Presentation is loading. Please wait.

Presentation is loading. Please wait.

Humana Prescription Drug Plan. ... about 2011 Medicare Changes and Humana Prescription Drug Plans 1. Medicare Part D prescription drug plans 2. How to.

Similar presentations


Presentation on theme: "Humana Prescription Drug Plan. ... about 2011 Medicare Changes and Humana Prescription Drug Plans 1. Medicare Part D prescription drug plans 2. How to."— Presentation transcript:

1 Humana Prescription Drug Plan

2 ... 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 What You Need To Know... 2

3 For 2011 To help you save money on your prescription medications, Medicare will continue prescription drug coverage (Medicare Part D) in 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 You can get Medicare Part D coverage even if you havent had prescription drug coverage in the past. Medicare Part D Prescription Drug Coverage 3

4 To get Medicare prescription drug coverage, you must: Have Medicare Part A and/or Part B Live in the plans service area Enroll in a Medicare-approved Prescription Drug Plan (PDP) or Medicare Advantage Prescription Drug Plan offered by a Medicare Advantage organization New Prescription Drug Plans 4

5 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 How To Get Your Drug Coverage 5

6 If youre already enrolled in a Medicare Advantage plan that includes drug coverage (MAPD), you dont 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). How To Get Your Drug Coverage 6

7 The basic plan (defined by Medicare). All Part D plans are required by law to offer benefits equal to or better than the following: New Prescription Drug Plan 2011 Medicare Prescription Drug Plan Basic Coverage 2011 Basic BenefitsYou Pay Deductible$310100% of first $310 Initial Coverage Limit$2,840 25% of the next $2,530 ($632.50) Coverage Gap$3, % of next $3, Annual Out-of-Pocket Amount$4,550 * Catastrophic CoverageMedicare and Plan 95%5% ** * 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 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. Coverage In The Gap Starting January 1, 2011, Medicare is making changes to reduce the financial impact of the coverage gap "donut hole." 8

9 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. Humana Prescription Drug Plans 9

10 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 Humana Prescription Drug Plans 10

11 Humana plans give you more! If you enroll in one of Humanas 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 Benefit SM Rx 11 What about when youre not sick?

12 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 Extra Services From Humana 12

13 Important Dates For Drug Coverage plan year Medicare timeline 2011 plan year Medicare timeline Pre-Enrollment: Oct. 1 – Nov. 14, 2009 Compare your plan options and costs, so youll 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. No change in 2010 Open Enrollment: Jan. 1 – Mar. 31, 2010 Youre 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 Youre 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 Youre not allowed to make a plan change unless special circumstances arise (e.g., you move, you qualify for or lose eligibility for Medicaid).

14 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: 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 Extra help 14

15 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) Questions? 15

16 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, 2010 – 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


Download ppt "Humana Prescription Drug Plan. ... about 2011 Medicare Changes and Humana Prescription Drug Plans 1. Medicare Part D prescription drug plans 2. How to."

Similar presentations


Ads by Google