Meet WellCare. We have plans that offer $0 generic co-payments. Welcome! No deductible. And affordable premiums. We make it easier to save with PDPs.

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1 Meet WellCare We make it easier to save with PDPs Welcome! Dear At WellCare, we help you get more for your Medicare dollar. WellCare has been in business for over 20 years. We offer only government health care programs like Medicare, so we know how to create plans that are easy to understand, easy to use, and give you real savings. This letter has lots of good information about our Prescription Drug Plans (also called PDPs or Part D), so you should keep it handy for future reference. We have plans that offer $0 generic co-payments. No deductible. And affordable premiums. (See the back page of this letter for the plans and rates for your state.) S5967_NA07465_PDP_LTR_ENG (09/05/2008) WellCare 2008 NA_05_08

2 Our WellCare Signature Plan has $0 generics. The Signature Plan is our best-selling PDP plan and for good reason. The plan offers: $0 co-payment for generic drugs No deductible Simple co-payments for brand drugs (see the grid on the back page) Affordable premiums (see the grid on the back page) Our WellCare Classic Plan is also popular. This plan offers: $0 co-payment for generic drugs No deductible if you use generic drugs Simple co-payments for brand drugs (see the grid on the back page) Affordable premiums (see the grid on the back page) If you qualify for both Medicare and Medicaid, the plan works differently. You could pay no monthly premium for the WellCare Classic Plan. Call Customer Service for details specific to your state. Using generic drugs can really help you save money. Great plans are just the beginning. Of course we offer money-saving plans, but we also want to make sure you get the prescriptions you need at a pharmacy you trust. We offer prescription drugs in every Medicare-approved category. Just take a look at the enclosed WellCare Abridged Formulary to see if the prescriptions you re taking now are covered. If you don t see a drug you take now, don t worry. It s just a partial list, so it s likely that your prescription drug is covered or that we have an alternative. If you have any questions, just give us a call. Or go to and click on Medication Guide for the complete list. If you really want to save, try generics. These days, more than half of all prescriptions are filled with generic drugs! Generics are FDA-approved to be the same as brand drugs in dosage, safety and strength. They re less costly because they are created after the original brand drug s patent expires that means many companies can make the same drug, so you get more competitive prices. To find out if generics may be right for you, just ask your doctor or pharmacist. Best of all, using generic drugs can help you stay out of the coverage gap. Want to know more? The chart to the right shows you how the gap works for the Signature Plan and how generics can help you avoid it. 2

3 How the WellCare Signature Plan covers you: REGULAR COVERAGE THE COVERAGE GAP CATASTROPHIC COVERAGE $0 $2,700 $4,350 Regular coverage starts right away, because the WellCare Signature Plan has no deductible. You pay the co-payment for the prescriptions you receive (remember, there s no co-payment for generic drugs). The coverage gap starts when you and WellCare have spent $2,700 on drugs. Now, you pay for 100% of your prescriptions (at WellCare s low, negotiated rate). Catastrophic coverage begins when you have spent $4,350 on drugs. For the rest of the year, WellCare pays 95% of your drug costs, while you pay 5%. The coverage gap works differently for people who qualify for extra help. Want to know more? Just call the toll-free Customer Service number listed below. Recognized by J.D. Power and Associates as An Outstanding Customer Service Experience. * We put a priority on customer service that s why J.D. Power and Associates recognized us for excellence in that category. One example of our commitment a real person on the line during our call hours Monday Sunday, 7am to 2am Eastern. Because when it comes to your health, talking to a machine isn t always right. There are three easy ways to join WellCare, so enroll today! All our plans offer real value and caring service to our members. If you want more from your Medicare, don t wait to join. Fill out and mail in the enclosed enrollment form; Enroll online at or Call us at (TTY/TDD users call ), Monday Sunday, 7am to 2am Eastern. We look forward to serving you soon. Sincerely, WellCare Prescription Insurance, Inc. *For certification status, a call center must perform within the top 20 percent of customer service scores, which are based on benchmarks established in J.D. Power and Associates cross-industry customer satisfaction research. As part of its evaluation, J.D. Power and Associates conducted a random survey of WellCare Health Plans, Inc. customers who recently contacted its call centers. For J.D. Power and Associates Certified Call Center Program SM information, visit 3

4 The WellCare Pharmacy Guide This is a partial list of the pharmacies you can use with WellCare (the full list was too long to include here). We have over 65,000 pharmacies in our network, including most major chains and lots of independent, neighborhood pharmacies, too. So if you don t see your pharmacy here, call Customer Service or visit our Web site at and click on Our Pharmacies to see if they are in our network and what alternatives are convenient for you. NOTE: Members must use network pharmacies to get their prescription drug benefits. There are some occasions, under emergency circumstances, where you can use a non-network pharmacy. Please call Customer Service for more information. 4

5 Don t see your pharmacy? There are a lot more in our network for a full list, visit or call (TTY/TDD users, call ), Monday Sunday, 7am to 2am Eastern. Acme Pharmacy Albertsons Pharmacy Aurora Pharmacy Bartell Bi-Lo Pharmacy Brooks Brookshire Costco Pharmacy Cub Pharmacy CVS Pharmacy 800-SHOP-CVS Dillon s Pharmacy 800-KROGERS Discount Drug Mart Dominick s Pharmacy Duane Reade Eckerd Family Pharmacy Farmer Jack Pharmacy 877-FARJACK Food City Pharmacy Fred Meyer 800-KROGERS Fry s 800-KROGERS Giant Eagle Giant Pharmacy H E B Pharmacy Happy Harry s Harris Teeter Hy-Vee Pharmacy Kash N Karry Pharmacy Kerr Drug King Soopers Pharmacy 800-KROGERS Kinney Drugs Kmart Pharmacy Kroger 800-KROGERS Longs Drugs Pharmacy Medicap Pharmacy Medicine Shoppe Meijer Pharmacy Osco Drug Pamida Pharmacy Pathmark Pharmacy Publix Raley s Drug Center 800-RALEYSS Ralphs Pharmacy 800-KROGERS Randalls Pharmacy Rite Aid Pharmacy 800-RITEAID Safeway Sam s Club 800-WAL-MART Save Mart Pharmacy Schnucks Pharmacy Shaw s/osco Pharmacy Shop N Save Shopko Pharmacy Shoprite Pharmacy Smith s Pharmacy 800-KROGERS Snyders Drug Store Stop & Shop Pharmacy Target Tom Thumb Pharmacy Tops Pharmacy Vons Pharmacy Wal-Mart 800-WAL-MART Walgreens Wegmans Pharmacy 800-WEGMANS Weis Pharmacy Winn-Dixie Pharmacy

6 Terms and Conditions 2009 To be eligible, you must be eligible for Medicare Part A, or enrolled in Medicare Part B. You must also live in the plan s service area. Network pharmacies include retail, mail-order, specialty, long-term care, home infusion and Indian Health Services pharmacies. For more information on mail-order prescription drug service, contact Customer Service. To obtain names/addresses of WellCare s network pharmacies, call (TTY/TDD users call ), Monday Sunday, 7am to 2am Eastern. You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances (e.g., emergencies) when you cannot reasonably use network pharmacies. You may be enrolled in only one Medicare Part D plan at a time. If you are enrolled in a Medicare Advantage Plan (or MA plan), you may not enroll in a Part D plan unless you are a member of a Private Fee-for-Service MA plan (PFFS) that does not provide Medicare Prescription Drug Coverage, a medical savings account MA plan (MSA), or an 1876 cost plan. If you are enrolled in an MA coordinated care (HMO or PPO) plan, or an MA PFFS plan that includes Medicare prescription drugs, you may not enroll in a PDP unless you disenroll from the HMO, PPO, or MA PFFS plan. Enrollment periods into a prescription drug plan occur during specific times of the year. Please call Customer Service to obtain more information on enrollment periods. If you have qualified for additional assistance with your Medicare Prescription Drug Plan costs, the amount of your premium and cost at the pharmacy will be less. Once you have enrolled in WellCare, Medicare will tell us how much assistance you are receiving, and we will send you information on the amount you will pay. You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: MEDICARE ( ). TTY/TDD users should call , 24 hours a day, 7 days a week; the Social Security Administration at (TTY/TDD users call ), Monday Friday, 7am to 7pm; your state Medicaid office WellCare may reduce its service area and no longer offer services in the area where you reside. Materials are available in alternative formats. Materials are designed for people on both Medicare and Medicaid. Medicare beneficiaries may enroll in WellCare through the Centers for Medicare and Medicaid Services Online Enrollment Center, located at For more information, contact WellCare at (TTY/TDD users call ), Monday Sunday, 7am to 2am Eastern. WellCare is open to all Medicare beneficiaries eligible by age or disability in the WellCare service area. Benefits, formulary, pharmacy network, premium and/or co-payments/coinsurance may change on January 1, Benefits and limitations may vary by plan and by region. Please contact WellCare for details. 6

7 The person who is discussing plan options with you is either employed by or contracted with WellCare Signature and Classic. The person may be compensated based on your enrollment in a plan. For full information on WellCare prescription drug benefits, call WellCare Customer Service at (TTY/TDD users call ), Monday Sunday, 7am to 2am Eastern. WellCare is a prescription drug plan with a Medicare contract that is renewed annually, and the availability of coverage beyond the end of the current contract year is not guaranteed. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. WellCare uses a formulary. WellCare s Grievance, Coverage Determination and Appeal Processes WellCare has an appeals and grievance process for plan members. If you think that WellCare should cover a certain benefit, you have the right to request a coverage determination. For situations in which you have a medication that is not on the WellCare formulary, or is part of a tier level designated as non-preferred, but you believe it should be placed in a different tier, an exceptions process has been established by the plan. Exception requests will be reviewed by the plan as coverage determinations. After a coverage determination, if WellCare denies coverage or payment for health care services that you think should be covered, you have the right to an appeal (redetermination). If the decision of the appeal (redetermination) is to continue the denial of coverage or payment, you have the right to file a request for reconsideration with Maximus, a company contracted by Medicare to review Managed Care Organization denials. You have the right to file a grievance when unsatisfied with WellCare, a provider, or health care services you have received. Please contact WellCare for questions regarding your right to file a coverage determination, an appeal (redetermination), a reconsideration, or a grievance

8 These are the 2009 WellCare PDP benefit costs for your area, including the premium rates for Pennsylvania, West Virginia/Region 06. WellCare Benefits WellCare Signature WellCare Classic Deductible $0 $295 Brand drug only Generic Drug Co-payment $0 co-payment $0 co-payment Preferred Brand Drug Co-payment $39 co-payment $31 co-payment Non-Preferred Brand Drug Co-payment $79 co-payment $78 co-payment Monthly Premium $33.90 $31.40 On a limited income? You may be eligible for extra help and your costs could be less than shown in the chart above. You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call MEDICARE ( ), 24 hours a day, 7 days a week (TTY/TDD users should call ). You may also call the Social Security Administration at between 7am and 7pm, Monday through Friday (TTY/TDD users should call ), or your state Medicaid office. If you have qualified for additional assistance for your Medicare Prescription Drug Plan costs, the amount of your premium and drug co-payment will be less than noted in the chart above. Once you have enrolled in WellCare, Medicare will tell us how much assistance you are receiving and we will send you information on the amount you will pay. And don t forget the WellCare Classic Plan offers $0 generic co-payments. Plus, if you qualify, you could pay little or no monthly premium. Only government-approved plans can carry this Medicare Rx logo. Enroll Today just give us a call! Call (TTY/TDD users, call ), Monday Sunday, 7am to 2am Eastern. Or, visit