Medicare NotebookHelping you make sense of Medicare

Welcome to your Medicare NotebookWhether you’re looking for a change or are new to Medicare, this handy guide gives you clear information, helpful checklists and more. It can help you find a plan you like and that fits your life, so you can enroll easily or switch for good.

Thinking of switching to a different plan?Maybe your needs have changed or you’re looking for a better value. We’ll help you compare options. Check out these Notebook topics:

Turning 65? Caring for someone who’s eligible?You may be unfamiliar with Medicare, so we’ll start with the basics. Be sure not to miss these Notebook sections:

Maximize value, flexibility and savings

Consider what else matters to you

Take the next steps

Meet the A, B, C & D of Medicare

Take a quick quiz to find the right plan

Know when to enroll

2

Hello!

1

Do you need prescription drug coverage?

Do you need dental coverage?

Do you need vision coverage?

Do you need coverage for hearing exams and hearing aids?

Would you like 24/7 access to a nurse by phone?

Will you need worldwide emergency care?

Do you want access to wellness programs or gym memberships?

Do you prefer a set monthly premium, or would you rather only pay for the care you need?

First, decide what you needTo help you choose which Medicare option is right for you, make a list of your health care needs so you can quickly compare plans. Here are a few questions to get you started:

Home

43

You should expect to pay premiums (at least for Part B), deductibles and coinsurance for covered services. And for services and supplies not covered by Parts A or B, you will pay the full amount out of your own pocket.

Original Medicare’s basic hospital and medical coverageOriginal Medicare, which is administered by the federal government, is made up of Parts A and B. It covers certain medical services and supplies in hospitals, doctors’ offices, and other health care settings.

Skilled nursing care

Inpatient hospital stays

Hospice care

Some in-home care

Doctor visits & preventive care

Outpatient services

Medical supplies

Tests and x-rays

Medicare Part A (Hospital Insurance) helps cover:

Medicare Part B (Medical Insurance) helps cover:

Remember, high medical costs from an unexpected illness or injury can impact your retirement savings. So it’s smart to add private Medicare insurance coverage to help protect your financial and physical health.

Explore other options with extra benefits

Option 1: Medicare Advantage plans (also known as Part C) combine Parts A and B with added benefits that can include prescription drug coverage for all-in-one convenience.

Option 2: Medicare Supplement insurance plans cover some of the expenses not covered by Parts A and B to give you more comprehensive coverage.

Option 3: Prescription drug coverage (also known as Part D) helps pay for the medications prescribed by your doctor.

Meet the A, B, C & D of MedicareGood health care means different things to different people, and that’s why you’ll find a variety of Medicare options. We want to help you understand every aspect so you can make a confident, well-informed choice now — and anytime you change plans.

Here’s the scoop. The four basic plan types are:

Original Medicare (Parts A and B)

Medicare Advantage (Part C)

Medicare Supplement Insurance

Prescription Drug Plans (Part D)

Original Medicare is the base level plan. It covers some aspects of your doctor visits and hospital stays, but it wasn’t meant to cover everything. That’s why you might choose to get additional coverage, available from a private insurance company approved by Medicare.

Home

65

Maximize value with an all-inclusive Medicare Advantage plan

Eligible for Medicare & Medicaid?You could get specifically designed coverage with a Medicare Advantage Special Needs Plan, known as a D-SNP. D-SNPs all include prescription drug coverage, and some offer extra benefits to help manage your health conditions such as transportation assistance.

Medicare Advantage (Part C) includes Part A hospital coverage and Part B medical coverage in a convenient, all-in-one plan.

Most Medicare Advantage plans also include prescription drug coverage (Part D).

Many plans also give you additional valuable benefits, like extra days in the hospital.

Some plans even offer dental, vision and hearing coverage, and/or access to wellness and fitness programs.

Unlike Original Medicare, Medicare Advantage plans have an annual limit on out-of-pocket costs for medical services.

You can choose from a wide range of Medicare Advantage plans to fit your needs and budget, with premiums and copays that are often less than Medicare Supplement insurance plans.

Maximize flexibility with a reliable Medicare Supplement insurance plan

With a Medicare Supplement insurance plan, also nicknamed Medigap, you’ll still have Original Medicare for Parts A and B coverage.

Your supplement will cover many of the out-of-pocket expenses that Original Medicare doesn’t cover. This is sometimes called “filling the gap.”

You get the peace of mind that comes from more predictable monthly costs and fewer surprises when you need care.

You’ll have the flexibility to choose any doctor or hospital that accepts Medicare patients.

Your coverage travels with you nationwide, and it’s guaranteed for life.

Even though plans are administered by private companies, their benefits are standardized by the government in most states with several plan types to fit different needs and budgets.

Home

87

You can add a prescription drug plan (PDP) from a private insurance company to cover blood pressure medication, cholesterol drugs, and many others to manage your health.

Most Medicare Advantage plans include prescription coverage.

PDPs cover generic and brand-name drugs, typically with a lower copay for generics.

PDPs must cover common types of drugs, but not specific drugs within each type. Check to see if your prescriptions are in the drug list of PDPs you consider.

If you don’t sign up for Part D coverage when you first become eligible, you will have to pay a penalty when you do eventually enroll.

You can purchase a PDP by itself or with a Medicare Supplement plan.

Enrolling into a PDP plan will cause you to be disenrolled from a Medicare Advantage plan. You cannot have a Medicare Advantage plan and a PDP plan at the same time.

Maximize savings with affordable prescription drug coverage Which Medicare plan is best for you? Think about what matters to

you most as you compare coverage types.

Medicare Advantage

Take a quick quiz to find the right plan

Out-of- pocket costs

Choosing my health care providers

Prescription drug coverage

Extra benefits

I’d like to keep costs as low as possible, and I’m especially interested in low cost options.

I want protection from more of the out-of-pocket costs not covered by Original Medicare.

I don’t mind staying within a plan’s doctor and hospital network to help control expenses.

I want the freedom to choose any doctor or hospital that accepts Medicare patients.

I’d like to have my prescription and medical coverage all in one plan.

I’m okay with purchasing a separate drug plan.

I’m looking for a plan that includes things like dental, vision and hearing coverage.

It’s more important that my general medical costs are covered.

Medicare Supplement Insurance

Home

Your current healthConsider how often you’ve been to the hospital lately, whether you have chronic conditions that need constant treatment, and which prescriptions you take.

How your health might change You may feel fine now, but there may be serious illnesses that run in your family or other risk factors to consider as you age.

Your financial situation Review your retirement savings and your budget to assess what you can afford to pay out of pocket … or lose if you’re hit with unexpected expenses.

Your doctors and hospitalsFind out if they accept Medicare and the plans you’re considering, and if you’ll need to pick a primary care physician within your plan.

If you’re working past age 65If you have an existing health plan you may want to keep it until you retire, so ask your benefits administrator how it works with Medicare.

Consider what else matters to youAs you review your Medicare choices and what kind of coverage each plan provides, you’ll want to keep a few more things in mind:

109

Turning 65? New to Medicare?You can enroll in Original Medicare anytime from three months before to three months after your 65th birthday. This is called your Initial Enrollment Period (IEP).

- 3 months before - - 3 months after -

Know when to enrollTiming’s important when it comes to changing your plan or enrolling for the first time, but it’s easy to be prepared if you keep a few things in mind.

Annual Enrollment Period: October 15 – December 7 Anyone who’s eligible for Medicare can choose a new Medicare Advantage plan or Prescription Drug Plan during the Annual Enrollment Period (AEP). This is a great time to review your current coverage — and switch or add plans if your needs have changed.

Special Enrollment Periods You may also enroll in a new Medicare Advantage plan or change your plan anytime outside the AEP if you are:

Losing your coverage or retiring Moving out of your plan’s area On Medicare and Medicaid Have certain chronic conditions

Enroll in Medicare Supplement insurance anytime To help you cover the expenses Original Medicare doesn’t, you can enroll in a Medicare Supplement insurance plan year round — without waiting for the next AEP.

Home

11 12

Take the next stepsOnce you understand the Medicare plan types and when to enroll, you’re ready to review specific plans and find the best fit for you. It might help to keep these things in mind:

CostMany people look for the lowest premiums, but you should also evaluate deductibles, coinsurance and copayments — and how they can add up each year. If you choose a Medicare Advantage plan, its annual out-of-pocket maximum can help limit your expenses.

CoverageLook at exactly what each plan includes, particularly if you’re interested in getting extra benefits like dental, vision and hearing. Also find out if the doctors, specialists and hospitals you like are part of the plan’s network, and whether you need to pay more for out-of-network care.

ConfidenceIf you’re considering a plan from a private company, check out their reputation. Look for a trusted company with a solid history of providing health coverage solutions, knowledgeable representatives who can give you personal guidance, and a strong network of doctors, hospitals and pharmacies.

DO enroll in Medicare Part B when you become eligibleSign up during your Initial Enrollment Period (IEP) or as soon as you retire and lose coverage through your employer. Then you can avoid the late penalty, which is a 10% increase in your monthly premium for every year you delayed getting Part B.

DO enroll in optional Medicare Part D, tooYou’re not required to get Part D prescription drug coverage, but as with Part B there’s a penalty if you don’t enroll when you first become eligible. So even if you don’t need it now, think about your future needs — and sign up promptly if you want to avoid a permanent penalty.

DON’T miss out on Medicare Supplement insurance coverageIf you leave a Medicare Supplement insurance plan but want to switch back more than a year later, your new premium might be higher. And in some states if you have a pre-existing condition, you might not be allowed to re-enroll. So check your state’s rules before giving up your Medicare Supplement insurance plan’s guaranteed coverage.

Do

Don’t

Follow these simple do’s and don’tsIt’s important to get your Medicare coverage in place at the right time because otherwise you could miss out on benefits … or pay a late enrollment penalty. Here’s how to stay on top of the situation.

Home

1413

Coinsurance An insured person’s percentage of the cost of health care services after the deductible has been paid.

Copayment or copay The amount a member pays for each doctor visit or prescription; usually the same set dollar amount per service or visit.

Deductible The amount of expenses a member may have to pay out of pocket for the calendar year before the plan begins to pay benefits.

Drug list or formulary A specific Medicare Part D plan’s list of covered drugs, often organized by levels of cost sharing called tiers.

Network A health plan’s group of doctors, hospitals, pharmacies and others who provide services for plan members.

Out-of-pocket maximum The annual total you could pay for expenses covered by your plan; a sum of the deductible, coinsurance and/or copayment amounts.

Premium The amount you may pay to maintain your health and/or prescription drug coverage, usually on a monthly basis.

Key Medicare terms

Will Medicare cover all my medical expenses? No. Original Medicare covers some basic medical expenses, but not all. To help you fill the gaps in coverage, you can choose among a range of plans from private insurance companies.

Will Medicare cover my prescription drugs? Original Medicare (Parts A and B) does not cover prescription drugs. However, private insurance companies help cover the costs of generic and brand name drugs through prescription drug plans (Part D) and some Medicare Advantage plans (Part C).

Can I keep my doctor when I’m on Medicare? With a Medicare Supplement insurance plan, you can use any doctor who accepts Medicare patients. With a Medicare Advantage plan, you can use any doctor who accepts Medicare and is in your plan’s network.

Can any insurance company offer additional Medicare coverage? No, an insurance company must be approved by the federal government to administer Medicare benefits.

How soon can I enroll in Medicare? You are eligible to enroll in Medicare beginning three months before your 65th birthday.

When will my coverage start? If you enroll as soon as you’re eligible, your coverage will begin as early as the first day of your birthday month.

FAQsHome

One-time “Welcome to Medicare” visit

Annual Wellness visit

Abdominal aortic aneurysm screening

Alcohol misuse screening

Bone mass measurement

Breast cancer screening/mammogram

Cervical and vaginal cancer screening

Depression screening

Diabetes screening

Hepatitis C screening

HIV screening

Laboratory services

Lung cancer screening

Medical nutrition therapy

Obesity screening and counseling

Shots for Flu, Hepatitis B and Pneumonia

1615

Take advantage of covered servicesMany preventive services are covered by Medicare to help guard against disease and detect it earlier — at little or no additional cost to you. If you’re eligible, Medicare covers 100% of its approved amount for your:

Your medical history and any recent health changes

Which medications you take, including prescriptions, over-the-counter drugs, and herbal and dietary supplements

Whether you’re experiencing any side effects from your medications

What tests, screenings and vaccinations you should schedule for someone of your age, gender and condition

Any major life events you’ve experienced recently or anticipate happening soon

How your daily routine may be changing including diet, exercise and social interactions

Get ready for your doctor visitsYour Medicare benefits include a “Welcome to Medicare” visit the first year you join, plus an annual Wellness visit every 12 months. Whether you’re seeing a doctor for one of these regular visits or for a specific medical concern, you should be prepared to discuss:

Home

Helpful hints for taking medicationsYou know it’s best to take your prescriptions in the right amount at the right time, but sometimes life gets in the way. Here are some hints to help you stay on track:

Store your medications in the same place every day, where they’re easily accessible

Once a day or once a week, depending on how many drugs you take, put your medications into a pill box or organizer that lets you check if you’ve taken them

Set a reminder alert on your phone, computer or alarm clock

Post a note on your calendar and after you’ve taken your medications for the day, move the note to the next day

Ask your pharmacy if they have an automatic refill program and if you can get a 90-day supply of your medications

Take advantage of mail order pharmacy services to get home delivery of your maintenance medications and refills

1817

Keep these websites and phone numbers handyThere are several resources available to help you.

To sign up for Original Medicare (Parts A & B), contact the Social Security Administration:

ssa.gov/medicare1-800-772-1213 (TTY: 1-800-325-0778)

For information about Medicare from the Federal Government:

medicare.gov1-800-MEDICARE (1-800-633-4227) (TTY: 1-877-486-2048) 24 hours a day, 7 days a week

To find contact information for your state’s State Health Insurance Assistance Programs (SHIPs):

medicare.gov/Contacts/#resources/ships

For help understanding your rights and benefits, contact the Medicare Rights Center:

medicareinteractive.org1-800-333-4114

Home

Y0114_17_32067_I_006

Anthem is a Medicare Advantage plan with a Medicare contract. Enrollment in Anthem depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information.

This policy has exclusions, limitations and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, contact your licensed insurance agent, Anthem Inc. or visit us on the web.

We do not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, sex, age or disability in our health programs and activities.