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Humana Medicare Plans Agents: these are potential remarks. This is NOT a script that must be read. However, required statements are noted for your benefit.

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Presentation on theme: "Humana Medicare Plans Agents: these are potential remarks. This is NOT a script that must be read. However, required statements are noted for your benefit."— Presentation transcript:

1 Humana Medicare Plans Agents: these are potential remarks. This is NOT a script that must be read. However, required statements are noted for your benefit. Humana is a private company with a Medicare contract to provide Medicare Advantage and Prescription Drug Plans to Medicare beneficiaries. REQUIREMENT: State which specific products are available in your market (e.g., MAPD, HMO, PPO or PFFS). If a seminar, you must indicate which product you will be presenting. This must be the product advertised in the seminar ad. Share information about yourself [e.g., I live here in the area, kids, 65+ parents or grandparents, etc. – things that help establish a connection.] I’ll guide you through the enrollment process. There’s no pressure. My goal today is to answer your questions and help you determine if a Humana plan fits your needs. Part of my job is to share Medicare information with as many people as possible. Please think of your friends and associates who need this important information.

2 Getting started… If you’re considering a Humana plan:
The person 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. Medicare/Medicaid Coverage (Dual-Eligible): If you are covered by both Medicare and Medicaid, you may be eligible for a special kind of MAPD plan. You should contact your state Medicaid agency and your doctor to determine if a Special Needs Plan (SNP) for dual eligibles is a good option for you. If you choose to enroll in a dual-eligible SNP, you may be responsible for any premiums, deductibles, copayments, and coinsurance associated with the plan’s services, depending on the level of extra help and/or Medicaid coverage you receive. Seminars: READ this slide to the group. In-home presentations: REQUIREMENT: read the “If you’re considering” section aloud (per CMS). Then, ask, “What questions do you have about this statement?” For the second part of the page, say: Some Medicare beneficiaries have both Medicare and Medicaid. Read each of the three bullet points. Then ask, “Do you have both Medicare and Medicaid?” If YES, read the second half of the page aloud to the beneficiary. Then, ask, “What questions do you have about the information?” If YES, ask, “What would you like to do? Do you want to investigate this or have you done so already? Should we stop or continue?” NEVER enroll if it will hurt their situation – do no harm. 2

3 Are you eligible? Enrolled in Medicare Part A and Part B through age or disability? Permanent resident in service area? Do you have End Stage Renal Disease (ESRD)? Federal law will not allow us to accept anyone who has End Stage Renal Disease (kidney failure), unless you: 1. Are a member of another health plan offered by the same organization within the same state, or 2. Were enrolled in a Medicare Advantage plan which was terminated or discontinued after December 31, 1998, and this is your first election following that plan termination or discontinuance. These are the eligibility requirements for a Medicare Advantage plan. If doing a seminar: Read the requirements aloud. Say, “If you’re eligible, congratulations! If you’re not certain, see me afterwards about your options.” If doing an in-home presentation: “May I please see your Medicare card. I just need to confirm your eligibility.” While viewing the card, ask: Is this the Medicare coverage you currently have? Is this your permanent address? Do you have End Stage Renal Disease? Note: If no Medicare card yet, they should have their Medicare entitlement letter. If they can’t find the card or letter, the beneficiary can call MEDICARE to determine their eligibility. Agent Notes - if you need information to answer common questions: Permanent residence is normally the primary residence of an individual, and the person is not away at any time for more than six consecutive months. If uncertain, you can confirm by seeing address on driver’s license or voter registration card. End State Renal Disease is permanent kidney failure usually requiring dialysis or a kidney transplant. People with ESRD stay with Original Medicare. If you have ESRD, see me later about Special Needs Programs and other information. PDP-only eligibility requirements: an individual must be entitled to Part A or enrolled in Part B of Medicare. 3

4 2010 Plan Year Medicare Timeline 2011 Plan Year Medicare Timeline
Important dates 2010 Plan Year Medicare Timeline 2011 Plan Year Medicare Timeline 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 Medicare health benefits, such as a Medicare Advantage plan with or without Prescription Drug Coverage or you can enroll in a stand-alone prescription drug plan. 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. You will no longer be able to switch Medicare Advantage carriers during this time. 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). Important dates. This is an important time of the year for you and all Medicare beneficiaries. You get to “elect” how to receive your Medicare benefits for It’s exciting, right? You have many choices to consider. And that’s why I’m here. I can help you navigate your way through these decisions. It’s not only an important time of the year, it can be a confusing one, too. Let me tell you about a few key dates. Make special note of the Annual Disenrollment Period of January 1 – February 14, and the Lock-In Period of February 15 – October 14. Are you clear on all your choices, how to enroll, and so forth? Speak to the information in the bullet points. Annual Disenrollment Period: This applies to all plans with the exception of MA PFFS plans, you must request disenrollment from the MA PFFS plan before you can enroll in a stand-alone drug plan. Note: This information does not apply to Medicare Supplement Plans 4

5 Our journey today . . . Let’s talk about . . .
Choosing the right plan for you Your Medicare coverage options Humana’s plans and extras How to enroll Choosing how to receive your Medicare benefits is an important decision. So, I hope our time together will be very helpful to you. We’ll need about minutes today. Here’s what we’ll cover: Ever wondered, “How do I decide?” I’ll share what we’ve learned. Next, we’ll go over your coverage options. Let’s make sure you’re well informed so that you feel ready to make a good decision. Third, you’ll learn about the specific benefits that will come with your Humana plan. You’ll get full disclosure on every benefit. And you can ask anything you want. Questions welcomed. Finally, you’ll learn how to enroll in your Humana plan and what happens after that. Sound like a good agenda? What else would you like me to cover? Seminars – ask the group to hold their questions. You might say: I need your help with something. If you have questions, please note them on the paper provided. I’ll take questions at a couple of points in the seminar. In my experience, if people ask questions as we go, half the audience gets mad at me because the meeting goes on-and-on. So, everyone please note your questions. Let’s have an educational and enjoyable seminar – one that helps everyone. 5

6 Humana — Experience behind the coverage
Dedication to the community Nearly 50 years of helping people during their pre-retirement and retirement years Financial Stability Fortune 100 Company National Coverage Providing Medicare plans in 50 states, Puerto Rico, and the District of Columbia Over 3 million Medicare Advantage and stand-alone prescription drug plan members Let me tell you about my company, Humana. I’m proud to be a Humana representative. I work for a good company, a company that helps people. Dedication to the community, financial stability, and national coverage are important descriptors of my company, Humana. Speak to the information on the slide. Other potential remarks: Did you know Humana has been helping older adults even longer than Medicare? We started with nursing homes in 1961 – Medicare started providing benefits in We understand Medicare beneficiaries. We’ve been providing creative alternatives to Original Medicare since the 1980s, when we were one of the first companies to offer Medicare HMOs in South Florida. So, we know Medicare and how to help Medicare beneficiaries. Something else you get with Humana is ME – your Humana agent. I’ll be there to provide guidance when you need it most. 6

7 How do I choose the right plan for my needs?
What type of plan do you currently have? What do you like about your coverage? What would you add to your current coverage to make it ideal for you? Who helps you make decisions about your healthcare coverage? That’s Humana. Does that give you enough information? Our tagline is “Guidance when you need it most.” This slide is a great example. With so many choices and new opportunities, it can be difficult deciding how to receive your Medicare benefits. Do you agree? Let me guide you. Many people aren’t sure how to select the plan that’s best for them. Here are two suggestions. One suggestion is to fill out the Suitability Assessment form in your Humana enrollment kit. (You are required to show and give it to them.) The second one is to write down answers to the questions posed on this slide. The answers to these questions will leave you feeling much more confident in making your enrollment decision. I can help. Ask permission to take notes. Ask each question. Write down their answers in large capital block letters. If they share information about monthly premium or drug costs, write it down and annualize it. Help them “see” what they have and the annual cost. Give them the notes. How helpful for you was this little exercise? Good. 7

8 Today’s Medicare environment
Original Medicare Supplemental Plan Okay – we’re now going to talk about your choices in the way you receive your Medicare for I’m playing the role of teacher – just educating. Your choices are:. 1. Original Medicare + a PDP. That’s one of your choices. If you go that route, you may need to enroll in a Medicare Part D prescription drug plan, often called a “Stand-Alone PDP.” That’s because Original Medicare doesn’t cover prescription drugs. 2. Original Medicare + a Medigap policy. Many people who select Original Medicare purchase Medicare supplemental insurance – a Medigap policy. They want to reduce their financial liability. If they need drug coverage, they add a PDP, too. 3. Medicare Advantage. On the other hand, you can elect to get your Medicare through Medicare Advantage (MA). With many Medicare Advantage plans, you’ll get a health plan, usually with drug coverage, and you won’t need Medicare supplemental insurance. One plan, one company. Easy. It’s great to have choices, isn’t it? In the next few pages you’ll learn more about each one. Medicare Part D 8

9 Original Medicare Original Medicare — you receive a service, you pay a fee You usually pay a monthly premium for Part B Access to any doctor or provider that accepts Medicare Out-of-pocket costs include hospital and medical deductible and coinsurance May want to purchase separate Medicare Supplement insurance to cover gaps This slide describes Original Medicare. The program was launched in 1965 and for many years was the only health plan choice available through the Medicare program. When Harry S. Truman received the first Medicare policy ever issued, he paid only $3 per month for Medicare Part B. Things have changed, haven’t they? A bit more about Original Medicare: Part A helps pay for hospital charges. Part B helps with medical charges, like the cost for doctor services received in a hospital or in an office, lab tests, and other services received on an outpatient basis. There are deductibles and coinsurance with Original Medicare. For Part B, you pay a monthly premium. For 2011, the premium is ____ and can be adjusted upward for those with higher incomes. Speak to the points on the slide. 9

10 Original Medicare + Medicare Supplemental Insurance
Medicare Supplement Insurance (also referred to as Medigap policies) Purchased from private insurance companies Supplements Original Medicare coverage Covers some or most costs that Original Medicare does not pay Medicare pays before the Medicare Supplement pays Plans are standardized and can be purchased with varying coverage options Medicare Supplement plans have no provider networks Speak to the points on the slide. Here’s a valuable tip: If you currently have a Medigap policy and have never had a Medicare Advantage plan, you can try Medicare Advantage for up to 12 months. If it’s not right for you, you can return to Original Medicare and your old Medigap. If your old Medigap isn’t available, you can enroll in a new A, B, C, or F Medigap with no underwriting. Questions about anything we’ve covered so far? NOTE: IF, the beneficiary expresses a desire to enroll in a Medigap policy, this slide is the transition place to discuss Humana Medigap policies. You can begin the Medigap presentation and application process. You do not have to come back to this presentation. IF Medigap is not the solution, go to the next slide and continue. 10

11 What are Medicare Advantage (MA) health plans?
Medicare Advantage (MA) plans are called Medicare Part C. Private insurance companies approved by Medicare provide this coverage MA plans are not the same as Medicare Supplement insurance Medicare pays the plan (Humana) a set amount every month for your care MA plans must offer all benefits of Original Medicare and can include Part D prescription drug coverage Over the next several slides you’ll learn about Medicare Advantage. Why, specifically, are you considering a Medicare Advantage plan? Speak to the points on the slide. Remember, when you enroll in a Medicare Advantage plan, you STILL have Medicare. You don’t lose it. You’re just choosing to take the Medicare Advantage version of Medicare, the version that’s administered by a private company rather than the Federal government. Here’s something for your peace of mind. Medicare Advantage plans are reviewed and approved annually by the Federal government’s Center for Medicare & Medicaid Services (CMS). By approving a plan, they’re saying that the benefits, in total, are at least as good as Original Medicare benefits. You don’t have to worry about being surprised later on. 11

12 What are Medicare Advantage (MA) health plans?
Most plans offer health and drug coverage, as well as extra benefits Most have lower out-of-pocket costs than with Original Medicare You may have to use certain healthcare providers You do not need a Medicare Supplement Less paperwork and fewer ID cards Speak to the points on the slide. The idea behind Medicare Advantage is private companies may be able to provide better benefits and reduce healthcare costs. That’s our specialty. Companies like Humana compete for your business, which may enable you to get more benefits and extras, and enjoy reduced out-of-pocket costs. You still have Medicare but a private company, Humana, will be administering your plan and paying the claims. The next thing you’re going to learn about is the different types of Humana Medicare Advantage plans that are available to you in this area. Before we move on, how is our session together going so far? How helpful is the information you’ve received? 12

13 Medicare Advantage offers more plan choices
Choices in Medicare Advantage (MA) Plans Health Maintenance Organization (HMO) LEARN MORE Preferred Provider Organization (PPO) LEARN MORE Private-Fee-For-Service (PFFS) LEARN MORE Plus, Part D Medicare Prescription Drug Coverage May be purchased as a stand-alone plan; or As part of a Medicare Advantage Prescription Drug plan (MAPD) All plans must meet minimum coverage level set by Medicare Speak to the MAPD points on the slide. Briefly differentiate between the three types of MAPD. This slide informs you that you have choices within Medicare Advantage. In this area, Humana offers these plans: _________ (fill in based on local offerings - HMO, PPO, PFFS, and/or PDP). Let me give you a brief description of each so that you can tell me which one you want to learn more about. You choose the type of MAPD that best meets your needs and budget. Then I’ll speak in more detail about that particular MAPD type. Let me also mention that you have several ways of getting your drug coverage. Speak to the Part D points on the slide. So, which of these options do you want to learn more about? Go to the MA plan that the prospect wants to learn more about, or go to the stand-alone PDP part of the presentation. PRESENTER NOTE If this is a seminar, just use the slides that explain the product that was the advertised seminar topic (HMO, PPO or PFFS). If you click on “Learn More” behind the PFFS plan, you are required to share all disclaimers related to this product. If this is an in-home presentation, do the following: Identify the product the prospect requested you explain when setting the appointment with you. Then, ask if it is the plan they still want to learn about today. After that, go over the slides for the selected product. You are not required to explain the details of each type plan. You are still giving a compliant presentation. 13

14 Is an HMO plan right for you?
Health Maintenance Organization (HMO) Defined network of providers Primary Care Physician (PCP) coordinates all of your care You may have to receive a referral from your PCP to see a Specialist You must use network providers for all scheduled care. No coverage for out-of- network care, except for emergency or urgent care Out-of-pocket costs may be significantly lower Speak to the points on the slide. Generally, with an HMO, there’s an established Humana network of participating doctors, specialists, hospitals, and other medical service providers. You’ll be required to receive services from network providers, except in the case of urgent or emergency care needed while away or non-network services approved by your PCP and the plan. You’ll have a PCP and you may need referrals for most specialist visits. On the other hand, you’ll have low out-of-pocket costs. Review our provider directory and see if your current doctor participates. If your physician doesn’t, the plan may bring you such value that it’s worth changing physicians. If that’s the case, you simply select a PCP from the directory. And you can change PCPs monthly in case your choice doesn’t suit you. Note: HMO referrals are not always required. If referrals are not required for the HMO in your market, then explain how to access specialist care inside the HMO network. Go to: Is a Stand-Alone drug plan right for you? 14

15 Is a PPO plan right for you?
Preferred Provider Organization (PPO) Defined network of providers No referral needed to see any doctor Flexibility to use providers who are not part of the network Out-of-pocket costs may increase significantly when out-of-network providers are used, except for emergency or urgent care Greater savings may be obtained when network providers are used because the plan pays a larger share of the cost Speak to the points on the slide. Flexibility is a good word for describing our PPO. Stay in network and get the care you need at advantageous rates. Yet, you have the flexibility to go out of network should you need or desire to do so. The best of both. Flexibility. Other Potential Remarks: A great feature for Humana is we have network providers in many locations around the country. Humana has the Medicare ChoiceCare Network. Why is that important to you? For those who travel, should you need medical treatment, you can call Humana to find out if there are in-network doctors you can access even though you are away from home. Also, if the best doctor or facility for treating your medical condition is located outside your plan’s service area, but they are part of our Medicare ChoiceCare Network, when you see them, you’ll be charged as if you’re using your plan’s in-network providers. Your costs will be lower. We’re proud to bring that kind of value. What do you think? Note: if there’s both a local and regional PPO available, the member simply chooses the one that brings them the most value. Go to: Is a Stand-Alone drug plan right for you? 15

16 Is a PFFS plan right for you?
Private-Fee-for-Service (PFFS) No referral needed to see any doctor Most plans include provider networks, but any provider can participate EXCEPT Your doctor must agree to accept the Private-Fee-for-Service plan’s payment terms and conditions For plans with Rx you must use network pharmacies to obtain prescription drugs, except in emergencies or urgent situations Most of Humana’s PFFS plans do have provider networks, and that helps identify providers who you know will accept the plan. You can see other providers not listed in the directory as long as the provider agrees to accept Humana’s payment terms and conditions. The points on this slide and the next few slides are intended to eliminate some of the confusion about PFFS. Let me speak to them. REQUIREMENT: READ the points on the slide aloud to the beneficiary. 16

17 Is a PFFS plan right for you?
Private-Fee-for-Service (PFFS) Before seeing a provider you should consider . . . If a provider decides not to accept the plan, you will need to find another provider who will If they choose to provide services, they must bill the Private-Fee-for-Service plan for your covered healthcare services. They may not bill you. If your PFFS plan has a network, you can still receive services from non-network providers, but you may pay more to see a doctor or other healthcare professional who is not in our network Private-Fee-for-Service plans do not pay after Medicare pays its share You are required to pay the appropriate deductibles, copayments, and coinsurance REQUIREMENT: READ the points on the slide aloud to the beneficiary. 17

18 Private-Fee-for-Service (PFFS) plan review
A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare Supplement plan. We have network providers (that is, providers who have signed contracts with our plan) for all services covered under Original Medicare in our fully networked plans. For partial network plans, contracted providers are limited to certain Durable Medical Equipment, home health providers, and some freestanding labs and hospitals. These providers have already agreed to see members of our plan. If you’re able to obtain covered services from network providers, you may pay less — even if your coinsurance is the same for both in-network and out-of-network services. All marketing representatives selling PFFS plans are required to verbally read or state this disclaimer during sales presentations in public venues and private meetings with beneficiaries. PFFS plans are prohibited from using any materials or making any presentations that imply PFFS plans function as Medicare Supplement plans or use terms such as “Medicare Supplement replacement.” MA organizations may not describe PFFS plans as plans that cover expenses that Original Medicare does not cover nor as plans that offer Medicare supplemental benefits. However, it is permissible for PFFS plans to clarify that the plan does not pay after Medicare pays its share; rather, it pays instead of Medicare and the beneficiary pays any applicable cost-share or co-pay. Model language is provided to incorporate into sales presentations describing the special aspects of PFFS plans which differ from supplements and other MA plans (refer to PFFS plans should refer to the above web link for additional information on the inclusion of balance billing notification in the EOC. 18

19 Private-Fee-for-Service (PFFS) plan review
If your provider is not one of our network providers, or if you have a non-network plan, then the provider is not required to agree to accept the plan’s terms and conditions of payment, and they may choose not to provide healthcare services to you, except in emergencies. If this happens, you will need to find another provider that will accept our terms and conditions of payment. Providers can find the plan’s terms and conditions of payment on our website. REQUIREMENT: READ the points on the slide aloud to the beneficiary. Go to: Is a Stand-Alone drug plan right for you? 19

20 Is a Stand-Alone drug plan right for you?
Medicare Part D Prescription Drug Plans (PDP) Plans offered by private companies under contract with Medicare Companies may offer plans with increased coverage Evaluate your prescription drug needs in relation to those covered by the plan, and your cost for those drugs Calculate your prescription drug costs here Want to know more about Medicare Part D? Are you starting to feel like we have a new healthcare alphabet? There’s Medicare Part A, Part B, Part C (Medicare Advantage), and, now, Part D – prescription drug coverage. The A, B, C, D’s of Medicare. Remember our tagline: Guidance when you need it most. Here’s some guidance about PDPs: Prescription drug plans, also called PDPs, vary from company to company. If a stand-alone PDP is the right solution for you, if you remember nothing else today, remember this: choose your plan based on the formulary. A formulary is a list of drugs covered by the plan. Formularies vary from company to company. Humana has a pharmacy network. You’ll save the most by using network pharmacies. Over 60,000 pharmacies participate. Here are a few: Wal-Mart, CVS, Walgreens, Eckerd Drugs, and many more. Mention local pharmacies of importance. Enrollment kits include a pharmacy directory. 20

21 Part D — Prescription Drug plan
The basic plan — 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%*** What’s this chart, you might wonder. Lots of numbers. In its simplest form, this chart is telling you that if you select a stand-alone PDP or a Medicare Advantage plan with drug coverage, you have the confidence of knowing that the drug benefit is at least as good as this benchmark created by CMS, the agency that oversees Medicare. You’ll see that the benefit has four phases. One of those, the third one, is called the Coverage Gap. Generally, you pay 100% of your costs in the gap. Why have a coverage gap, you might ask. If there was no coverage gap, few people could afford PDPs. Premiums would be much higher. * See Coverage in the Gap on following slide ** 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. 21

22 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. 22

23 Learn about your Humana plan benefits
Now is the time to distribute and explain the Summary of Benefits booklet, which is found in the enrollment kit. Note: Explain how the benefits booklet is organized. Go through the booklet, page for page. Address every section and benefit. Use the next few slides (fitness plan, 24-hour nurse hotline, SmartSummary, and RightSource mail-order Rx) while explaining the benefits. If this is a PFFS presentation, be sure to draw attention to the AHIP/CMS required PFFS handouts. Define service area. Address the annual contract with CMS as detailed on page 2 of Summary of Benefits. You cannot write in the booklet. You can encourage the beneficiary to take notes as you explain ways to get the most from the plan. 23

24 What about when you’re not sick?
Mail-order pharmacy Fitness plan 24-hour nurse hotline SmartSummary® Your Humana plan works for you even when you’re not sick. For example: Use RightSource, our mail order pharmacy, to save money and for convenience. Your maintenance medications will be mailed to you. Some plans include a fitness plan or guidance on exercising for fun and health. Use this to stay well and enjoy life even more. Have you ever simply not felt well and wondered what’s wrong or whether you need to see a doctor? With your Humana plan, you’ll have a 24x7 Registered Nurse available by phone to give you guidance. If you’ve had Medicare, you know about the mountains of paperwork that accompany claims. It’s confusing. What’s information? What’s a bill? With your Humana Plan, you’ll receive a SmartSummary that gives you valuable information in an easy-to-read format. And it includes cost-saving tips to help you save money. If you have an example with you, show it to them. Don’t underestimate how valuable SmartSummary is to beneficiaries. It’s a big hit. 24

25 How can Humana offer these benefits?
You might question how Humana can do so much for you without charging more than we do. When you join Humana, the Federal agency that administers Medicare, CMS, will pay us a flat monthly amount while you are a member of our MAPD. The money is sent whether you have claims or not. When you have claims for using plan benefits, the claims come to Humana and we are responsible for paying them. That’s what we do with the money we receive. We process and pay your claims and administer the plan. Does that make sense? 25

26 What happens now? Complete an application and you will receive your ID card in about two weeks Complete Humana’s Health Assessment — you may qualify for special health programs Take full advantage of your plan and the extras Contact Humana or your Humana Agent any time you want Speak to the points on the slide. Summarize the notes from your need analysis and how Humana meets those needs. You can ask, “Are you ready to enroll today?” or “I just need your Medicare card to get you started for a proposed effective date of: _________________ .” If Not Ready to Enroll What’s your reservation about enrolling? Tell me your concerns or what you’re feeling. Let’s talk it out. Whatever you decide is fine by me. On the other hand, I don’t want you to miss out on a great plan because I didn’t explain something thoroughly enough or speak to your concerns. There’s no pressure to enroll. 26

27 You are invited . . . Please join us for a meeting!
Humana offers “New Member Orientation Meetings” for new members. You’ll learn how to get the most from your Humana Medicare Advantage plan. Please join us for a meeting! Read the points on the slide. Here’s what a New Member Orientation meeting will do for you: Provide information about how to get the most from your Humana membership. Help you sign up or take advantage of services like RightSource or the fitness program. Provides a chance for you to get additional information about plan benefits. There will be people there who can answer your questions. We covered a lot today. It’s hard to remember everything about Humana’s plan. And more. 27

28 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. 28

29 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 care to verify any information we’ve discussed, here are sources for the information. Referrals Early in our conversation I mentioned that my job is to help educate as many people as possible about their Medicare choices. I see individuals, couples, church groups, walking or golf groups, etc. If you’d like me to share information about Humana and our Medicare choices and options to anyone you know or to any groups to which you belong, the best way to help is for you to have them contact me. I’ll leave some business cards for you. Permission to Contact I’d like to stay in touch with you. Is it okay for me to contact you periodically? If you’ll sign this “Permission to Contact” form and indicate your preferred approach, I’ll file that as a record and be in touch with you periodically. And you can always call or me. 29

30 Let’s review a couple of key points:
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 Health plan with a Medicare contract, available to anyone enrolled in both Part A and Part B of Medicare. 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, except for Group Medicare or Special Needs Plans, 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, 2011. 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. If an enrollment, then: Let’s review a couple of key points: You’ll get an ID card in about two weeks. You can begin using your Humana plan as soon as _______ . What are three of your top reasons for joining Humana? Why don’t you write those on your enrollment kit envelope. It will be a good reminder and information to possibly share with friends. Don’t forget about RightSource and the fitness program. You’ll get a couple of calls in the near future. One is from a Humana associate who does a Health Assessment to see if you qualify for any special programs. If you have diabetes, COPD or other conditions, Humana has programs to help you manage your condition. You may also get a call from someone inviting you to a New Member Orientation meeting. Be sure to attend. They’re fun and useful. If no enrollment, then: Thank you. The plan wasn’t right for you today. I’m available in the future if you reconsider or want information about new plans. Although the plan wasn’t right for you today, it may be right for others. Please encourage others to contact me. They’ll get the same professional service you’ve received. Take some extra business cards. Y0040_GNA0587HH_MAPD_CMS Approved 30

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