F R E Q U E N T L Y A S K E D Q U E S T I O N S UnitedHealthcare Group Medicare Advantage PPO Plan

F R E Q U E N T L Y A S K E D Q U E S T I O N S UnitedHealthcare Group Medicare Advantage PPO Plan A. General Information About the UnitedHealthcare Group Medicare Advantage PPO Plan... 1 1. Why is Johnson & Johnson making this change?... 1 2. Who administers the Johnson & Johnson Medicare Advantage plan?... 1 3. What is the name of the Johnson & Johnson Medicare Advantage plan?... 1 4. What is the Customer Service phone number for the UnitedHealthcare Group Medicare Advantage PPO Plan?... 1 5. What is the website for the UnitedHealthcare Group Medicare Advantage PPO Plan?... 1 6. How does the new UnitedHealthcare Group Medicare Advantage PPO Plan work compared to the current 2015 Cigna Out-of-Area Plan?... 1 7. How will my coverage under the new UnitedHealthcare Group Medicare Advantage PPO Plan compare to my current coverage under the Cigna Out-of-Area Plan?... 2 8. How does the UnitedHealthcare Group Medicare Advantage PPO work when I receive a service?... 2 9. What if I receive a service from a provider that does not participate with Medicare?... 3 B. Eligibility And Enrollment... 3 1. Who is eligible for the UnitedHealthcare Group Medicare Advantage PPO Plan?... 3 2. What if both myself and my covered dependent are eligible for Medicare, but one or both of us do not have Medicare Part B?... 3 3. How do I enroll in the UnitedHealthcare Group Medicare Advantage PPO Plan?... 4 4. What will happen if I and/or one of my covered dependents are already enrolled in another Medicare Advantage plan?... 4 5. What should I or my dependent do if we do not want to be covered by the UnitedHealthcare Group Medicare Advantage PPO Plan?... 4 6. Can I have just medical coverage?... 4 7. Can a dependent have just medical coverage?... 4 8. Can I or my covered dependent have just prescription drug coverage?... 5 9. If I m not currently covering a dependent and want to cover him/her in the future, will I be able to keep my coverage in the UnitedHealthcare Medicare Advantage PPO Plan?... 5 C. Opting Out Of Or Dropping The UnitedHealthcare Group Medicare Advantage PPO Plan... 5

1. What should I do if I do not want to be covered by the UnitedHealthcare Group Medicare Advantage PPO Plan?... 5 2. How do I disenroll from the UnitedHealthcare Group Medicare Advantage PPO Plan after I ve enrolled?... 6 3. If I opt out of the UnitedHealthcare Group Medicare Advantage PPO Plan or disenroll from it after I ve enrolled, how is my Johnson & Johnson-sponsored medical and prescription coverage impacted both for me and my covered dependents?... 6 4. If I opt out or drop my UnitedHealthcare Group Medicare Advantage PPO Plan, can I reenroll in the future?... 7 5. What if I mistakenly enroll in another Medicare Advantage plan and want to have the UnitedHealthcare Group Medicare Advantage PPO Plan instead?... 7 6. If my dependent opts out of the UnitedHealthcare Group Medicare Advantage PPO Plan or disenrolls from it after having enrolled, how is his or her Johnson & Johnsonsponsored medical and prescription coverage impacted?... 7 D. Other Health Care Coverage That Could Impact My UnitedHealthcare Group Medicare Advantage PPO Plan... 8 1. What if I have other health care coverage through an employer other than the Johnson & Johnson Family of Companies or through a spouse s or partner s employer?... 8 2. What happens if I or my dependent is already enrolled in another Medicare Advantage plan?... 8 3. What if I have a Medigap policy?... 9 E. Networks/Providers... 9 1. What if one of my doctors or a facility I use is not in the plan s PPO network?... 9 2. How do I find out if a provider is in the UnitedHealthcare PPO network?... 9 F. ID Cards... 9 1. Will we be getting new ID cards with this plan?... 9 G. Monthly Contributions... 10 1. What will I pay for this new plan?... 10 H. More Information... 10 1. Am I covered when I travel?... 10 2. What if I am receiving care such as hospital care when my new medical plan coverage begins?... 10 3. How do I file a complaint or appeal?... 10 4. What should I include with my appeal?... 11 5. How many levels of appeal are there?... 11 I. Glossary of Medicare Terms... 11 1. What is Medicare Part A?... 11

2. What is Medicare Part B?... 11 3. What is Medicare Part C?... 11 4. What is Medicare Part D?... 12 5. What is a Medigap policy?... 12 6. What is the cost for a Medicare Advantage plan?... 12 7. Who is eligible for Medicare Advantage plans?... 12 8. What s the difference between an individual and a group Medicare Advantage plan?... 13

These Frequently Asked Questions (FAQs) provide information about the UnitedHealthcare Group Medicare Advantage PPO Plan for Medicare-Eligible Individuals A. General Information About the UnitedHealthcare Group Medicare Advantage PPO Plan 1. Why is Johnson & Johnson making this change? You will enjoy essentially the same benefits as are offered by today s plan for Medicare-eligible individuals and the Company can take advantage of a more efficient, more cost-effective way to deliver benefits. 2. Who administers the Johnson & Johnson Medicare Advantage plan? UnitedHealthcare administers this plan. 3. What is the name of the Johnson & Johnson Medicare Advantage plan? The plan is referred to as the UnitedHealthcare Group Medicare Advantage PPO Plan (the Plan ). 4. What is the Customer Service phone number for the UnitedHealthcare Group Medicare Advantage PPO Plan? The Customer Service phone number is 1-866-868-0511, TTY 711, 8 a.m. 8 p.m. local time, Monday Friday. This number is also on your UnitedHealthcare ID card that you will receive. 5. What is the website for the UnitedHealthcare Group Medicare Advantage PPO Plan? After your coverage in this Plan has become effective, you can create a secure online account at www.uhcretiree.com/jnj. After you ve registered, you can track your bills and payments, view your account history and access other plan information, materials and programs. 6. How does the new UnitedHealthcare Group Medicare Advantage PPO Plan work compared to the current Cigna Out-of-Area Plan? In the current Cigna Out-of-Area Plan, Medicare is the primary payer which means that claims are filed with Medicare first; then after Medicare pays its share, Cigna (a secondary payer) pays its share. With the new UnitedHealthcare Group Medicare Advantage PPO Plan, claims don t go through Medicare first. UnitedHealthcare is approved by and under contract with the Centers for Medicare & Medicaid Services (CMS) to administer all of your medical claims. 1

7. How will my coverage under the new UnitedHealthcare Group Medicare Advantage PPO Plan compare to my current coverage under the Cigna Out-of-Area Plan? This new plan offers all the benefits of Medicare Part A and Part B and expands on the benefits of the current Cigna Out-of-Area Plan. As a result, the UnitedHealthcare Group Medicare Advantage PPO Plan has: A lower annual deductible of $150. One inpatient hospital deductible of $250 per year. A better out-of-network benefit for eligible preventive care all eligible preventive care is covered at 100%, not subject to the annual deductible. A better out-of-network benefit for other eligible care eligible services received from out-of-network providers are covered at the same coinsurance level as those received from in-network providers (Plan pays 90% and you pay 10%). A hearing aid benefit of $500 toward hearing aids every 36 months. New programs such as Nurseline sm, House Calls and SilverSneakers. Information about these programs can be found in the UnitedHealthcare Group Medicare Advantage PPO Plan Guide. 8. How does the UnitedHealthcare Group Medicare Advantage PPO Plan work when I receive a service? As long as your provider participates in Medicare, present your UnitedHealthcare ID card when you see an in-network provider or any outof-network provider that is willing to submit your claim to UnitedHealthcare for covered services; then: If Your Provider Is in the UnitedHealthcare network Is not in the UnitedHealthcare network What This Means to You Your provider will always submit the claim directly to UnitedHealthcare Your provider may file the claim directly with UnitedHealthcare; or You may need to pay the provider upfront and file a claim directly with UnitedHealthcare. You will then be reimbursed according to Plan provisions. Call UnitedHealthcare and ask them to contact your doctor to see if he or she will be willing to accept payment and file a claim directly with UnitedHealthcare. 2

9. What if I receive a service from a provider that does not participate with Medicare? If a provider has opted out of Medicare (that is, does not accept Medicare patients), then you will be responsible for the full cost of any service received from that provider. Federal regulations prohibit payments from Medicare Advantage plans to providers that have opted out of Medicare. (Refer to section E, Networks/Providers, that starts on page 9 for additional provider questions. B. Eligibility And Enrollment 1. Who is eligible for the UnitedHealthcare Group Medicare Advantage PPO Plan? A salaried, non-union or Local 670 retiree; or Long Term Disability (LTD) participant; or surviving spouse/partner and their covered dependents are eligible, provided everyone who is enrolled in the Plan: Is enrolled in both Medicare Part A and Part B. Lives in the U.S. or a U.S. territory and has a physical street address (not just a PO box). Ultimately, the Centers for Medicare & Medicaid Services (CMS) determine eligibility. If CMS determines that you or a covered dependent are not eligible, your and your family s medical coverage will be changed to the UnitedHealthcare Group PPO Plan. 2. What if both myself and my covered dependent are eligible for Medicare, but one or both of us do not have Medicare Part B? You and your dependent won t be able to be enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan. Instead, you ll be enrolled in the UnitedHealthcare Group PPO Plan which has the same benefits as the current Cigna Out-of-Area Plan. While you and your dependent are covered under the UnitedHealthcare Group PPO, UnitedHealthcare will process all of your claims on a secondary basis to Medicare, even for the individual who doesn t have Medicare Part B. This means that the UnitedHealthcare Group PPO Plan will not pay for anything that Medicare would have paid, resulting in higher out-of-pocket costs for that individual. You and/or your covered dependent should enroll in Medicare B as soon as possible so that both of you may then be enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan which is more advantageous for those who are Medicare eligible. 3

3. How do I enroll in the UnitedHealthcare Group Medicare Advantage PPO Plan? During Annual Enrollment for 1/1/2016 Coverage You do not have to take any action. If you and all of your covered dependents are eligible for the UnitedHealthcare Group Medicare Advantage PPO Plan, you and your covered dependents will automatically be enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan effective January 1, 2016, provided the Centers for Medicare & Medicaid Services (CMS) approve your enrollment. Important: If you and/or a covered dependent are already enrolled in another Medicare Advantage plan, see questions 4 and 5 below and section C, Opting Out Of Or Dropping The UnitedHealthcare Group Medicare Advantage PPO Plan, that starts on page 5. After 1/1/2016 If you and all of your covered dependents become eligible for the UnitedHealthcare Group Medicare Advantage PPO Plan after January 1, 2016, you and your covered dependents will automatically be enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan on a prospective basis, provided the Centers for Medicare & Medicaid Services (CMS) approve your enrollment. 4. What will happen if I and/or one of my covered dependents are already enrolled in another Medicare Advantage plan? You and your covered dependents will still automatically be enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan. Refer to question 2 under section D, Other Health Care Coverage That Could Impact My UnitedHealthcare Group Medicare Advantage PPO Plan, on page 8. 5. What should I or my dependent do if we do not want to be covered by the UnitedHealthcare Group Medicare Advantage PPO Plan? Refer to section C, Opting Out Of Or Dropping The UnitedHealthcare Group Medicare Advantage PPO Plan, that starts on page 5. 6. Can I have just medical coverage? Yes, you may be enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan and choose to not be covered under the Express Scripts Medicare (PDP) for Johnson & Johnson. 7. Can a dependent have just medical coverage? Provided you have coverage for yourself in the UnitedHealthcare Group Medicare Advantage PPO Plan (with or without coverage under the Express Scripts Medicare (PDP) for Johnson & Johnson) a covered dependent 4

may be enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan and choose to not be covered under the Express Scripts Medicare (PDP) for Johnson & Johnson. 8. Can I or my covered dependent have just prescription drug coverage? No. You must be enrolled in a Johnson & Johnson-sponsored medical plan to have coverage under the Express Scripts Medicare (PDP) for Johnson & Johnson. For a dependent to have coverage under the Express Scripts Medicare (PDP) for Johnson & Johnson, both you and your dependent must be enrolled in a Johnson & Johnson-sponsored medical plan. 9. If I m not currently covering a dependent and want to cover him/her in the future, will I be able to keep my coverage in the UnitedHealthcare Medicare Advantage PPO Plan? It depends on the Medicare status of your dependent. If the dependent you want to cover is enrolled in both Medicare Part A and Part B: You will stay enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan, and after the Centers for Medicare & Medicaid Services (CMS) approve your dependent s enrollment, he/she will also be enrolled in that Plan. If the dependent is eligible for Medicare but is not enrolled in both Medicare Parts A and B: Your dependent should enroll in Medicare Parts A and B immediately. Until then, you and your dependent will be enrolled in the UnitedHealthcare Group PPO Plan which coordinates with Medicare Parts A and B for all covered individuals who are eligible for Medicare (even if they aren t enrolled in both Part A and Part B). If the dependent is not eligible for Medicare: You and your dependent will be enrolled in the UnitedHealthcare Group PPO Plan. This Plan will coordinate with Medicare Parts A and B for your expenses. C. Opting Out Of Or Dropping The UnitedHealthcare Group Medicare Advantage PPO Plan 1. What should I do if I do not want to be covered by the UnitedHealthcare Group Medicare Advantage PPO Plan? You and/or a covered dependent may opt out of this coverage for January 1, 2016 by calling the Johnson & Johnson Benefit Service Center (BSC) at 5

1-800-565-0122 (Monday-Friday, 9 am 5 pm ET) by November 6, 2015. (If you or a covered dependent are enrolled in another Medicare Advantage plan as of December 31, 2015, please refer to the letter you received with the Health Care Benefits for Medicare-Eligible Individuals brochure that you received for special instructions that apply to you.) Important: Because opting out will have a serious impact on your and your family s medical and prescription drug coverage, before deciding to opt out, please refer to questions 3 and 4 below to make sure you fully understand the implications of opting out. 2. How do I disenroll from the UnitedHealthcare Group Medicare Advantage PPO Plan after I ve enrolled? If you would like to disenroll from this Plan, please call the Johnson & Johnson Benefit Service Center (BSC) at 1-800-565-0122. They will send you a form to complete. You and all of your covered dependents will be disenrolled from the UnitedHealthcare Group Medicare Advantage PPO Plan as well as the Express Scripts Medicare (PDP) for Johnson & Johnson. After the Centers for Medicare & Medicaid Services (CMS) process the disenrollment, you will be notified of the effective date of your disenrollment. The UnitedHealthcare Group Medicare Advantage PPO Plan and the Express Scripts Medicare (PDP) will not pay for any services received or prescriptions filled after the effective date of your disenrollment. Important: Because disenrolling will have a serious impact on your and your family s medical and prescription drug coverage, before deciding to disenroll, please refer to questions 3 and 4 below to make sure you fully understand the implications of disenrolling. 3. If I opt out of the UnitedHealthcare Group Medicare Advantage PPO Plan or disenroll from it after I ve enrolled, how is my Johnson & Johnson-sponsored medical and prescription coverage impacted both for me and my covered dependents? You, the retiree, LTD participant or surviving spouse/partner, will lose not only your coverage under the UnitedHealthcare Group Medicare Advantage PPO Plan, but you will also automatically lose any Johnson & Johnsonsponsored prescription drug coverage you have. Additionally, if you are covering any dependents, they will automatically lose their Johnson & Johnson-sponsored medical and prescription drug coverage. Therefore, it s very important to carefully consider the impact that you, the retiree, LTD participant or surviving spouse/partner, will have on your entire family s medical and prescription drug coverage if you drop your own coverage in the UnitedHealthcare Group Medicare Advantage PPO Plan. 6

Another very important consideration is that in most cases once you ve opted out of or dropped your coverage in the UnitedHealthcare Group Medicare Advantage PPO Plan, you cannot reenroll in the future. The only exception to the reenrollment restriction is that if you are a retiree who is still under age 65, you may enroll yourself and eligible dependents any first of the month up to the first of the month of your 65 th birthday. 4. If I opt out or drop my UnitedHealthcare Group Medicare Advantage PPO Plan, can I reenroll in the future? What about my dependents? If you are an LTD participant or a surviving spouse/partner, you may not reenroll in the future. If you are a retiree age 65 or older, you may not reenroll in the future. If you are a retiree under age 65, you may enroll yourself and eligible dependents any first of the month up to the first of the month of your 65 th birthday. If you as the LTD participant, surviving spouse/partner or retiree have coverage in the UnitedHealthcare Group Medicare Advantage PPO Plan, during an Annual Enrollment Period or as a result of a qualified family status change, you may add a dependent who had previously opted out of or dropped the UnitedHealthcare Group Medicare Advantage PPO Plan (provided they are still an eligible dependent). 5. What if I mistakenly enroll in another Medicare Advantage plan and want to have the UnitedHealthcare Group Medicare Advantage PPO Plan instead? If you or a Medicare-eligible dependent enroll in another Medicare Advantage plan (including if automatically enrolled in a spouse s employer s group Medicare Advantage plan) and then realize you want to have the UnitedHealthcare Group Medicare Advantage PPO Plan instead, you ll have a limited period of time (21 days) during which your plan selection from that other plan can be reversed. For assistance, call the Johnson & Johnson Benefit Service Center (BSC) at 1-800-565-0122 during this 21-day period. After this 21-day period, you may not be able to enroll in the UnitedHealthcare Group Medicare Advantage PPO Plan (see question 4 above). 6. If my dependent opts out of the UnitedHealthcare Group Medicare Advantage PPO Plan or disenrolls from it after having enrolled, how is his or her Johnson & Johnson-sponsored medical and prescription coverage impacted? Your dependent will not have any Johnson & Johnson-sponsored medical and prescription drug coverage unless added back during a subsequent Annual Enrollment Period or as a result of a qualified status change. 7

D. Other Health Care Coverage That Could Impact My UnitedHealthcare Group Medicare Advantage PPO Plan 1. What if I have other health care coverage through an employer other than the Johnson & Johnson Family of Companies or through a spouse s or partner s employer? In some cases, joining a Medicare Advantage plan might cause you to lose that other coverage. And if you lose coverage for yourself, you may also lose coverage for your spouse and dependents. In other cases, if you join a Medicare Advantage plan, you may still be able to use that other coverage along with the Medicare Advantage plan you re enrolled in. Remember that if your spouse or partner drops their employer or union coverage, they may not be able to get it back. Therefore, when you and/or a dependent are enrolling in any Medicare Advantage plan, including the UnitedHealthcare Group Medicare Advantage PPO Plan, if you or any of your dependents have any other health care coverage through another employer or union, it s very important to talk with that employer, union or other benefits administrator about their rules before joining a Medicare Advantage plan. 2. What happens if I or my dependent is already enrolled in another Medicare Advantage plan? The Centers for Medicare & Medicaid Services (CMS) allows someone to be enrolled in only one Medicare Advantage plan and considers the last plan you re enrolled in to be your Medicare Advantage plan. Therefore, if you and/or your dependent are enrolled in another Medicare Advantage plan, enrollment into the UnitedHealthcare Group Medicare Advantage PPO Plan will disenroll you and/or your dependent from that other Medicare Advantage plan. Remember that this rule also applies if you or your dependent are enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan and join another Medicare Advantage plan CMS will disenroll you and/or your dependent from the UnitedHealthcare Group Medicare Advantage PPO Plan. Refer to questions 3 and 4 under section C, Opting Out Of Or Dropping The UnitedHealthcare Group Medicare Advantage PPO Plan, beginning on page 6 for the impact of being disenrolled from this Plan. Therefore, before deciding which Medicare Advantage plan you and/or your dependent want to be enrolled in, consider the impact on you and your family of enrolling in or disenrolling from the UnitedHealthcare Group Medicare Advantage PPO Plan or another Medicare Advantage plan. 8

3. What if I have a Medigap policy? If you have a Medigap policy (also referred to as a Medicare Supplement Insurance policy) and become enrolled in the UnitedHealthcare Group Medicare Advantage PPO Plan, you may want to drop your Medigap policy. Your Medigap policy can t be used to pay your Medicare Advantage plan deductibles, coinsurance amounts, copays or premiums. To cancel your Medigap policy, contact your insurance company. In most cases, if you drop your Medigap policy to join a Medicare Advantage plan, you won t be able to get it back. E. Networks/Providers 1. What if one of my doctors or a facility I use is not in the plan s PPO network? The new medical plan is a national PPO plan, which stands for Preferred Provider Organization. Providers that belong to the PPO are said to be in the network. With the UnitedHealthcare Group Medicare Advantage PPO Plan, however, you have the option of using in-network or out-of-network providers as long as they accept Medicare and the Plan. Either way, your coinsurance percentage for in-network and out-of-network providers is the same. You may call UnitedHealthcare and ask them to contact your doctor to see if he or she will be willing to accept payment and file a claim directly with UnitedHealthcare. 2. How do I find out if a provider is in the UnitedHealthcare PPO network? Contact UnitedHealthcare at 1-866-868-0511 (TTY 711) or at www.uhcretiree.com/jnj. F. ID Cards 1. Will we be getting new ID cards with this plan? Yes, each individual will receive their own ID card from UnitedHealthcare with a unique ID number. This will occur after the Centers for Medicare & Medicaid Services (CMS) approve your enrollment into the Plan. The new member ID cards replace your current medical plan ID cards. Beginning January 1, 2016 (or later if your enrollment is after January 1, 2016), each covered member should start showing their new card to doctors and other providers at the time they receive medical services. Medicare red, white and blue ID cards (issued by the Social Security Administration) will no longer be needed to be shown to providers, but should be kept with your important records. 9

If you and your covered dependents are enrolled in the Express Scripts Medicare (PDP) for Johnson & Johnson, you will each continue to use your Express Scripts Medicare ID cards. G. Monthly Contributions 1. What will I pay for this new plan? For 2016 there is no increase from what you pay for your current coverage in the Cigna Out-of-Area Plan, provided you have the same coverage category (e.g., you only, you + spouse/partner, etc.) in 2016 as in 2015. H. More Information 1. Am I covered when I travel? You re free to see any provider that accepts Medicare, anywhere in the U.S. or U.S. territories. If you travel outside the U.S. or U.S. territories, you will be covered for emergency medical services only. However, you will have to pay the provider directly and submit a letter with documentation of the services (itemized bill showing your name, the service, the date of service and the amount) to UnitedHealthcare for reimbursement. Note: If you reside permanently outside of the U.S. or U.S. territories, you will not be eligible for the UnitedHealthcare Group Medicare Advantage PPO Plan. Instead, you will be eligible for the UnitedHealthcare Group PPO Plan. 2. What if I am receiving care such as hospital care when my new medical plan coverage begins? UnitedHealthcare has processes in place to assure a smooth transition between the current medical plan and the new UnitedHealthcare Group Medicare Advantage PPO Plan. Call UnitedHealthcare at 1-866-868-0511 (TTY 711) if you find yourself in this situation. 3. How do I file a complaint or appeal? You, your doctor or your authorized representative can file a complaint or appeal by phone or mail within sixty (60) calendar days of the initial coverage determination. This is considered a Level 1 appeal. By Phone: Call 1-866-868-0511 (TTY 711) By Mail: UnitedHealthcare Appeals and Grievances Department P.O. Box 6106, MS CA124-0157 Cypress, CA 90630 10

4. What should I include with my appeal? You should include Your name Your address Your member ID number Reason(s) for appealing Also attach any supporting documentation such as medical records, doctors letters, or other information that explains your reason(s) for submitting the appeal. 5. How many levels of appeal are there? There are up to five levels of appeal. If an appeal is turned down at a certain level, the next level appeal can be requested in accordance with the steps on how to file for each subsequent level of appeal that will be in all response notices from the respective appeal level entity. I. Glossary of Medicare Terms 1. What is Medicare Part A? Medicare Part A (Hospital Insurance) helps cover: Inpatient care in hospitals Skilled nursing facility care Hospice care Home health care 2. What is Medicare Part B? Medicare Part B (Medical Insurance) helps cover: Services from doctors and other health care providers Outpatient care Home health care Durable medical equipment Some preventive services 3. What is Medicare Part C? Medicare Part C (also known as Medicare Advantage) plans: Include all benefits and services covered under Part A and Part B Often include Medicare prescription drug coverage (Part D) Are offered by private insurance companies approved by and under contract with the Centers for Medicare & Medicaid Services (CMS) May include extra benefits and services for an extra cost 11

Common types of Medicare Advantage plans include HMOs and Preferred Provider Organizations (PPOs) When you re enrolled in a Medicare Advantage plan, you re still in Medicare and are still entitled to all the rights and protections of Medicare. Medicare Part C plans are a way to receive all the coverage of Part A and Part B (and more). 4. What is Medicare Part D? Medicare Part D (Medicare prescription drug coverage): Helps cover the cost of prescription drugs Is run by Medicare-approved private insurance companies 5. What is a Medigap policy? A Medigap policy (also referred to as a Medicare Supplement Insurance policy) is health insurance offered by private insurance companies to help fill the gaps in Original Medicare Part A and Part B coverage. This may include deductibles, coinsurance and/or copays. These plans offer benefits that are standardized meaning that one company s Medigap Plan F must provide the same benefits as another company s Medigap Plan F (but the cost for the plans or the providers may differ) With these plans, you can go to any doctor or hospital that accepts Medicare In addition to your Part B premium, you ll pay a monthly premium to the private insurance company for the Medigap policy Medigap policies don t typically cover prescription drugs Medigap policies can t cover unreimbursed expenses from Medicare Advantage plans 6. What is the cost for a Medicare Advantage plan? When you enroll in a Medicare Advantage plan, since you still have Medicare, you must continue to pay your Part B premium. In addition to the Part B premium, an individual may have to pay a monthly premium for the Medicare Advantage plan. 7. Who is eligible for Medicare Advantage plans? To join a Medicare Advantage plan, you must meet these conditions: You are enrolled in Part A and Part B. You live in the plan s service area. 12

8. What s the difference between an individual and a group Medicare Advantage plan? Both are plans that must be approved by the Centers for Medicare & Medicaid Services. An individual plan is available to any person who has Medicare A and B who meets the individual plan s requirements. A group plan is often sponsored by an employer and is available only to former employees and their dependents who meet the group plan s eligibility requirements. Effective January 1, 2016, Johnson & Johnson is sponsoring a group Medicare Advantage plan, administered by UnitedHealthcare. The name of the plan is the UnitedHealthcare Group Medicare Advantage PPO Plan. 13