2012 Health Plans

The plans shown below are available for enrollment during the 2012 annual election period from October 15 to December 7, 2011. The plans will be effective January 1, 2012.

The following is information on 2012 health plans.

Keystone 65 HMO – Health Maintenance Organization

Keystone 65 HMO plan provides more coverage than a typical Medicare Supplement and Original Medicare combined. There’s emphasis on preventative care — with many services covered at no cost to you. What’s more, with Keystone 65 HMO, you can have added convenience — with a plan that includes both your medical and your Medicare prescription drug coverage.

Keystone 65 Select and Preferred HMO
Keystone 65 HMO Select and Preferred are Medicare Advantage HMO plans designed for members who are looking for everything from lower monthly premiums to higher copays or higher monthly premiums to lower copays and everything in between.

Personal Choice 65^SM PPO – Preferred Provider Organization (PPO)

Personal Choice 65 PPO
Personal Choice 65 PPO, our Medicare Advantage PPO plan, gives you the freedom to go to any doctor or hospital in the U.S. without a referral. Unlike our HMO plan, you won’t need to select a primary care physician for your care.

MedigapSecurity – Medigap

MedigapSecurity
MedigapSecurity is our series of Medicare Supplement plans (Medigap). With a MedigapSecurity plan, members can visit any doctor that accepts Original Medicare. Our MedigapSecurity plans combine the benefits of Original Medicare and features of a traditional, fee-for-service health plan.

You can also purchase an individual Medicare prescription drug plan that can go hand in hand with any MedigapSecurity plan.

BlueExtra

BlueExtra
BlueExtra is designed as an individual supplemental insurance plan. With a BlueExtra plan, members receive coverage for vision, dental, and hearing services not covered by Medicare or your current health care plan.

More Information

For more information, please contact us.

You must continue to pay your Medicare Part B premium.

The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change January 1, 2013. Members may enroll in the plan during specific times of the year. Contact the plan for more information. Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment and any applicable conditions associated with using the plan benefits, as well as limitations, copayments, and restrictions. Members must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances, and quantity limitations and restrictions may apply.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

• 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week;
• The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or
• Your State Medicaid Office.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

Medicare beneficiaries may enroll in Keystone 65 HMO, Personal Choice 65 PPO, or Select Option PDP through the CMS Medicare Online Enrollment Center located at www.medicare.gov.

You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor Keystone 65 HMO or Personal Choice 65 PPO will be responsible for the costs.

Please contact Keystone 65 HMO or Personal Choice 65 PPO Customer Service for more information.

Website last updated: 3/6/12
Y0041_HM_12_300a Pending CMS Approval