How to Assist Beneficiaries Impacted by Aetna/Coventry 2015 Part D Plans

**SPECIAL ALERT** How to Assist Beneficiaries Impacted by Aetna/Coventry 2015 Part D Plans Due to inaccurate information posted about in-network pharmacies and cost-sharing for certain Aetna/Coventry Part D plans, CMS has authorized affected beneficiaries to take advantage of a "Special Enrollment Period" (SEP) to choose a new Part D plan. Here s how you can help your patients: Beneficiaries, or their caregivers, need to call 1-800-Medicare (633-4227), and select 0 to speak directly with an agent. (Patients should be prepared to provide their Medicare information.) Phone lines may be busy, please be patient. This is the ONLY way beneficiaries can switch plans outside of the Annual Enrollment Period. Beneficiaries or their caregivers can explain to the customer service representative that they need to select a new Part D plan due to inaccurate, misleading, or deceptive marketing information about the pharmacy network that was presented on Medicare Plan Finder or Aetna s website during the 2014 open enrollment period. New enrollments won't take effect until February at the earliest, so patients may be forced to use another pharmacy for their January prescriptions or pay higher outof-pocket costs to continue to fill their prescriptions at your pharmacy. However, per CMS and Aetna, if patients continue to fill their prescriptions at your pharmacy (during the period from January 1 through March 31, 2015) they may qualify for a one-time in-network cost-sharing refund. Attached is a sample communication to affected beneficiaries on their plan options. Please continue to send in examples of patient harm or access issues to NCPA s complaint form on the NCPA homepage, under Advocacy. http://bit.ly/medicarecomplaint

Important Medicare Part D Patient Information Dear Valued Patient, Each year, Medicare prescription plans may make changes to their coverage, benefits, and costs that may affect you. Since January, you may have noticed that information provided by certain plans during the fall Annual Enrollment Period changed, affecting your ability to continue using your local trusted pharmacy. Our pharmacy s participation in Aetna s 2015 Medicare retail networks may have been inaccurately reflected on Medicare Plan Finder, Aetna s websites, and/or shared by Aetna representatives. If you have concerns about your coverage or your ability to continue to use your pharmacy, YOU MUST CALL 1-800-MEDICARE (1-800-633-4227) and follow THESE STEPS: 1. Once connected, select option 0 to speak to an agent. 2. Tell the agent you name, plan ID number (if known) and the plan in which you are enrolled. 3. Tell the agent I was misled into selecting my plan based on incorrect marketing information about a plan s network of pharmacies on Medicare s Plan Finder. I want to request a special enrollment period to switch my plan due to inaccurate information posted about my plan. As your pharmacy, we are happy to answer questions you may have about your current prescription drug plan, along with any others you may be considering. We can also print a copy of the prescriptions you re currently taking, so you can use it to make sure your drugs are covered and how much they will cost. As always, we re happy to help you get the most from your Medicare drug coverage. To your health, Your Community Pharmacy

Medicare Alert: Temporary Member Access Plan Sponsor: Coventry/Aetna Medicare Part D Effective Date: Jan. 12, 2015 Geographic Area: National If your pharmacy is a Non Participating provider in the Aetna/Coventry 2015 Standard or Standard Preferred networks, you will be able to TEMPORARILY process claims for certain Coventry Medicare Part D members at Premier Preferred in-network reimbursement rates starting Monday, Jan. 12, 2015. The effective date of this temporary transition will be Jan. 1, 2015. Standard Network Coventry Medicare Part D claims associated with this network should successfully process starting Jan. 12, 2015. Standard Preferred Network: During the temporary transition period, non-participating providers will be able to process claims for Coventry Medicare Part D members associated with the Standard Preferred network in weekly transition phases through January/February and thereafter. Announcement: This TEMPORARY Medicare Part D network transition will not impact the ongoing contracting process for the Standard or Standard Preferred Network, and you will continue to receive separate communications concerning the status of your agreement. If you have previously requested network access via our pharmacy network mailbox (PharmNetwrkSrvc@Aetna.com), we are continuing to process those requests. Aetna s goal with this temporary transition is to ensure members can easily access the drugs they need at Aetna s network pharmacies. Please look for continuing updates. We will keep you informed, including providing the date when this temporary access will end. If there are any questions regarding this communication, please contact our pharmacy network mailbox: PharmNetwrkSrvc@Aetna.com

Medicare Alert: Temporary Member Access (Continued) Please process claims for these members using the information below. Prescription Processing Information: BIN: 610014 PCN: MEDDPRIME RxGroup: CVTYMED Or CVTYRTL Or CVTYMEB Sample ID Card:

Medicare Alert: Temporary Member Access (Continued) ATTACHMENT A: Plan to Network Crosswalk Contract PBP Plan Name States Pharmacy Network COVENTRY MAPD H1013 011 Coventry Vista Ideal (HMO) FL Premier Preferred H1013 021 Coventry Vista Ideal (HMO) FL Standard Preferred H1013 024 Coventry Vista Maximum (HMO SNP) FL Standard H1013 029 Coventry Summit Plus (HMO) FL Standard Preferred H1013 030 Coventry Summit Maximum (HMO SNP) FL Standard H1013 031 Coventry Summit Ideal (HMO) FL Premier Preferred H1013 032 Coventry Summit Plus (HMO) FL Premier Preferred H1013 033 Coventry Summit Ideal (HMO) FL Premier Preferred H1013 034 Coventry Summit Maximum (HMO SNP) FL Standard H1013 035 Coventry Summit Ideal (HMO) FL Premier Preferred H1608 001 Coventry Advantra Platinum (PPO) IA, SD Standard Preferred H1608 004 Coventry Total Care (PPO) SD Standard Preferred H1608 007 Coventry Total Care (PPO) IA Standard Preferred H1608 008 Coventry Total Care (PPO) IA Standard Preferred H1609 001 Coventry Advantra Silver (HMO) IA Standard Preferred H1609 009 Coventry Total Care (HMO) IA Standard Preferred H1609 010 Coventry Total Care (HMO) IA Standard Preferred H1692 001 Advantra Silver (HMO) WV Premier Preferred H1692 002 Advantra Silver (HMO) WV Premier Preferred H2611 001 Advantra (PPO) IL, MO Standard H2611 008 Advantra Premier Plus (PPO) AR Standard Preferred H2611 018 Coventry Premier Plus (PPO) MO Standard Preferred H2663 002 Advantra Option 2 (HMO) IL, MO Standard H2663 005 Gold Advantage (HMO) IL, MO Standard H2663 006 Advantra Option 1 (HMO-POS) IL, MO Standard H2663 014 Advantra Dual Eligible SNP (HMO SNP) MO Standard H2663 015 Coventry Total Care (HMO-POS) MO Standard H2663 016 Coventry Total Care (HMO) IL Standard H2663 017 Coventry Total Care (HMO) IL Standard H2663 018 Advantra (HMO) IL Standard H2667 001 Coventry Advantage (HMO) MO Standard Preferred H2667 017 Coventry Advantage Plus (HMO-POS) MO Standard Preferred H2672 001 Advantra Advantage (HMO) KS, MO Standard Preferred H2672 008 Advantra Advantage (HMO) KS Standard Preferred H2672 009 Coventry Medicare Advantage Total Care (HMO) KS Standard Preferred H2672 010 Advantra Total Care (HMO) AR Standard Preferred H2672 012 Coventry Advantage (HMO) OK Standard Preferred H2672 018 Advantra Select Plus (HMO) AR, KS, MO, OK Standard Preferred H3928 001 Advantra (HMO) LA Premier Preferred H3928 002 Advantra (HMO) LA Premier Preferred H3959 001 Advantra Gold (HMO) PA Premier Preferred H3959 002 Advantra Gold (HMO) PA Premier Preferred H3959 010 Advantra Silver (HMO) PA Standard H3959 011 Advantra Silver (HMO) PA Premier Preferred H3959 031 Advantra Silver (HMO) PA Standard H3959 032 Advantra Silver Plus (HMO) PA Premier Preferred H3959 033 Advantra Silver (HMO) PA Standard H3959 035 Advantra Cares (HMO SNP) PA Standard H3959 036 Advantra Cares (HMO SNP) PA Standard H3959 037 Advantra Northern Pennsylvania Gold (HMO) PA Premier Preferred

ATTACHMENT A: Plan to Network Crosswalk Contract PBP Plan Name States Pharmacy Network H3959 038 Advantra UCPN Plus (HMO) PA Standard H3959 039 Advantra Silver Plus (HMO) PA Premier Preferred H5048 001 Advantra (HMO) TX Standard Preferred H5048 002 Advantra (HMO) TX Standard Preferred H5302 003 Advantra Silver (HMO-POS) GA Premier Preferred H5509 001 Advantra Freedom (PPO) KS, MO Standard Preferred H5509 003 Coventry Medicare Advantage (PPO) KS Standard Preferred H5509 010 Advantra Freedom (PPO) KS, MO Standard Preferred H5509 011 Advantra Freedom (PPO) MO Standard Preferred H5509 012 Advantra Freedom (PPO) KS Standard Preferred H5509 016 Advantra Freedom (PPO) AR Standard Preferred H5509 017 Coventry Freedom (PPO) OK Standard Preferred H5509 018 Advantra Freedom Plus (PPO) KS, MO Standard Preferred H5509 019 Coventry Total Care (PPO) KS Standard Preferred H5522 001 Advantra Gold (PPO) PA Premier Preferred H5522 002 Advantra Gold (PPO) PA Premier Preferred H5522 004 Advantra Silver (PPO) PA Premier Preferred H5522 005 Advantra Silver (PPO) PA Premier Preferred H5522 013 Advantra Silver Plus (PPO) PA Premier Preferred H5522 014 Advantra Gold (PPO) PA Premier Preferred H5522 015 Advantra Gold (PPO) PA Premier Preferred H5522 017 AdvantraOne (PPO) PA Premier Preferred H5522 018 ADVANTRA SILVER (PPO) PA Premier Preferred H7149 001 Coventry Advantra Silver (HMO) NE Standard Preferred H7149 004 Coventry Total Care (HMO) NE Standard Preferred H7149 005 Advantra Select Plus (HMO) NE Standard Preferred H7301 002 Advantra (PPO) IL Standard H7301 006 Advantra Value (PPO) IL Standard Preferred H7301 007 Advantra Value (PPO) IL Standard Preferred H7301 008 Advantra Select Plus (PPO) IL Standard Preferred H7306 001 Advantra (PPO) TX Standard H8393 001 Coventry Advantra Platinum (PPO) NE Standard Preferred H8649 003 Altius Advantra (HMO) UT, WY Standard Preferred H8980 002 Advantra Silver (PPO) OH Standard Preferred H8980 004 Advantra Gold (PPO) OH Standard Preferred H8980 005 Advantra Gold (PPO) WV Premier Preferred H8980 006 Advantra Gold (PPO) WV Premier Preferred H9847 001 Advantra Gold (PPO) NC Standard Preferred H9847 005 Advantra Preferred (PPO) GA Premier Preferred COVENTRY PDP S5569 006 First Health Part D Value Plus (PDP) NY Standard Preferred S5569 008 First Health Part D Premier Plus (PDP) NY Premier Preferred S5768 125 First Health Part D Value Plus (PDP) NH, ME Standard Preferred S5768 126 First Health Part D Value Plus (PDP) CT, MA, RI, VT Standard Preferred S5768 127 First Health Part D Value Plus (PDP) NJ Standard Preferred S5768 128 First Health Part D Value Plus (PDP) DE, DC, MD Standard Preferred S5768 129 First Health Part D Value Plus (PDP) PA, WV Standard Preferred S5768 130 First Health Part D Value Plus (PDP) VA Standard Preferred S5768 131 First Health Part D Value Plus (PDP) NC Standard Preferred S5768 132 First Health Part D Value Plus (PDP) SC Standard Preferred S5768 133 First Health Part D Value Plus (PDP) GA Standard Preferred S5768 134 First Health Part D Value Plus (PDP) FL Standard Preferred S5768 135 First Health Part D Value Plus (PDP) AL, TN Standard Preferred

ATTACHMENT A: Plan to Network Crosswalk Contract PBP Plan Name States Pharmacy Network S5768 136 First Health Part D Value Plus (PDP) MI Standard Preferred S5768 137 First Health Part D Value Plus (PDP) OH Standard Preferred S5768 138 First Health Part D Value Plus (PDP) IN, KY Standard Preferred S5768 139 First Health Part D Value Plus (PDP) WI Standard Preferred S5768 140 First Health Part D Value Plus (PDP) IL Standard Preferred S5768 141 First Health Part D Value Plus (PDP) MO Standard Preferred S5768 142 First Health Part D Value Plus (PDP) AR Standard Preferred S5768 143 First Health Part D Value Plus (PDP) MS Standard Preferred S5768 144 First Health Part D Value Plus (PDP) LA Standard Preferred S5768 145 First Health Part D Value Plus (PDP) TX Standard Preferred S5768 146 First Health Part D Value Plus (PDP) OK Standard Preferred S5768 147 First Health Part D Value Plus (PDP) KS Standard Preferred S5768 148 First Health Part D Value Plus (PDP) IA, MN, MT, ND, NE, SD, WY Standard Preferred S5768 149 First Health Part D Value Plus (PDP) NM Standard Preferred S5768 150 First Health Part D Value Plus (PDP) CO Standard Preferred S5768 151 First Health Part D Value Plus (PDP) AZ Standard Preferred S5768 152 First Health Part D Value Plus (PDP) NV Standard Preferred S5768 153 First Health Part D Value Plus (PDP) OR, WA Standard Preferred S5768 154 First Health Part D Value Plus (PDP) ID, UT Standard Preferred S5768 155 First Health Part D Value Plus (PDP) CA Standard Preferred S5768 164 First Health Part D Premier Plus (PDP) DE, DC, MD Premier Preferred S5768 165 First Health Part D Premier Plus (PDP) PA, WV Premier Preferred S5768 166 First Health Part D Premier Plus (PDP) VA Premier Preferred S5768 167 First Health Part D Premier Plus (PDP) NC Premier Preferred S5768 168 First Health Part D Premier Plus (PDP) SC Premier Preferred S5768 169 First Health Part D Premier Plus (PDP) GA Premier Preferred S5768 170 First Health Part D Premier Plus (PDP) AL, TN Premier Preferred S5768 171 First Health Part D Premier Plus (PDP) MI Premier Preferred S5768 172 First Health Part D Premier Plus (PDP) OH Premier Preferred S5768 173 First Health Part D Premier Plus (PDP) WI Premier Preferred S5768 174 First Health Part D Premier Plus (PDP) IL Premier Preferred S5768 175 First Health Part D Premier Plus (PDP) MO Premier Preferred S5768 176 First Health Part D Premier Plus (PDP) AR Premier Preferred S5768 177 First Health Part D Premier Plus (PDP) MS Premier Preferred S5768 178 First Health Part D Premier Plus (PDP) LA Premier Preferred S5768 179 First Health Part D Premier Plus (PDP) TX Premier Preferred S5768 180 First Health Part D Premier Plus (PDP) OK Premier Preferred S5768 181 First Health Part D Premier Plus (PDP) KS Premier Preferred S5768 182 First Health Part D Premier Plus (PDP) CO Premier Preferred S5768 183 First Health Part D Premier Plus (PDP) AZ Premier Preferred S5768 184 First Health Part D Premier Plus (PDP) NV Premier Preferred S5768 185 First Health Part D Premier Plus (PDP) NH, ME Premier Preferred S5768 186 First Health Part D Premier Plus (PDP) CT, MA, RI, VT Premier Preferred S5768 187 First Health Part D Premier Plus (PDP) NJ Premier Preferred S5768 188 First Health Part D Premier Plus (PDP) FL Premier Preferred S5768 189 First Health Part D Premier Plus (PDP) IN, KY Premier Preferred S5768 190 First Health Part D Premier Plus (PDP) IA, MN, MT, ND, NE, SD, WY Premier Preferred S5768 191 First Health Part D Premier Plus (PDP) NM Premier Preferred S5768 192 First Health Part D Premier Plus (PDP) OR, WA Premier Preferred S5768 193 First Health Part D Premier Plus (PDP) ID, UT Premier Preferred S5768 194 First Health Part D Premier Plus (PDP) CA Premier Preferred S5768 195 First Health Part D Premier Plus (PDP) HI Premier Preferred S5768 196 First Health Part D Premier Plus (PDP) AK Premier Preferred

ATTACHMENT A: Plan to Network Crosswalk Contract PBP Plan Name States Pharmacy Network S5768 197 First Health Part D Value Plus (PDP) AK Standard Preferred S5768 198 First Health Part D Value Plus (PDP) HI Standard Preferred