, you must:
Have Medicare Part A and/or Part B
Live in the plan’s service area
Enroll in a Medicare-approved Prescription Drug Plan (PDP) or Medicare Advantage Prescription Drug Plan offered by a Medicare Advantage organization
Medicare prescription drug coverage is available to everyone with Medicare – that means Medicare Part A, or Part B, or both.
This almost goes without saying … but to enroll in a prescription drug plan from any insurance company, you need to live in an area served by that insurance company. That’s what we mean by the “plan’s service area.”
To get prescription drug coverage, you need to join a Medicare-approved plan, offered by a Medicare-approved organization. So, at this point, I want to assure you that Medicare has approved Humana’s prescription drug plans – and has also given Humana approval to sell them! 4

5. How To Get Your Drug Coverage
You can get prescription drug coverage several ways:
Prescription drug plan (PDP) as a stand-alone plan
A stand-alone PDP gives you prescription drug coverage, but no other medical benefits
You can use a stand-alone PDP with Original Medicare only or with Original Medicare plus a Medicare Supplement (Medigap) plan
You can use a stand-alone PDP with a Private-Fee-for-Service (PFFS) plan that does not contain drug coverage
As a part of a Medicare Advantage plan. Also referred to as Medicare Advantage + Prescription Drugs (MA-PD)
As a part of your retiree benefit package, if available from your former employer or union
Now let’s talk about HOW you get prescription drug coverage. Again, the choice is yours, and your particular prescription drug needs certainly must play into your decision.
Read the page. Discuss, answer any questions. 5

6. How To Get Your Drug Coverage
If you’re already enrolled in a Medicare Advantage plan that includes drug coverage (MAPD), you don’t have to take any action. You will be enrolled in a new prescription drug plan automatically, when your plan renews. You can only be enrolled in one Medicare Part D plan at a time.
Warning!
If you are now enrolled in a Medicare Advantage plan and then you also enroll in a stand-alone PDP, you will automatically be disenrolled from your Medicare Advantage Plan (except for a Private-Fee-for-Service plan with no prescription drug coverage, a Medical Savings Account MA plan, or an 1876 Cost Plan).
On the previous slide, I mentioned you can get prescription drug coverage as part of a Medicare Advantage plan.
So if you already have a Medicare Advantage plan that includes prescription drug coverage, you don’t have to do anything. You’ll be enrolled in prescription drug coverage automatically. If you enroll in a separate prescription drug plan, you could lose your Medicare Advantage coverage. The only exception is if you’re enrolled in a Medicare Advantage Private-Fee-for-Service plan that does not include prescription drug coverage. 6

7. New Prescription Drug Plan
The basic plan (defined by Medicare). All Part D plans are required by law to offer benefits equal to or better than the following:
2011 Medicare Prescription Drug Plan Basic Coverage
2011 Basic Benefits
You Pay
Deductible
$310
100% of first $310
Initial Coverage Limit
$2,840
25% of the next $2,530 ($632.50)
Coverage Gap
$3,607.50
100% of next $3,607.50
Annual Out-of-Pocket Amount
$4,550*
Catastrophic Coverage
Medicare and Plan 95%
5%**
Go over this chart to ensure that the Medicare beneficiary understands the 2011 deductible, initial coverage limit, coverage cap and catastrophic coverage.
* Annual Out-of-Pocket Amount does not include monthly premiums.
** Member pays the greater of $2.50 for generic/preferred multiple-source drug and $6.30 for all other drugs, or 5 percent coinsurance. 7

8. Coverage In The Gap Brand Coverage Discounts
Starting January 1, 2011, Medicare is making changes to reduce the financial impact of the coverage gap — "donut hole."
Brand Coverage Discounts
CMS will work with drug companies to provide a 50% discount on covered, brand-name drugs while in the coverage gap.
People with Medicare who receive a low-income subsidy or are enrolled in an employer-sponsored retiree drug plan (with exception of employer groups with waivers) won't be eligible for this discount.
Generic Coverage Discounts
CMS will partner with healthcare plans to provide a 7% discount on generic drugs while in the coverage gap.
Speak to the points on the slide.
Coverage in the Gap Brand Drugs (donut hole)
Starting Jan. 1, 2011, Medicare beneficiaries will receive assistance covering brand-name drugs when they enter the coverage gap (donut hole). The legislation requires a voluntary agreement with drug manufacturers to provide a discount of 50 percent for brand-name drugs used by Part D enrollees. This will reduce Medicare beneficiaries’ out-of-pocket costs by at least 50 percent for those brand-name drugs produced by participating manufacturers. If pharmaceutical manufacturers don’t participate in the agreement, they will not be authorized to contract with any Medicare providers.
Coverage in the Gap Generic Drugs (donut hole)
Starting Jan. 1, 2011, Medicare members will have help covering generic drugs when they enter the coverage gap, or “donut hole.” The legislation requires that health plans cover seven percent of the cost in 2011. 8

9. Humana Prescription Drug Plans
In 2011, Humana will offer two or three different stand-alone prescription drug plans in each region.
Plan availability and benefits will vary by region.
With more than 60,000 national pharmacies — including more than 20,000 independent pharmacies — in our network, you're likely to find one near you.
So we’ve covered the basics about how and when to get prescription drug coverage. Now let’s take a look at the prescription drug plans available from Humana for 2011. 9

10. Humana Prescription Drug Plans
The person that is discussing plan options with you will review the following important documents:
2011 Summary of Benefits
2011 Drug Formulary
The person that is discussing plan options with you is either employed by or contracted with Humana
The person may be compensated based on your enrollment in a plan
REQUIREMENT: Hand out benefit summaries and sales brochures for the plans; explain that the benefit summaries give details of the information shown in the one-page overview. Solicit and answer questions.
Provide a high-level overview summary of the PDP plans available in your service area. 10

11. What about when you’re not sick?
Humana plans give you more!
If you enroll in one of Humana’s prescription drug plans, you get these additional services at no extra cost:
Mail-order prescription service
SmartSummary Rx® benefit summary
Online tools on Humana.com
Tips by phone through Maximize Your BenefitSM Rx
Here’s a list of the extra services you get from Humana. Let’s go through them, one by one. 11

12. Extra Services From Humana
The products and services described below are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Humana grievance process.
Dental care discounts
Vision care discounts
Hearing discounts
Over-the-counter discounts
Rx discounts 12

13. Important Dates For Drug Coverage
2010 plan year
Medicare timeline
2011 plan year
Pre-Enrollment: Oct. 1 – Nov. 14, 2009
Compare your plan options and costs, so you’ll be ready to enroll by November 15.
No change in 2010
Annual Election: Nov. 15 – Dec. 31, 2009
If you're eligible, you can enroll in a Prescription Drug Plan (PDP) or change to a new PDP during this time.
Open Enrollment: Jan. 1 – Mar. 31, 2010
You’re allowed to make one change – Medical coverage only.
Annual Disenrollment: Jan. 1 – Feb. 14, 2011
Medicare Advantage plan members can return to Original Medicare and can enroll in a stand-alone drug plan.
Lock In: Apr. 1 – Nov. 14, 2010
You’re not allowed to make a plan change unless special circumstances arise (e.g., you move, you qualify for or lose eligibility for Medicaid).
Lock In: Feb. 15 – Oct. 14, 2011
You’re not allowed to make a plan change unless special circumstances arise (e.g., you move, you qualify for or lose eligibility for Medicaid).
Now that you know HOW to get prescription drug coverage, let’s talk about WHEN you can join a plan.
If you're eligible, you can enroll in 2011 Medicare health benefits, such as a PDP or Medicare Advantage plan. During this period, you can also change plans or enroll in a separate prescription drug plan.
If you have PDP coverage but want to make a switch, you can enroll in a new plan between November 15 and December 31, 2010, for coverage beginning January 1, This is the Annual Enrollment Period. During this period, you can also change plans or enroll in a separate prescription drug plan. Additionally, you can elect or enroll in any plan:
Original Medicare + PDP
Original Medicare + Medicare Supp + PDP
Medicare Advantage + PD
December 31, 2010: last day to enroll in or change Part D coverage in 2011*; *The exception may be qualifying events.
Discuss the Disenrollment Period and the Lock-In. 13

14. Extra help
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:
1-800-MEDICARE ( ). TTY/TDD users should call , 24 hours a day/7 days a week;
The Social Security office at between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, ; or
Your state Medicaid office
If you’re worried about whether you can afford your prescription medications, write down the number on this page. Contact to find out if you might qualify for money the Federal government has set aside to help people with their drug expenses.
Refer to the points on the slide. 14

15. Questions? Thanks for your time and attention. Any questions?
Where to find information:
“Medicare and You 2011” handbook (available in October or November 2010)
Your local State Health Insurance Program (SHIP)
If you need information, either before or after you’ve enrolled in a plan, you can go to any of these sources:
Your “Medicare and You 2011” handbook, which you should receive in the mail from the Centers for Medicare and Medicaid Services.
is the Medicare website, which contains a lot of helpful information about Medicare benefits and prescription drug plans.
You can call MEDICARE or its TTY line to get answers to your questions.
And you can call your local State Health Insurance Program. [You may want to provide the SHIP phone number for your state, to save your audience the trouble of having to look it up. Ask them to write the number down in case they should ever need it.]
You can also call Humana at for any questions about our plans. 15

16. Y0040_GNA0923HH_PDP_CMS Approved 08022010 810
The person that is discussing plan options with you is either employed by or contracted with Humana. The person may be compensated based on your enrollment in a plan.
A stand-alone prescription drug plan with a Medicare contract, available to anyone entitled to Part A and/or enrolled in Part B of Medicare. Medicare beneficiaries, may enroll in the plan only during specific times of the year. Contact Humana for more details.
You must use network pharmacies, except under non-routine circumstances. Quantity limitations and restrictions may apply. If you are a member of a qualified State Pharmaceutical Assistance Program, please contact the Program to verify that the mail-order pharmacy will coordinate with that Program.
This document is available in alternative formats or languages. Please call Customer Care at , if you use a TTY, call 711. Both numbers are available 8 a.m.to 8 p.m., seven days a week, Nov. 15, – Feb. 14, 2011 and  8 a.m.to 8 p.m.,  Monday-Friday, Feb. 15, 2011 –  Oct 14, Este documento está disponible en formatos o lenguajes alternativos. Llame al Departamento de Servicio al Cliente al , si usted utiliza un dispositivo TTY, marque el 711. Ambos números están disponibles de 8 a.m. a 8 p.m., los siete días de la semana, del 15 de noviembre de 2010 al 14 de febrero de 2011; desde el 15 de febrero, hasta el 14 de octubre de 2011, de 8 a.m. a 8 p.m., de lunes a viernes.
Y0040_GNA0923HH_PDP_CMS Approved 16