YOUR CARE. YOUR COVERAGE. YOU RE CONNECTED.

Transcription

1 YOUR CARE. YOUR COVERAGE. YOU RE CONNECTED. One plan brings it all together for you.

2 Why Choose Advantage MD for my Medicare plan? With Johns Hopkins Advantage MD (HMO and PPO), you re getting more than a typical Medicare plan. You re connecting with a comprehensive health care plan that combines your coverage and your care, which includes the Advantage MD Care Team. You ll also have a choice of plan options that help protect you from rising health care costs. All with low monthly premiums, low copays and $0 medical deductibles. And, it s all from Johns Hopkins, a Maryland health care leader.* For over 125 years, we ve been taking care of our neighbors. We re ready to take care of you, too. 3 Easy Steps 1 to find the plan that s right for you. It s easy to find a Medicare plan that exceeds your expectations. Advantage MD members can enjoy life with greater confidence and security, knowing the expertise, strength and knowledge of a highly rated global leader in health care is behind their Medicare plan. LEARN what s missing from your current Medicare coverage. What s missing from my Medicare plan?... p. 3 Why Advantage MD is my choice: When you re ready to enroll, we re here to help! (8 a.m. to 8 p.m., Monday Friday between April 1 and September 30) Or enroll online today at HopkinsMedicare.com. It s nice knowing this plan comes from a name I know and trust. People who care about Maryland residents. To enroll in Advantage MD, you must have Medicare Part A and Part B and live in one of these counties: Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico or Worcester. *Best Regional Hospitals Rankings, U.S. News & World Report. 2 3 Am I paying too much for my Medicare Supplement plan?... p. 3 DISCOVER the advantages of Johns Hopkins Medicare Advantage plans and compare our plans to your current coverage. What s better about Johns Hopkins Medicare Advantage plans?... p. 4 What will the Advantage MD Care Team do for me?... p. 4 Which plan is right for me?... p. 5 ENROLL in the Advantage MD plan that s right for you! How extensive is the Advantage MD network?... p. 7 I have more questions!... p. 8 1 ADVANTAGE MD Plan Highlights 2 ADVANTAGE MD Plan Highlights

3 1 LEARN 2 DISCOVER What s Missing from my Medicare plan? Did you know Original Medicare pays just 80% of the costs for covered expenses? You pay the rest! As good as it is, Medicare was never meant to cover all your medical, prescription and wellness expenses. On average, Medicare covers about 80%, leaving the other 20% for you to pay. That 20% can add up to thousands of dollars in a year. Medicare also does not pay for prescription drugs. There are no benefits for routine dental, vision or hearing care either. You pay for Medicare. You pay for your Supplement. You pay for your drug plan. Here is one example of how you may be overpaying for health insurance: Simply put, relying on Medicare alone to provide for all your health and well-care cannot give you the well-rounded benefits you need, and you could find it puts your finances at risk. Am i paying too much for my Medicare supplement plan? There is a better, less costly answer, and one that still gives you the freedom to see the providers you want.** What s BETTER About: More benefits. Built-in savings. Prescription drug coverage. Access to quality care. PLUS, you have access to the newly expanded Care Team. Choose from three affordable all-in-one plans that offer you: Medical and hospital benefits beyond Original Medicare 100% coverage for Medicare Parts A and B deductibles save up to $1,523 a year Prescription drug coverage with low copays New, lower Urgent Care copay for 2019 Dental, hearing and vision benefits $150 annual eyewear reimbursement Access to over 10,000 doctors and hospitals across Maryland including Johns Hopkins providers Comprehensive. Cost-conscious. Connected. Johns Hopkins Advantage MD connects you to what you need to stay healthy and save money. Why Advantage MD is my choice: I like having an Advantage MD Care Team so I can get personalized care when I need it. Premiums for popular Medicare Supplement Plan F in Maryland range from $151 to $344 a month.* Add to that Medicare s Part B premium of $134 a month. Plus, as with Medicare, Medicare Supplement plans won t pay for prescription drugs or other health care like preventive dental, routine vision or hearing care. Having three plans is costly and inconvenient. What will the Advantage MD Care Team do for me? You ll have access to a team of professionals dedicated to providing personalized support at no extra cost. From setting up appointments and medication guidance, to managing a health condition we re here for you! There s even a 24/7 Nurse Chat service by phone or online for medical advice and answers to health questions. It s a complete suite of personalized care services to help you live your best life. * Monthly premiums for Medicare Supplement Plan F in MD range from $151 $344. Based on available 2018 premium information on medicare.gov. Applicable to HMO and PPO Plus only. ** Out-of-network costs are slightly higher for the PPO plans. HMO plan members Annual coverage/savings based on combined cost of Medicare 3 ADVANTAGE MD Plan Highlights Part A deductible ($1,340) and Medicare Part B deductible ($183). 4 ADVANTAGE MD Plan Highlights must use in-network providers.

4 2 DISCOVER Which plan is right for me? Looking for expert care in an all-in-one plan with a low monthly premium? Our HMO members save each month with low monthly premiums while enjoying easy access to the Advantage MD network of the state s leading health systems including Johns Hopkins physicians and hospitals. From everyday and preventive health needs to the most critical medical procedures, our members rest easy, knowing they have the best of care. Want the freedom to see any doctor you want,** have lower copays, and get a fitness plan? Advantage MD (PPO) members enjoy access to health care providers both in- and out-of-network,** and lower copays for nearly all health care services. PPO Plus also includes the Silver&Fit fitness program. Earn rewards exercising at a gym, or in the comfort of your own home. Join Healthy Aging classes (online or DVD), or order home fitness kits for yoga, Pilates, tai chi, cardio, strength and more. Medical Benefits (Partial listing; In-network) Johns Hopkins Advantage MD (HMO) Monthly Plan Premium Baltimore City: $0 Other cities/counties in Advantage MD Service Area: $25 Johns Hopkins Advantage MD (PPO) $60 $90 Medical Deductible $0 $0 $0 Primary Care Provider Visit $5 copay $10 copay $5 copay Specialist Visit $50 copay $50 copay $50 copay Referrals Required Not required Not required Urgent Care $40 copay $40 copay $40 copay Outpatient Surgery, ASC $250 copay $250 copay $250 copay Emergency Care $90 copay $90 copay $90 copay Inpatient Hospital Stay $310/day copay for days 1 6; $0 copay for days 7 90 Lifetime Reserve Annual Routine Vision Exam $0 copay; up to $150 allowance for eyewear every two years Preventive Dental Services $15 $25 copay, depending on service $310/day copay for days 1 6; $0 copay for days 7 90 Lifetime Reserve $0 copay $15 $25 copay, depending on service Johns Hopkins Advantage MD Plus (PPO) $310/day copay for days 1 6; $0 copay for days 7 90 Lifetime Reserve $0 copay; up to $150 allowance for eyewear every two years $10 $20 copay, depending on service Routine Chiropractic Care N/A N/A $20 copay; up to 12 annually Hearing Aid Services Two options available, Two options available, Two options available, $699 or $999 copay per aid $699 or $999 copay per aid $699 or $999 copay per aid Silver&Fit Program Optional* Optional* Included Supplemental Comprehensive Dental PRESCRIPTION DRUG BENEFITS (30-day supply) Optional* (see separate brochure for more information) Deductible $0 $350 (for Tiers 3, 4 and 5) $350 (for Tiers 3, 4 and 5) *Optional benefits available for additional premiums. ** Out-of-network costs are slightly higher for the PPO plans. HMO plan members must use in-network providers. Johns Hopkins Advantage MD (PPO) has an in-network out-of-pocket maximum of $6,700 and a combined in- and out-of-network maximum of $10,000 for Johns Hopkins Advantage MD Plus (PPO) has an in-network out-of-pocket maximum of $6,700 and a combined in- and out-of-network maximum of $10,000 for For out-of-network benefits, you pay a percentage for most covered services. Johns Hopkins Advantage MD (HMO) has an in-network, out-of-pocket maximum of $6,700 for Preferred generic Generic Preferred brand Non-preferred drug Specialty $0 copay $10 copay $47 copay $100 copay 33% of the cost $7 copay $15 copay $47 copay $100 copay 26% of the cost $4 copay $12 copay $47 copay $100 copay 26% of the cost Mail order Available Available Available Advantage MD (HMO) $25 premium for the following counties: Anne Arundel, Baltimore, Calvert, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico and Worcester 5 ADVANTAGE MD Plan Highlights 6 ADVANTAGE MD Plan Highlights

5 3 ENROLL Better care begins with your doctor. Your primary doctor is the key to coordinating your health care. It s why Advantage MD gives you access to over 10,000 providers all connected to the services you need to stay healthy. You have questions. We have answers. Q: Are Medicare Advantage and Medicare Supplement plans the same thing? Adventist HealthCare Anne Arundel Medical Center Frederick Regional Health System Johns Hopkins Medicine Other providers are available in our network. LifeBridge Health Mercy Medical Center Peninsula Regional Medical Center A: Medicare Advantage (MA) plans are offered by private companies, contracted through the federal Medicare program, to administer your health plan and pay your health care bills. MA plans often include prescription drug coverage and extra benefits like dental, vision and wellness benefits to help keep you healthy while also protecting you against expenses that Medicare doesn t cover. MA plans typically cap your annual out-of-pocket costs and are also well-regarded for ease of use, convenience and affordability. Medicare Supplement plans work in conjunction with your traditional Medicare coverage to help offset some of the expenses that Original Medicare doesn t cover. You would need to purchase a separate Medicare prescription drug plan, however, as Medicare Supplement plans do not cover prescription drugs, nor do they include the kinds of extra benefits that MA plans do. There is also no cap on your annual out-of-pocket spending with Medicare and a Medicare Supplement plan.** Ready to enroll in Advantage MD? Q: What does it cost to have this coverage? A: Advantage MD (HMO) is $25 a month ($0 in Baltimore City). Advantage MD (PPO) is $60 a month. Advantage MD Plus (PPO) is $90 a month. However, you must also continue to pay your Medicare Part B premium. Q: How can I pay my Advantage MD premium? Visit HopkinsMedicare.com to enroll online.* 8 a.m. to 8 p.m., Monday Friday between April 1 and September 30 7 ADVANTAGE MD Plan Highlights Use the application enclosed and return by mail. Call today to enroll right over the phone. * Medicare beneficiaries may also enroll in Johns Hopkins Advantage MD through the CMS Medicare Online Enrollment Center located at A: You can pay your premium by using electronic funds transfer (EFT) from your bank account or automatically deducting it from your Social Security or Railroad Retirement Board (RRB) benefit check. You can also receive a monthly statement. If you enroll in EFT, Social Security or RRB you don t have to wait on monthly statements or write checks. The EFT enrollment process usually takes 4 5 weeks. Enrolling in automatic withdraw from Social Security takes a minimum of 90 days. While you are waiting for EFT or Social Security withdraw to start, you will receive monthly statements. You must pay your premium directly to Advantage MD. Q: What benefits does Advantage MD cover that Original Medicare doesn t? A: You ll want to review the enclosed Summary of Benefits to see all of the benefits covered under Advantage MD. To summarize, Johns Hopkins Advantage MD covers doctor, specialist and hospital care, medical services, prescription drugs, preventive dental, routine vision and hearing care. (Continued on next page) **Medicare Supplement plans K and L offer an out-of-pocket limit. 8 ADVANTAGE MD Plan Highlights

6 Why Advantage MD is my choice: I like having coverage beyond Original Medicare I save money every time I fill my prescriptions. (Continued from previous page) Q: What s the difference between a PPO plan and an HMO plan? A: The monthly cost and copays of an HMO plan are usually lower because you need to use in-network doctors and hospitals. You also need a referral from your primary care physician (PCP) to see specialists when you have an HMO plan. With a PPO plan, you don t need a referral from your PCP to see specialists and you can go in- and out-of-network for care. However, going out-of-network can result in a slightly higher cost. If you go to a provider outside of our HMO network for non-emergency care, you will be responsible for the entire cost. Q: Do I need to go to Baltimore for my health care? Johns Hopkins Advantage MD is a Medicare Advantage Plan with a Medicare contract offering HMO and PPO products. Enrollment in Johns Hopkins Advantage MD HMO or PPO depends on contract renewal. This information is not a complete description of benefits. Call (TTY: 711) for more information. To join a Johns Hopkins Advantage MD plan, you must have Medicare Part A and Part B, and live in the service area (Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico and Worcester counties). Please contact the plan for more details. Medicare beneficiaries may also enroll in Johns Hopkins Advantage MD through the CMS Medicare Online Enrollment Center located at Silver&Fit is a registered trademark of American Specialty Health Incorporated. Out-of-network/non-contracted providers are under no obligation to treat Johns Hopkins Advantage MD members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Advantage MD products are offered by Hopkins Health Advantage, Inc., a Maryland health insurer. A: No. While Baltimore County and Baltimore City are included in our service area, you can choose any of our 10,000+ participating providers located in your community and across Maryland. With both Advantage MD PPO plans, you also have the freedom to use any other doctor or hospital you want. Please note that out-of-network costs are slightly higher. Q: When are the Medicare Enrollment Periods? A: Those already on Medicare must enroll during the Annual Election Period (AEP), which takes place every year from October 15 to December 7. If you re new to Medicare, you have a 7-month window in which to enroll (this is your Initial Enrollment Period): three months before you turn 65, the month of your birthday, and three months after the month you turn 65. If you don t enroll during these seven months, you re subject to a possible penalty. Have a Question? Ask A local Medicare Specialist. 8 a.m. to 8 p.m., Monday Friday between April 1 and September 30 9 ADVANTAGE MD Plan Highlights 10 ADVANTAGE MD Plan Highlights

7 Questions? Want to enroll by phone? Connect with one of our local Medicare Specialists today. We re ready to help you. 8 a.m. to 8 p.m., Monday Friday between April 1 and September 30 Y0124_PEKBRO2_0818_M Accepted 8783(10/18)BRO