Secondary Information Here

1. Secondary Information Here Care Improvement Plus- Making the Right Choice for You 2012 Plan Options Y0072_OE12_6211_A _GA SC_CMS Approved 09262011

2. Making the Right Choice for You • Medicare and You • Welcome to Care Improvement Plus • Selecting the Plan That’s Right for You • Prescription Drug Overview • Additional Services • How to Enroll

3. Medicare and You

4. Who Qualifies for Medicare? • You or your spouse worked for at least 10 years (40 quarters) • Citizen or permanent resident of the U.S. • Age 65 • Under age 65 and disabled • Living with ESRD (end stage renal disease)

5. Original Medicare • Part A – hospital insurance • Part B – doctor and medical insurance • Part D – prescription drug coverage

6. Medicare Advantage Plans • Health plan options that are part of the Medicare program • Also known as “Part C” • Must offer all benefits of Original Medicare and most include Part D prescription drug coverage • In most plans – including Care Improvement Plus– there are generally extra benefits and lower out-of-pocket costs than with Original Medicare

7. Medicare Advantage Plans • It is important to note • If you join a Medicare Advantage plan, you are still in the Medicare program. • These plans are part of the Medicare program. • Medicare approves health plans such as Care Improvement Plus and pays them to provide your benefits. • Your Medicare coverage does not go away!

8. Welcome to Care Improvement Plus

9. Care Improvement Plus • Is dedicated to caring for the health and well-being of chronically ill and other underserved Medicare beneficiaries • Provides a variety of plan options to fit the health and financial needs of Medicare beneficiaries • Offers comprehensive medical and prescription drug benefits

10. Complete Health Coverage • Hospital (Medicare Part A) • Medical (Medicare Part B) • Prescription Drugs (Medicare Part D) • Most Medicare-approved generic drugs included • Full or partial coverage through the gap • Depending on your level of subsidy

11. An Open Access Provider Network • No referrals required for Medicare-covered services • Go to any Medicare-approved provider who accepts payment from our plan • Check to make sure your provider accepts the plan

12. Benefits Beyond Original Medicare • Offering you additional benefits and services • Vision benefits for eyewear and eye exams • Preventive dental coverage • Transportation • Routine Podiatry

13. Unique Programs Exclusive to Members • HouseCalls • PharmAssist • Social Service Coordinators • Comprehensive Care Management and more...

14. Selecting the Plan That’s Right for You

15. Available Where You Live • The Care Improvement Plus service area includes the entire states of Georgia and South Carolina.

16. “Best Fit Plan Options” *where available

17. Silver Rx • If you have diabetes and/or heart failure and full Medicaid, consider Silver Rx (Regional PPO SNP) or (PPO SNP). • To be eligible for this plan, you must: • Live in the service area • Have both Medicare Part A and Part B; and • Have been diagnosed with diabetes and/or heart failure

18. Silver Rx Highlights • $33.60 monthly plan premium and cost sharing that is similar to Original Medicare • For those with full Medicaid, monthly plan premium and cost sharing as low as $0 • Vision and transportation benefits • Dental benefits (including dentures; referral required) • Over-the-Counter benefit – monthly allowance for drugs and other health purchases via mail order

19. Silver Rx – Georgia & South Carolina (RPPO)

20. Gold Rx • If you are a Medicare beneficiary with diabetes and/or heart failure, and do NOT receive full Medicaid, consider Gold Rx (Regional PPO SNP) or (PPO SNP). • To be eligible for this plan, you must: • Live in the service area. • Have both Medicare Part A and Part B; and • Have been diagnosed with diabetes and/or heart failure

21. Gold Rx Highlights • $0 monthly plan premium and low, predictable cost sharing • Vision and transportation benefits • Dental benefits (including denture adjustments)

22. Gold Rx – Georgia & South Carolina (RPPO)

23. Dual Advantage • Dual Advantage (PPO SNP) is a Special Needs Plan designed specifically for those who have both Medicare and full Medicaid. • To be eligible for this plan, you must: • Live in the service area • Have both Medicare Part A and Part B; and • Have your Medicare Parts A and B cost sharing covered by the State

24. Dual Advantage Highlights • $0 monthly plan premium and $0 cost sharing options for Medicare-covered services • Vision and transportation benefits • Dental benefits (including dentures; referral required)

25. Dual Advantage – select counties

26. Medicare Advantage • Medicare Advantage (Regional PPO) or (PPO) was specifically designed for beneficiaries with Medicare only • Such as caregivers and spouses of our Special Needs Plan members • To be eligible for this plan, you must: • Live in the service area • Have both Medicare Part A and Part B

27. Medicare Advantage Highlights • Affordable monthly plan premium and predictable cost sharing • Vision and transportation benefits • Dental benefits (including denture adjustments) • Convenience of one health plan for everyone in your household

28. Medicare Advantage – Georgia & South Carolina (RPPO)

29. Prescription Drug Overview

30. Part D Benefit • Comprehensive, low-cost Part D coverage • Covers most generics and the common branded medications that are not excluded by Medicare • Accepted at nearly 60,000 network pharmacies nationwide, including many national and local chains • Mail-order pharmacy service is available for added convenience and savings

31. Part D Benefit • A formulary (list of covered drugs) chosen by our pharmacy experts to meet our member’s healthcare needs • Mailed to all members and available online • www.careimprovementplus.com • Use the formulary to: • See if your medications are covered • Determine the copayment for your medications

32. “Extra Help” • People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. • If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. • Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty.

33. “Extra Help” cont... • Many people are eligible for these savings and don’t even know it. To see if you qualify for Extra Help, contact: • 1-800-MEDICARE (1-800-633-4227), (TTY: 1-877-486-2048), 24 hours per day, 7 days per week. • Social Security: 1-800-772-1213, 7 a.m. – 7 p.m., Monday-Friday. (TTY: 1-800-325-0778) • Your State Medicaid Office

34. Low Income Subsidy • Beneficiaries with Low Income Subsidy (LIS) receive help paying their drug costs • Various levels depending on individual factors • $0-$2.60 or 15% for generics or $0 - $6.50 or 15% for others • Coverage through the gap (“donut hole”)

35. Coverage Gap • Most Medicare drug plans have a coverage gap (“donut hole”). • This means there’s a temporary limit on what the drug plan will cover for drugs. • Not everyone will enter the coverage gap. • The coverage gap begins after you and the plan have spent a certain amount for covered drugs.

36. Coverage Gap cont… • The member reaches the coverage gap once they have spent $2,930 in drug spend – what the members plus (+) what the plan pays • Once a member enters the coverage gap, they pay 50% of the cost of brands and 86% for generics until the total amount paid reaches the out-of-pocket limit. • Members who receive LIS still have coverage during the coverage gap.

37. Additional Services

38. Our Commitment • Care Improvement Plus remains committed to our members and to the Medicare Community at-large. • Care Improvement Plus members receive the extra help they need through valuable programs such as: • Comprehensive Care Management • 24/7 Nurse Hotline • HouseCalls • PharmAssist

39. Care Management • Supports, helps, and assists people living with long-term chronic illnesses • Provides personalized care to meet individual needs of members • Nursing support • Medication monitoring/counseling • Health education • Tools to help manage your health • in-home monitoring equipment (if needed)

40. Care Coordination • The management of healthcare between doctor visits coordinated among multiple providers. • Making sure you are getting the right care at the right time.

41. 24/7 Nurse Hotline • Information and support when you need it • Nurses are available 24 hours a day to answer health-related questions • Communicate better with your provider • Call before or after you see your doctor to make the most of your appointment. • Guidance for difficult decisions • The more you know, the better decision you can make.

42. Social Service Coordinators • Available to help determine your eligibility for state, local and federal programs that can assist with expenses such as • Medical costs • Prescription drugs • Heating and electric bills • Housing/rent • Meals • Legal

43. HouseCalls • In-person visit with a physician or nurse practitioner who performs a health assessment to: • Gather information to help Care Improvement Plus provide additional health education and care coordination • Identify urgent health problems or health risks • Provide advice on health-related topics to discuss at the next appointment with provider • No additional cost to members • All members are eligible for this program

44. PharmAssist • Specialist Pharmacists are available for personalized, private counseling • Review of medications to avoid duplication • Educate members about their medications • Ensure medications are being taken as prescribed • Assess needs for any new drugs • Discuss any issues with physician

45. How to Enroll

46. So...How Do You Choose? Factors to consider when choosing your plan: • Health needs- How often and for what services will you use the plan most often? • Cost- Compare your current out of pocket costs including monthly premium, copayment and coinsurance amounts. • Providers- Are your providers (doctors and hospitals) Medicare-approved? And are they willing to accept payment from the plan? • Benefits- Does the plan offer you the coverage and benefits you need including valuable extras at no additional cost?

47. Keep in Mind • No matter which Care Improvement Plus plan you choose to join, you are still part of the Medicare program and you must continue to pay your applicable Medicare premiums. • Care Improvement Plus is not a “stand-alone” Part D plan (PDP) • Care Improvement Plus is not a Medicare Supplement plan (Medigap)

48. Keep in Mind • If you currently have a Medicare Supplement or Medigap plan, you should not cancel or stop paying your premiums until your enrollment in Care Improvement Plus has been confirmed by Medicare. • If you currently have Medicare Advantage (MA), Medicare Advantage Part D (MAPD) or Part D coverage you will be automatically disenrolled from your plan by Medicare upon your effective date with Care Improvement Plus.

49. Important Dates

50. Special Election Period • If you have diabetes, heart failure or Medicaid/Low Income Subsidy (LIS), you may enroll in a Care Improvement Plus Special Needs Plan ANYTIME during the year by exercising a “Special Election Period”. • There are other times you are eligible for a special election period; for example: • If you permanently move to another service area • Other Medicare-approved circumstances