Benefit Presentation PowerPoint Without Fun Facts Medicare

e WELCOME Were glad youre here!

This year make a change for the better.

Premera Blue Cross Medicare Advantage HMO Plans

PresenterPresentation NotesFACILITATOR NOTE: Introduce yourself. Provide attendees with your name, title and a little bit about your background to instill confidence: You are a licensed sales agent with Premera Blue Cross; you have xx years experience in the healthcare industry, etc. Keep it brief and relevant (30 seconds or less).

Please also quickly refer to the sign-in sheet (if you are using one), and advise attendees that it is not mandatory to sign in.

Meeting agenda Medicare basics

Your Medicare coverage options

Premera Blue Cross Medicare Advantage Plans

Enrolling is easy!

The new member experience what to expect

PresenterPresentation NotesFACILITATOR: Today we are going to be together for about 45 minutes this morning/afternoon. During that time Im going to give you information to help you make an informed decision about your Medicare coverage.

Well begin by speaking briefly about Medicare and the basics of understanding how Medicare works. Well talk about the different coverage options you have as a Medicare beneficiary.

And then well spend a few minutes talking about Premeras Medicare Advantage plans. Well go through the benefits and copays for each of our Medicare Advantage plans. The goal of this section of the presentation is to give you a clear understanding of what is covered in each of those plans and to help you decide which Premera Medicare Advantage plan might be the right fit for you.

And for those that are interested, Ill be available to help you chose the right plan for you and assist you in completing the enrollment application, so you can become a new Premera Blue Cross Medicare Advantage member.

Finally, well end the presentation today by talking about what you can expect as a new plan member.

Medicare basics

PresenterPresentation NotesFACILITATOR: Lets begin with an introduction to Medicare, what it is and why you need it. We call it Medicare basics. How many of you know exactly what Medicare is? Lets see a show of hands. Are you knowledgeable about Parts A, B, C and D?RESPOND: If they say no, then let them know youll be filling in the information for them. If they say yes, remember his or her name, and let them know youll be calling on them to help explain some of those things when you reach them later in the presentation. (If warranted give the person a nominal giveaway to help encourage audience participation.)

Who qualifies for Medicare? Citizen or U.S. resident and

Age 65 and older or

Under age 65 and disabled* or

Living with end-stage renal disease (ESRD)

*Permanently disabled for 24 months or longer.

PresenterPresentation NotesFACILITATOR: Medicare is a federal health insurance program that pays for hospital and medical care.

In order to qualify for Medicare you need to be:A U.S. citizen or resident, andAge 65 or over, orUnder 65 and permanently disabled for at least 24 months, orBe living with End-Stage Renal Disease (ESRD)

For those of you who havent already done so enrolling in Medicare is easy.

If youre already receiving Social Security benefits before you turn 65, you wont need to file a Medicare application; youll automatically receive your Medicare card two months before your 65th birthday.

If you dont already receive Social Security, you may apply for Medicare at any Social Security office or by calling 1-800-772-1213 or visiting their website at www.ssa.gov.

Initial Enrollment Period (IEP): 3 months before, the month of, and 3 months after your 65th birth month

Annual Enrollment Period (AEP): October 15 December 7

Medicare Advantage Disenrollment Period (MADP): January 1 February 14

Special Enrollment Period (SEP): Example: Loss of employer coverage or moving to new service area

Medicare Enrollment Periods

PresenterPresentation NotesFACILITATOR: There are several Medicare Enrollment Periods that you should know about:

The first of which is your Initial Enrollment Period (IEP) that begins 3 months prior, the month of, and 3 months after your 65th birthday. This is when you are first eligible to enroll in Medicare.

The Annual Enrollment Period (AEP) takes place between October 15 and December 7 of each year. This is the only time you can sign up for a plan or change plans for the following year, unless you are eligible for one of these other enrollment periods.

The Medicare Advantage Disenrollment Period (MADP) takes place between January 1 and February 14 of the year of coverage. This is the only time you can disenroll from a Medicare Advantage Plan.

The Medicare Advantage Disenrollment Period (MADP) is an opportunity to disenroll from a Medicare Advantage plan and return to original Medicare, not to join or to switch Medicare Advantage plans.

You may also qualify for a Special Enrollment Period (SEP). Some examples of a special enrollment period are when you move to a new service area or lose your employer group coverage.

Part A & Part B Original Medicare

Know your A, B, Cs and D

PresenterPresentation NotesFACILITATOR: The federal Medicare program is made up of four parts that help cover specific services.

Lets take a look at them one by one.


Part A is free for most people

There is a $1,316 Part A deductible per benefit period

After 60 days in the hospital, you pay: $329 per day copay for 61-90 days

$658 per day copay for 91-150 days

After day 150, you pay all hospital costs

FIGURES ARE FOR 2017

Part A Hospital Insurance

PresenterPresentation NotesFACILITATOR: Medicare Part A is hospital insurance. It helps pay for inpatient care in hospitals and skilled nursing facilities, for hospice care and for home healthcare.

Part A is free for most people, because most people have contributed to the cost of Part A during their working lifetime.

However, there is a $1,316 deductible per benefit period. So one stay in the hospital could cost you over $1,000.

After a 60-day period stay in the hospital, you are responsible to pay a $329 copay per day for any stays between 61 and 90 days, a $658 copay per day for any stays between 91 and 150 days, and any hospital stays after 150 days will require you to pay all hospital costs.

There is a $121.80 standard per monthly premium*

There is a $166 annual deductible

Original Medicare covers 80% of most Part B costs, leaving you to pay the other 20% for services like:

Most physician services

Outpatient therapies

Durable medical equipment

Home health care


FIGURES ARE FOR 2016 *Varies for higher income consumers. *Some individuals receiving insurance through an employer or

Part B Medical Insurance

spouse may elect to postpone enrollment in Medicare Part B.

PresenterPresentation NotesFACILITATOR: Medicare Part B is medical insurance. This is optional coverage that helps pay for doctors services and other medical services.

There is a premium for Part B. The Part B premium is $121.80; however, it does vary for higher-income consumers.

For most items, Medicare covers 80% of the cost. You pay the other 20% but after the $147 annual deductible is met. You would also pay 20% for most doctor services while you are an inpatient at a hospital.

NOTE: Point out that the figures are for 2016.


Medicare Advantage plans are offered by private companies

Cover some of the costs not covered by Medicare

Often include extras like fitness and wellness programs

Many also offer Part D prescription drug coverage

Part C Medicare Advantage plans

PresenterPresentation NotesFACILITATOR: You might be wondering why you would need insurance if you already have Medicare. Good question! Original Medicare was never meant to cover all your healthcare expenses, so many people enroll in a Part C plan or a Part D plan to help pay for some of the costs and benefits that arent paid by Original Medicare.

To enroll in a Medicare Advantage plan (Part C), you must qualify for Medicare Part A; AND be enrolled in Medicare Part B; AND live in the plans service area. If you have End-Stage Renal Disease (ESRD), most plans cannot enroll you. However, if you develop ESRD while a member, you cannot be dis-enrolled.

Medicare Part C is known as Medicare Advantage. These are private health insurance plans like HMOs and PPOs, and they combine hospital care, doctor visits and outpatient care in a single plan. If you enroll in a Medicare Advantage plan, your Medicare benefits are managed by the plan you join. These plans provide all Part A and Part B benefits and help offset costs like the Part A hospital deductible and the 20% of costs that Medicare does not cover. Member copays and coinsurances vary by plan.

Many Medicare Advantage plans also include prescription drug coverage. This means you have one plan and one card for your medical and prescription coverage.

Voluntary program and run by private companies

You pay a monthly premium

You pay a portion of the drug cost

Plan designs must be equal to or better than standard Medicare benefit designed by CMS

Coverage varies from plan to plan

Some may pay penalty for late Part D enrollment


Part D Prescription Drug Coverage

PresenterPresentation NotesFACILITATOR: Which brings us to Medicare Part D... Medicare Part D plans help cover the cost of prescription drugs. Lets take a closer look...

Part D is prescription drug coverage with a unique product design. The federal government designed Part D to serve as insurance to help Medicare participants with the cost of their prescription drugs. Part D enrollment is a voluntary benefit and is not required. It serves as catastrophic coverage for those who have high prescription costs, and it helps to keep costs manageable for those with lower prescription expenses.

All Part D plans are run by private insurance companies approved by Medicare. If you are selecting a Medicare Advantage plan that also provides Part D coverage, you must select your Part D coverage through that plan. If you are already on a stand-alone Part D prescription drug plan (one that includes Part D coverage only), and you enroll in a Medicare Advantage plan, you will automatically be dis-enrolled from your stand-alone Part D plan. Like all insurance plans, you pay a monthly premium to participate, and for each prescription, youll pay a portion of the cost. If you do not sign up for Part D when you are first eligible you may owe a late enrollment penalty which will be added to your monthly premium.

The cost of your late enrollment penalty will depend on how long youve been without creditable prescription drug coverage after your initial enrollment period ended. The penalty is calculated by multiplying 1% of the national base beneficiary premium ($35.63 in 2017) by the number of full, uncovered months you were eligible for drug coverage but did not join a Medicare prescription plan.

The government sets a standard benefit plan that has four steps or phases, which we will cover in a moment. Private insurance companies offer a variety of Part D plans. How much you pay and how much the plan pays varies based on the plan you join and how many drugs you use during the year. Plans also vary based on monthly premiums and types of drugs that are covered.

$400

$3,700

$4,950

5% COPAY

1 Deductible YOU PLAN 100% 0%

2 Initial Coverage YOU PLAN

3 Coverage Gap YOU YOU

4 Catastrophic YOU PLAN

25% 75%

40% 51%

5% 95%

YOU pay $3.30/Generic and $8.25/Brand or 5%

BRAND GENERIC

4

3 2

1 How Medicare Part D phases work annually

This is an example of how Medicare Part D works and is not intended to portray a specific plan. In some instances, these costs will be approximate amounts.

FIGURES ARE FOR 2017

PresenterPresentation NotesFACILITATOR: Youll start the year in the deductible phase. The deductible is the amount you pay before your insurance kicks in. The deductible is set by Medicare and can change from year to year. During this phase, you pay the full cost of your prescription drugs included in the formulary until your costs reach your yearly deductible amount. The 2016 deductible is $400. Step 1 ends when you reach your deductible. As a reminder, this is the basic model Medicare designed as a starting point.

Once youve met your deductible, you move into the initial coverage phase. During this phase, you and the plan each pay a portion of the cost for each prescription included in the formulary. Keep in mind that some plans may have fixed copays for each prescription rather than a percentage. Youre in this phase until your year-to-date drug costs (paid by you, including your deductible from Step 1, and the plan combined) reach the Initial Coverage Limit or ICL. For 2016 the ICL is $3,700 Once you reach your Initial Coverage Limit, welcome to the gap!The coverage gap or donut hole as some call it is the next phase. In the past, you would have had to pay all costs at this phase out of your own pocket. For 2017, you pay 40% of brand-name drug costs and 51% of generic drug costs. If you reach your coverage gap limit of $4,950, Step 3 ends and you move into the final phase.If your total outofpocket spending on prescriptions reaches a set amount $4,950 (for 2017) and the years not over, you move into the catastrophic coverage phase for the rest of the year. You pay very little for your prescriptions either 5% or $3.30 per generic and $8.25 per brand, whichever is higher. The plan pays the rest unlimited to the end of the calendar year.

Extra Help (or Low Income Subsidy LIS) is the name of the Part D drug program to help beneficiaries pay for drug costs

Extra Help is available from the government if you meet certain requirements

Those that qualify may get help paying monthly premiums, copays, coinsurance and deductibles*

Do you qualify? You dont know unless you apply

*Premiums, copayments, coinsurance and deductibles may differ depending upon the level of help for which beneficiaries may qualify.

Part D Extra Help

PresenterPresentation NotesFACILITATOR: People with limited incomes may qualify for Extra Help to pay for their prescription drug costs through the federal and/or state government.

If you qualify, you may receive help with drug costs including monthly prescription drug premiums, copays, coinsurance and deductibles. Keep in mind that any Extra Help you receive will only apply to the Part D prescription drug portion of your premium, and not the Part C medical portion. Those who receive Extra Help are also not subject to the Part D coverage gap.

The income limits and the amount of help you receive may differ depending on your yearly income. So you may qualify, but you wont know unless you apply.

You can complete an application for Extra Help by going to www.ssa.gov, calling or visiting your local Social Security office. I am also happy to help you apply if you think you may be eligible.

Common formulary terms Formulary

A list of drugs covered by the health plan.

Prior Authorization (PA) For some covered drugs, you will need to get approval from the plan before you fill your prescriptions. Without approval, your drug may not be covered.

Quantity Limits (QL) For some covered drugs, the plan may place limits on the amount of the drug that we cover per prescription or for a defined period of time.

Step Therapy (ST) For some covered drugs, the plan may require you to try certain drugs to treat your condition before we will cover another drug for that condition.

Transition Supply A temporary supply of your prescription drugs that allows you to transition to a new prescription covered by your plan formulary.

The formulary may change at any time. You will receive notice when necessary.

PresenterPresentation NotesFACILITATOR: Here are some common terms associated with a health plan formulary.

A formulary is:

Read the bullets listed on the slide.

Your Medicare coverage options

PresenterPresentation NotesFACILITATOR: Now that weve given you a basic understanding and overview of the different parts of Medicare, lets talk about the different coverage options you have as a Medicare beneficiary.

The Medicare program is good and benefits lots of people, but it was never meant to cover 100% of your healthcare expenses. Deductibles, copayments and coinsurance are your responsibility.

Many people want and need more coverage than just Original Medicare.

There are two main choices of how you get your Medicare coverage. Lets use these steps to help you decide which option is right for you.

Medicare coverage options

START with Original Medicare

DECIDE if you want more coverage

Part A (hospital insurance)

+ Part B

(medical insurance)

Medicare Advantage Plan Combines Parts A & B Many cover prescription drugs

and may include extra benefits

Your monthly plan premium could be as low as $0

Medicare Part D Prescription Drug Plan

Medicare Supplement Insurance Plan

Option 1 Option 2

and / or

PresenterPresentation NotesFACILITATOR: If you start with Medicare Parts A & B, you can then decide what option is best for you.

In Option 1, you can add a Medicare Part D plan for prescription coverageor a Medicare Supplement plan to help pay your share of hospital and medical costs... or both.

Both types of plans are sold through private insurance companies, and you pay a monthly premium for each plan.

In Option 2, you can join a Medicare Advantage plan and get hospital, medical and Part D drug coverage combined into a single plan.

Some plans may have premiums as low as $0, and many Medicare Advantage plans include extra benefits you dont get with Medicare like a fitness membership. Medicare Advantage plans are offered through private health insurers like Premera Blue Cross.

Premera Blue Cross Medicare Advantage Plans

PresenterPresentation NotesFACILITATOR: Premera has stood for quality and reliability in Washington for more than 80 years! In 2017, we have three Medicare Advantage Plans. You can get all your Medicare hospital and doctor benefits we previously discussed PLUS Part D prescription drug coverage fitness and more in one easy-to-use plan. Our plans are designed for who you are today from a local company youve known your whole life.

Medicare Advantage eligibility To enroll, you must:

Have Medicare Parts A & B

Continue to pay your Part B premium

Not have ESRD (in most cases)

Live in plan service area

Have a valid enrollment period

PresenterPresentation NotesFACILITATOR: In order to qualify for a Medicare Advantage plan, you must:Have Medicare Parts A & BContinue to pay your Part B premiumNot have ESRD (in most cases)Live in plan service areaHave a valid enrollment period

Plan service area

Snohomish Spokane

Thurston

King

Pierce

PresenterPresentation NotesFACILITATOR: At this meeting, we are covering Premera Medicare Advantage plans for people who live in King, Pierce, Snohomish, Spokane and Thurston counties.

In order to enroll in a Premera Medicare Advantage plan, you must live in one of the five counties at least six months of the year.

Premera Blue Cross is proud to present our

2017 Medicare Advantage plans

Premera Blue Cross Medicare Advantage Classic Plus (HMO)

Option 3 Classic Plus HMO

Option 2 Classic HMO

Option 1 HMO

Premera Blue Cross Medicare Advantage Classic (HMO)

Premera Blue Cross Medicare Advantage (HMO)

PresenterPresentation NotesFACILITATOR: Each person has unique needs and a personal budget when it comes to Medicare Advantage coverage. That is why we offer three Health Maintenance Organization (HMO) plans.

An HMO plan has a network of providers from which to choose. All HMO plans require you to select a primary care provider (PCP) who is in charge of your health. If you want to see a specialist for any reason, your primary care provider is responsible for providing you with a referral.

Lets review our

Medicare Advantage plans

This year make a change for the better

PresenterPresentation NotesFACILITATOR: Now lets review our Medicare Advantage HMO plans.

Our most POPULAR planno monthly premium Premera Blue Cross Medicare Advantage (HMO)

In-network only

Monthly plan premium $0

Medical deductible $0

Annual out-of-pocket maximum $6,700

Primary care provider visit $15 copay

Specialist visit $50 copay

Inpatient hospital care $450 copay (days 14) $0 copay (days 5+)

Outpatient hospital care Ambulatory surgical center Outpatient hospital center

15% coinsurance 20% coinsurance

Ambulance $300 copay/each one-way trip

Emergency care (worldwide coverage) $75 copay (waived if admitted)

Urgent care (worldwide coverage) $65 copay

X-rays and Lab services $20 copay

Preventive care $0 copay

Annual physical exam $0 copay

Annual routine eye exam Not covered

Eyewear allowance Not covered

Fitness benefit program Not covered You must continue to pay your Medicare Part B premium.

PresenterPresentation NotesFACILITATOR: Lets review our most popular plan.

Using your copy of the Benefit Highlights, you can following along as I go through each of the benefits and copays.

Prescription coverage

Premera Blue Cross Medicare Advantage (HMO) Drug Coverage

Prescription drugs (30-day supply from a preferred network pharmacy)

Drug deductible (applies to tiers 3-5) $320

Tier 1 Preferred generic $5 copay (deductible waived)

Tier 2 Generic $15 copay (deductible waived)

Tier 3 Preferred brand $45 copay

Tier 4 Non-preferred drug 30% coinsurance

Tier 5 Specialty 26% coinsurance

Transition Supply Period As a new Premera Medicare Advantage member, your plan will cover a temporary supply of your drugs during the first 90 days of membership. A temporary supply of your prescription drugs allows you to transition to a new prescription covered by your plan formulary.

Search online at premera.com/ma

PresenterPresentation NotesFACILITATOR: Read the prescription coverage limits and requirements on the slide.

Transition Supply Period As a new Premera Medicare Advantage member, your plan will cover a temporary supply of your drugs during the first 90 days of membership. A temporary supply of your prescription drugs allows you to transition to a new prescription covered by your plan formularyor gain any needed prior authorizations.

Premeras in-network mail-order delivery program allows you to receive prescription drugs shipped directly to your home. You can order at least a 30-day supply of your medication and no more than a 90-day supply. Usually a prescription placed through a mail-order pharmacy will get to you in no more than 3-5 business days after the pharmacy receives your order. If you do not receive medications within this timeframe, we recommend you call Customer Service at 1-888-850-8526 (TTY: 711). You can call from 8 a.m. to 8 p.m., 7 days a week.

Preventive dental coverage optional rider

Premera Blue Cross Medicare Advantage (HMO) Preventive Dental Coverage

Preventive dental optional rider ($0 copays from a preferred network dentist)

Monthly dental premium $26

Routine oral exams $0 copay (2 every year)

Cleanings $0 copay (2 every year)

Fluoride treatments $0 copay (1 every year)

Bitewing X-rays (set of 4) $0 copay (1 set every year)

Periapical X-rays $0 copay

Panoramic or complete series X-rays $0 copay (1 set every 60 months)


Add Dental Coverage You may add the optional dental rider within 60 days of enrolling in your Premera Blue Cross Medicare Advantage (HMO) plan. Coverage is effective the first of the month following the date we receive your completed enrollment form.


You may add the optional dental rider within 60 days of enrolling in your Premera Blue Cross Medicare Advantage (HMO) plan. Coverage is effective the first of the month following the date we receive your completed enrollment form.

X-ray definitions:

Bitewing X-rays Bitewing X-rays show the upper and lower back teeth and how the teeth touch each other in a single view. These X-rays are primarily used to check for decay (cavities) between the teeth and to show how well the upper and lower teeth line up. Bitewing X-rays can also show bone loss when severe gum disease or a dental infection is present. Bitewing X-rays are most often performed in conjunction with routine periodic oral examinations based on the persons age and oral health.

Periapical X-rays Periapical X-rays show the entire tooth, from the exposed crown to the end of the root and the bones that support the tooth, these X-rays are often used when a person is having symptoms with a tooth or follow up to a dental procedure. Periapical X-rays are most often used to find dental problems below the gum line or in the jaw, such as abscesses, deep decay, cysts, tumors, and bone changes linked to diseases.

Panoramic X-rays Panoramic X-rays show a broad view of the jaws, teeth, sinuses, nasal area, and temporomandibular (jaw) joints. Panoramic X-rays are not intended to find cavities, they are intended to show problems such as impacted teeth, bone abnormalities, cysts, solid growths (tumors), infections, and fractures.

Complete series (full-mouth series) X-rays A full-mouth series of periapical and posterior bitewing X-rays (about 14 to 22 X-ray films) is most often done during a person's first visit to the dentist to determine the current status of oral health and help identify future changes in the growth and development of teeth.

Classic coverage and extra benefits

Premera Blue Cross Medicare Advantage Classic (HMO) In-network only








15% coinsurance 20% coinsurance







Annual routine eye exam $50 copay

Eyewear allowance $150 reimbursement

Fitness benefit program $0

You must continue to pay your Medicare Part B premium.

PresenterPresentation NotesFACILITATOR: Lets review our plan that offers classic coverage and extra benefits.



Premera Blue Cross Medicare Advantage Classic (HMO) Drug Coverage













Preventive dental coverage included

Premera Blue Cross Medicare Advantage Classic (HMO) Preventive Dental Coverage

Preventive dental included ($0 copays from a preferred network dentist)










X-ray definitions:





Lower out-of-pocket costs PLUS extra benefits Premera Blue Cross Medicare Advantage

Classic Plus (HMO) In-network only








$250 copay







Annual routine eye exam $40 copay

Eyewear allowance $150 reimbursement

Fitness benefit Program $0 You must continue to pay your Medicare Part B premium.

PresenterPresentation NotesFACILITATOR: Lets look at our plan that provides lower out-of-pocket costs plus extra benefits.



Premera Blue Cross Medicare Advantage Classic Plus (HMO) Drug Coverage













Preventive dental coverage - included

Premera Blue Cross Medicare Advantage Classic Plus (HMO) Preventive Dental Coverage

Preventive dental included ($0 copays from a preferred network dentist)









PresenterPresentation NotesFACILITATOR: Read the dental benefits and requirements on the slide.

X-ray definitions:





Medical network With thousands of local doctors in our Medicare Advantage network, youll be sure to find a provider thats right for you and close to home.

Western Washington Providers Eastern Washington Providers

EvergreenHealth Columbia Medical Associates

MultiCare Health System Deaconess Medical Center

Overlake Medical Center Providence Health and Services

Providence Health & Services

Swedish Medical Center

The Everett Clinic

The Polyclinic Rockwood Clinic

Virginia Mason Valley Hospital

UW Medicine The above list is not a complete list of participating and/or preferred providers.

Providence Holy Family Hospital

Providence Sacred Heart Medical

Center & Childrens Hospital


PresenterPresentation NotesFACILITATOR: Medical Network: Premera contracts with thousands of doctors in our Medicare Advantage network.

Its likely your preferred provider is already part of our health plan.

Ask us if you need help finding a provider thats right for you close to home.

Pharmacy network Premera contracts with national pharmacy chains and many independent

and local pharmacies. Preferred pharmacies allow members to pay the lowest cost for covered

generic medications.

Preferred Pharmacies Standard Pharmacies

Bartell Drugs Providence Pharmacy The Medicine Shoppe

Bi-Mart Pharmacy QFC Pharmacy Rite-Aid Pharmacy

Costco Pharmacy Safeway Pharmacy Target Pharmacy

Franciscan Pharmacy Savon Pharmacy Wal-Mart Pharmacy

Fred Meyer Pharmacy Walgreens Pharmacy

Haggan Pharmacy Yokes Pharmacy

Hi-School Pharmacy

The above list is not a complete list of participating and/or preferred pharmacies.


PresenterPresentation NotesFACILITATOR: The provider and pharmacy directory lists all of the plans in-network providers and pharmacies, or visit our website for the most up to date listing.

Premera Blue Cross Medicare Advantage Plans use both preferred network and network pharmacies. Preferred network pharmacies may offer lower cost-sharing than other network pharmacies. Please see the provider and pharmacy directory for a complete listing of both preferred network and network pharmacies.

A list of covered medications can be found using our plans formulary or online at premera.com/ma. The formulary includes information on restrictions, limitations and transition coverage.

Enrolling is easy!

Five things to remember 1. You have a choice of Premera plans

including a $0 premium

2. Plans with extra benefits, dental, vision, gym membership

3. Providers you know and trust

4. Were part of your community (for 80+ years)

5. You have a local team focused on you

PresenterPresentation NotesFACILITATOR: Read the bullets listed on the slide.

Our team includes me, our sales team and our customer service unit dedicated to Medicare and you.

Enroll today

PresenterPresentation NotesFACILITATOR: We can help you enroll today in one of Premera Blue Cross Medicare Advantage Plans.

I also want to point out that there are other, convenient ways to enroll as well. You can enroll by mailing in a paper application, by going online at premera.com/ma or you can enroll over the phone by calling 888-868-7767 (TTY: 711), seven days a week from 8 a.m. to 8 p.m.

You have an enrollment form in front of you. It only takes a few minutes to become a Premera Medicare Advantage member today.

The new member experience

The new member experience

PresenterPresentation NotesFACILITATOR: Lets take a final few moments to talk about what you can expect as a new member of Premera Blue Cross.

The new member experience Your new member welcome kit with important plan information about covered benefits and

services will be mailed to you. To learn more about the entire provider network, visit premera.com/ma.

Your plan membership ID card will be mailed separately in a Premera envelope. Your ID card must be used when accessing covered medical and plan services.

Your welcome call will give you an opportunity to ask us questions.

Youll receive an Outbound Enrollment Verification (OEV) communication confirming your intent in enrolling in the Medicare Advantage plan you selected.

Your fitness benefit provider will send you an ID card for use at participating gyms and fitness centers if you elect the Classic HMO or Classic Plus HMO plan.

A Health Risk Assessment (HRA) survey will also be mailed to you with basic questions about your overall health. A prepaid envelope will allow you to return the survey at no cost to you.

Your membership will generally become effective on the first day of the following month.

Plans will become effective as of January 1 for enrollees in October, November and December (during the Annual Enrollment Period).

PresenterPresentation NotesFACILITATOR: Read the bullets listed on the slide.

Important plan information Premera Blue Cross is an HMO plan with a Medicare contract. This information is not a complete description of benefits. Contact the plan for more information. Enrollment in Premera Blue Cross depends on contract renewal. Limitations, copayments and restrictions may apply. Benefits, premium and/or copayments/coinsurance may change on January 1 of each year. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary. You must continue to pay your Part B premium. For 2017, Premera Blue Cross Medicare Advantage plan received an overall 3.5 out of 5 Star Rating from Medicare. Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next. Premera Blue Cross is an Independent Licensee of the Blue Cross and Blue Shield Association.

028403 (11-2016) H7245_PBC0804_Approved

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