Addendum to "2014 Guide to Health Insurance for People with Medicare"; Issued 1/31/14

DEVAL L. PATRICK GOVERNOR COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation DIVISION OF INSURANCE 1000 Washington Street, Suite 810 • Boston, MA 02118-6200 (617) 521-7794 • Toll-free (877) 563-4467 http://www.mass.gov/doi GREGORY BIALECKI SECRETARY OF HOUSING AND ECONOMIC DEVELOPMENT BARBARA ANTHONY UNDERSECRETARY OF CONSUMER AFFAIRS AND BUSINESS REGULATION JOSEPH G. MURPHY COMMISSIONER OF INSURANCE ## BULLETIN 2014-02 TO: Commercial Health Insurers, Blue Cross and Blue Shield of Massachusetts, Inc., and Health Maintenance Organizations FROM: Joseph G. Murphy, Commissioner of Insurance DATE: January 31, 2014 Joseph G. Murphy RE: Addendum to "2014 Guide to Health Insurance for People with Medicare" Attached please find a copy of the "Massachusetts Bulletin for People with Medicare." The Massachusetts Bulletin must be provided along with the "2014 Guide to Health Insurance for People with Medicare" to those people eligible for Medicare pursuant to Massachusetts regulations 211 CMR 42.09(4) and 211 CMR 71.13(2)(d)4. Questions regarding this Bulletin may be directed to Nancy Schwartz, Director, Bureau of Managed Care at the Division of Insurance at (617) 521-7347. [LOGO] DEVAL L. PATRICK Governor ANN HARTSTEIN Secretary The Commonwealth of Massachusetts Executive Office of Elder Affairs One Ashburton Place, Boston, MA 02108 Tel: (617) 727-7750 Fax: (617) 727-9368 TTY/TTD 1-800-872-0166 www.ma.gov/elder # Massachusetts Bulletin for People with Medicare ## Health Insurance Options for People with Medicare - Original Medicare(Part A and Part B) - Medicare Supplement Insurance (Medigap) - Medicare Advantage Plans (Medicare Part C) - Medicare Prescription Drug Coverage (Medicare Part D) - Employer, Union, Retiree, other group health insurance coverage - COBRA - Veterans Health Benefits - Military Benefits(TRICARE) - Indian Health Services ## Programs for People with Limited Income and Resources - Extra Help Paying for Medicare Prescription Drug Coverage (Part D) - Medicare Savings Programs (help with Medicare costs) - Prescription Advantage (prescription drug insurance assistance program for Massachusetts residents) - MassHealth (Medicaid) This Bulletin provides basic health insurance information for people eligible for Medicare. Contact your plan benefits administrator for information about employer, union, retiree, or other group health coverage. Contact your local Veterans Service Officer for Veterans and TRICARE health insurance information. Contact the Indian Health Services for health information for American Indians and Alaska Natives. January 1, 2014 SHINE ship state health insurance assistance programs LOCAL HELP FOR PEOPLE WITH MEDICARE [LOGO] ELDER EXECUTIVE OFFICE OF AFFAIRS Preventing Your Independence 1 # Medicare Medicare is a Federal Government health insurance program administered by the Centers for Medicare and Medicaid Services (CMS) for people: - age 65 or older - under age 65 with certain disabilities Medicare has four parts: - Part A (Medicare Hospital Insurance) Helps pay for inpatient care in hospitals, skilled nursing facilities, hospice, home health care and other services. - Part B (Medicare Medical Insurance) Helps pay for outpatient medical services including doctor visits, medical equipment, home health care, outpatient care, and some preventive services. - Part C (Medicare Advantage Plan) Medicare Advantage Plans include Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Some Medicare Advantage Plans may offer Medicare Part D, prescription drug coverage at additional charge and other services not covered by Medicare. Medicare Advantage Plans (like HMOs, PPOs) are sold by private health insurance companies approved by Medicare. - Part D(Medicare Prescription Drug Coverage) Helps pay for outpatient prescription drugs. Medicare prescription drug plans are sold by private insurance companies approved by Medicare. There are (2) ways to get Medicare coverage: (1) Original Medicare is fee-for-service coverage administered directly by Medicare. Original Medicare covers Medicare Part A (Hospital) and Part B (Medical) services. Under Original Medicare, you have the choice of doctors, hospitals and other providers that accept Medicare. You may purchase optional Medicare Supplement (Medigap) insurance from a private company or have employer or other health insurance to help pay for deductibles and coinsurance in Original Medicare. You may decide to purchase a Medicare Prescription Drug plan (Part D) January 1, 2014 SHINE ship state health insurance assistance programs LOCAL HELP FOR PEOPLE WITH MEDICARE FEDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence 2 to help pay for outpatient prescription drugs. (2) Medicare Advantage Plan (like an HMO or PPO) Medicare Advantage Plan/s (MAP) cover Medicare Part A and Part B Services. MAPs are sold by private companies approved by Medicare and usually charge a monthly premium. Some plans offer additional benefits not covered by Medicare. Most plans require use of network doctors, hospitals and other providers. Some MAPs offer Medicare prescription drug coverage (Part D) at additional cost. You must be enrolled in Medicare A and B, pay plan premiums, deductibles, copays and coinsurance. (Medicare Supplement Insurance cannot be sold to MAP enrollees) Medicare Advantage Plans sold in Massachusetts • Health Maintenance Organizations (HMO) Must be a resident of the plan's service area and use provider network • Preferred Provider Organization (PPO) Must be a resident of the plan's service area May use out-of-network Medicare providers at higher premium • Point-of Service (HMO/POS) Must be a resident of the plan's service area May use of out-of-network Medicare providers at higher premium • Private Fee-for-Service (PFFS) May use any Medicare provider that agrees to treat patient The Plan determines provider and patient payment for the services • Special Needs Plan (SNP) For people with Medicare and Medicaid or special conditions Medicare Prescription Drug Coverage (Part D) Medicare prescription drug coverage (Part D) helps pay for prescription drugs. Medicare prescription drug plans are sold by private companies approved by Medicare. Each plan can vary in cost and specific drugs covered. Medicare Prescription Drug Plans (PDPs) are stand-alone plans for for enrollees in Original Medicare. Most Medicare Advantage Plans offer optional Medicare prescription drug coverage. January 1, 2014 SHINE ship state health insurance assistance programs LOCAL HELP FOR PEOPLE WITH MEDICARE ELDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence 3 # Medicare Supplement Insurance (Medigap) Medicare Supplement Insurance (also called Medigap Insurance) is sold by private insurance companies to help pay health care costs that Original Medicare does not cover such as deductibles and coinsurance. Some Medigap insurers may include coverage for services that are not covered by Original Medicare. Two standard Medigap policies are offered to Massachusetts residents: Medicare Supplement Core and Medicare Supplement 1 Note: In compliance with Medicare rules, Medicare Supplement 2, (included prescription drugs), cannot be sold after December 31, 2005. Existing enrollees in Supplement 2 could choose to remain enrolled. Medicare Supplement Insurance (Medigap) for Massachusetts residents is regulated by federal and state laws including the following: - Medigap policies must be clearly identified as “Medicare Supplement Insurance” - Policies and text are standard for all insurers, Basic benefits are the same, some may offer additional benefits - Medigap insurance is guaranteed renewable and cannot be cancelled unless the beneficiary stops paying the premium or provides false information on the application. - Medigap insurers cannot refuse to sell a policy, exclude or limit coverage, or require a waiting period before coverage starts due to existing health problems. - Medigap insurers must offer the same premium (a “community rate”) to all policyholders and cannot charge a different premium based on age or health. The Massachusetts Division of Insurance monitors insurance companies authorized to sell insurance in Massachusetts, For information contact, Massachusetts Division of Insurance 617-521-7794 (Boston) January 1, 2014 SHINE ship state health insurance assistance programs LOCAL HELP FOR PEOPLE WITH MEDICARE ELDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence 4 www.state.ma.us/doi # Programs for People with Limited Income and Resources Extra Help (LIS) for Medicare Prescription Drug Coverage (Part D) also known as the Limited Income Subsidy (LIS) is a federal program that helps Medicare beneficiaries with limited income and assets pay some of the costs for Medicare prescription drug coverage (Part D). For more information or to enroll in Extra Help, contact Social Security at 1-800-772-1213 or visit www.socialsecurity.gov Medicare Savings Program (MassHealth Buy-In) are federal programs that help pay Medicare premiums and Part A and Part B deductibles and coinsurance for Massachusetts residents with limited income and assets and not receiving other MassHealth benefits. For more information about Medicare Savings Programs contact MassHealth Customer Service 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss) Prescription Advantage/State Pharmacy Assistance Program (SPAP) Is a state program that helps people with limited income and/or medical condition and age pay for prescription drugs. Prescription Advantage is funded by state legislation and is administered by the Massachusetts Executive Office of Elder Affairs. For information about eligibility and enrollment contact Prescription Advantage Customer Service 1-800-AGE-INFO (1-800-243-4636) press 2 (TTY: 1-800-610-0241 for people with partial or total hearing loss) January 1, 2014 SHINE ship state health insurance assistance programs LOCAL HELP FOR PEOPLE WITH MEDICARE ELDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence 5 # MassHealth MassHealth provides a wide range of medical services and other benefits. These programs are authorized by state and federal laws and help pay medical costs for people with limited income and resources and meet other eligibility requirements - MassHealth Standard provides a full range of health care benefits - MassHealth CommonHealth for people with disabilities with whose income is too high to be eligible for MassHealth Standard - MassHealth Frail Elder Waiver Program provides coordinated community based services to frail elders living in the community - MassHealth Personal Care Attendant Services(PCA) helps people with long-term disabilities live independently at home - Program for All-inclusive Care for the Elderly (PACE) PACE providers deliver needed medical and support services to people living in the community - MassHealth SCO (Senior Care Options) is a coordinated health plan that combines Medicare and Medicaid health care services with social support services - One Care (Integrated Care Organization or ICO) is a coordinated care demonstration project in MA. that combines Medicare and Medicaid services with social supports for people under 65 with disabilities. Enroll through MassHealth - MassHealth Long-Term Care(LTC) covers LTC costs for individuals living in LTC facilities January 1, 2014 SHINE ship state health insurance assistance programs LOCAL HELP FOR PEOPLE WITH MEDICARE ELDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence 6 For information or questions about eligibility and enrollment MassHealth Customer Service 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss) or visit www.mass.gov/masshealth ## Helpful Numbers Massachusetts Executive Office of Elder Affairs To directly connect with elder services in your area call press or say: 1-800-AGE-INFO (1-800-243-4636) - to connect to your local elder service agency or caregiver program 1 - to connect to Prescription Advantage-state prescription drug program 2 - to connect to your regional SHINE Program 3 - to report elder abuse, neglect or financial exploitation 4 - all other matters 5 MassHealth 1-800-841-2900 www.mass.gov/masshealth TTY: 800-497-4648 MassHealth provides a wide range of health care services that pay for all or part of the health care cost for people with limited income and resources. Call MassHealth for One Care enrollment MassHealth Senior Care Options (SCO) 1-888-885-0484 www.mass.gov/masshealth TTY: 1-888-821-5225 A health plan that combines Medicare and Medicaid services with home services Massachusetts Division of Insurance Boston 617-521-7794 www.state.ma.us/doi Springfield 413-785-5526 TTY: 617-521-7490 Regulates insurance companies authorized to sell insurance in Massachusetts Elder Protective Services Elder Abuse Hotline (24 hour/7 days) 1-800-922-2275 A statewide program is administered by the Executive Office of Elder Affairs. Protective Service Agencies investigates reports of elder abuse and provide protective services to abused elders January 1, 2014 SHINE ship state health insurance assistance programs LOCAL HELP FOR PEOPLE WITH MEDICARE ELDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence 7 Attorney General of Massachusetts Elder Hotline 1-888-243-5337 www.ago.state.ma.us The Attorney General of Massachusetts is the state's chief law enforcement officer The Hotline provides information about elder-related issues and programs Massachusetts Medicare Advocacy Project (MAP) 1-800-323-3205 Provides Medicare beneficiaries free legal advice and legal representation for appealing medical decisions Massachusetts College of Pharmacy and Health Services 1-866-633-1617 Pharmacy Outreach Program www.massmedline.com Provides free prescription drug information and referrals. The Pharmacy Outreach Program is a public service of the MCPHS and EOEA Social Security Administration 1-800-772-1213 www.ssa.gov Contact SSA to enroll in Medicare and for information and issues about Social Security and other related programs Massachusetts Health Connector 1-877-623-6765 www.MAhealthconnector.org Health insurance, assistance and on-line application for people without insurance or small businesses SHINE (Serving Health Insurance Needs of Everyone) 1-800-243-4636 www.800ageinfo.com SHINE, a State Health Insurance Assistance Program (SHIP), provides information, counseling and assistance to Medicare beneficiaries and their families regarding Medicare and other health insurance issues SHINE Health Insurance Counselors are trained and certified by the Massachusetts Massachusetts Executive Office of Elder Affairs( EOEA). SHINE is administered by EOEA in partnership with elder service agencies, councils on aging, independent living centers and community based programs SHINE is partially funded by Centers of Medicare and Medicaid Services January 1, 2014 SHINE ship state health insurance assistance programs EDUCATION LOCAL HELP FOR PEOPLE WITH MEDICARE 8 ELDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence January 1, 2014 SHINE ship state health insurance assistance programs HEALTHY LIVING LOCAL HELP FOR PEOPLE WITH MEDICARE ELDER EXECUTIVE OFFICE OF AFFAIRS Promoting Your Independence 9 # Standard MediGap Plans Available in Massachusetts in 2014 | Comparison of Plans | Core | Supplement 1 | | --- | --- | --- | | Basic Benefits Included In All Plans: | | | | Hospitalization Part A Co-payments | | | | Days 61 - 90: $304 per day | X | X | | Days 91-150: $608 per day | X | X | | 365 Additional Lifetime Hospital days - Paid in full | X | X | | Part B Coinsurance - | | | | Coverage of coinsurance, in most cases, 20% of approved amount | X | X | | Parts A and B Blood First 3 pints | X | X | | Additional Benefits | Core | Supplement 1 | | Part A Deductible for Hospital Days 1 - 60 | | X | | $1216 per benefit period | | | | Skilled Nursing Facility Coinsurance | | X | | Days 21-100 - $152 per day | | | | Part B Annual Deductible - $147 | | X | | Foreign Travel - For Medicare-covered services needed while traveling abroad. | | X | | Inpatient Days in Mental Health Hospitals In addition to Medicare's coverage of 190 lifetime days and less any days previously covered by plan in same benefit period | 60 days per calendar year | 120 days per benefit period | # Medicare Supplement Plans ## Offered in Massachusetts in 2014 | Medigap Carriers Please note that rates may change in 2014 | Medicare Supplement Core | Medicare Supplement 1 | | --- | --- | --- | | **Blue Cross & Blue Shield of MA (Medex™)** 1-800-678-2265 sales/apps 1-800-258-2226 member services 1-800-522-1254 (TDD) www.bluecrossma.com (continuous open enrollment) | $92.64 | $175.10 | | Optional Preventive Care Benefits Rider^{1} | $7.67 | $7.67 | | **Fallon Health & Life Assurance Company** 1-866-330-6380 sales/apps 1-800-868-5200 member services 1-877-608-7677 (TDD) www.fchp.org/medicare-choices (continuous open enrollment) | $103.00 | $187.00 | | **HNE Insurance Company** 1-877-443-3314 1-800-439-2370 (TDD/TTY) www.hne.com (continuous open enrollment) | $97.00 | $189.00 | | **HPHC Insurance Company, Inc.** 1-800-782-0334 sales/apps 1-877-907-4742 member services 1-888-259-8276 (TDD) www.harvardpilgrim.org (continuous open enrollment) | $100.50 | $189.50 | $^{1}$ Effective January 1, 2013, an optional innovative hearing and vision coverage benefit rider will be available with Blue Cross and Blue Shield of Massachusetts, Inc.'s Supplement Core and Supplement 1 policies. # Medicare Supplement Plans ## Offered in Massachusetts in 2014 | Medigap Carriers Please note that rates may change in 2014 | Medicare Supplement Core | Medicare Supplement 1 | | --- | --- | --- | | **Humana Insurance Company** 1-800-872-7294 sales/apps 1-800-866-0581 member services 1-800-833-3301 (TDD) www.humana-medicare.com (continuous open enrollment) | $143.26 | $221.84 | | **Humana Insurance Company** HEALTHY LIVING (including dental and vision benefits) 1-800-872-7294 sales/applications 1-800-866-0581 member services 1-800-833-3301 (TDD) www.humana-medicare.com (continuous open enrollment) | $155.97 | $232.55 | | **Monumental Life Insurance Company** 1-800-458-5736 (Group Medicare Supplement Insurance sponsored exclusively for physicians by the American Medical Association) www.amainsure.com (continuous open enrollment) | $97.47 | $168.58 | | **Tranamerica Life Insurance Company** For eligibility & plan information: 1-800-247-1771 (Group Medicare Supplement insurance sponsored for members of various participating industry, trade, professional and other special interest associations.) | $111.16 | $192.28 | # Medicare Supplement Plans ## Offered in Massachusetts ### in 2014 | Medigap Carriers Please note that rates may change in 2014 | Medicare Supplement Core | Medicare Supplement 1 | | --- | --- | --- | | Tufts Insurance Company 1-800-714-3000 sales/apps 1-800-701-9000 member services TDD 1-800-208-9562 (member services) 1-888-899-8977 (sales/apps) www.tuftsmedicarepreferred.org (continuous open enrollment) | $104.76 | $203.69 | | United HealthCare Insurance Company Only for members of AARP (American Association of Retired Persons) 1-800-523-5800 (continuous open enrollment) | $122.75 | $216.25 | In addition to the above-noted Medicare Supplemental plans, Massachusetts residents may enroll in Medicare Advantage Plans as well as Part D Prescription Drug Plans with the Centers for Medicare and Medicaid Services ("CMS"). For further information regarding these plans please visit the following website: https://www.medicare.gov/find-a-plan/questions/home.aspx # Medicare Advantage Plans ## Offered in Massachusetts in 2014 | | Plan Name | Plan Type | Monthly Premium | Drugs | Doctor Choice | Counties | | --- | --- | --- | --- | --- | --- | --- | | AARP Medicare Complete Provided by Secure Horizons Phone: 1-800-547-5514 | Medicare Complete | HMO | $0.00 | Yes | Plan Doctors Only (some exceptions) | Hampden | | | Medicare Complete Plan 1 | HMO | $0.00 | Yes | Plan Doctors Only (some exceptions) | Middlesex Suffolk | | | Medicare Complete Plan 2 | HMO | $45.00 | Yes | Plan Doctors Only (some exceptions) | Middlesex Suffolk | | | Medicare Complete Choice | PPO | $30.00 | Yes | Any Doctor | Barnstable Berkshire Bristol Dukes Essex Franklin Hampden Hampshire Middlesex Nantucket Norfolk Plymouth Suffolk Worcester | | Blue Cross Blue Shield of Massachusetts Phone: 1-800-678-2265 TTY: 1-800-522-1254 | Medicare HMO Blue PlusRx | HMO | $167.00 | Yes | Plan Doctors Only | Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester | January 2014 | | Plan Name | Plan Type | Monthly Premium | Drugs | Doctor Choice | Counties | | --- | --- | --- | --- | --- | --- | --- | | Erickson Advantage Phone: 1-800-989-1389 | Erickson Advantage Signature with Drugs | HMO POS | $189.00 | Yes | Plan Doctors Only | Essex Plymouth | | | Erickson Advantage Signature without Drugs | HMO -POS | $149.00 | No | Plan Doctors Only | Essex Plymouth | | | Erickson Advantage Freedom | HMO -POS | $48.00 | Yes | Plan Doctors Only | Essex Plymouth | | Fallon Community Health Plan Phone: 1-888-377-1980 TTY: 1-877-608-7677 | Fallon Senior Plan Plus Enhanced Rx | HMO | $143.00 | Yes | Plan Doctors Only | Bristol Middlesex Norfolk Plymouth | | | Fallon Senior Plan Plus Enhanced Rx | HMO | $88.00 | Yes | Plan Doctors Only | Hampden Hampshire | | | Fallon Senior Plan Plus Enhanced Rx | HMO | $226.00 | Yes | Plan Doctors Only | Franklin Worcester | | | Fallon Senior Plan Plus Enhanced Rx | HMO | $167.00 | Yes | Plan Doctors Only | Suffolk Essex | | | Fallon Senior Plan Plus Enhanced Rx | HMO | $192.00 | Yes | Plan Doctors Only | Barnstable | | | Fallon Senior Plan Saver | HMO | $15.00 | No | Plan Doctors Only | Bristol Essex Franklin Middlesex Norfolk Plymouth Suffolk | | | Fallon Senior Plan Saver | HMO | $44.00 | No | Plan Doctors Only | Franklin Worcester | | | Fallon Senior Plan Saver | HMO | $0.00 | No | Plan Doctors Only | Hampden Hampshire | | | Fallon Senior Plan Saver | HMO | $53.00 | No | Plan Doctors Only | Barnstable | January 2014 | | Plan Name | Plan Type | Monthly Premium | Drugs | Doctor Choice | Counties | | --- | --- | --- | --- | --- | --- | --- | | Harvard Pilgrim Healthcare Phone: 1-888-609-0692 TTY: 1-800-720-3480 | Stride | HMO | $163.00 | Yes | Plan Doctors Only | Bristol Norfolk Suffolk Worcester | | Health New England Phone: 1-877-443-3314 TTY: 1-800-439-2370 | HNE Medicare Basic No RX | HMO | $14.00 | No | Plan Doctors Only | Berkshire Franklin Hampden Hampshire | | | HNE Medicare Basic RX | HMO | $72.00 | Yes | Plan Doctors Only | Berkshire Franklin Hampden Hampshire | | | HNE Medicare Plus RX | HMO | $107.00 | Yes | Plan Doctors Only | Berkshire Franklin Hampden Hampshire | | | HNE Medicare Premium No RX | HMO | $84.00 | No | Plan Doctors Only | Berkshire Franklin Hampden Hampshire | | | HNE Medicare Premium RX | HMO | $158.00 | Yes | Plan Doctors Only | Berkshire Franklin Hampden Hampshire | | | HNE Medicare Value | HMO | $18.00 | Yes | Plan Doctors Only | Berkshire Franklin Hampden Hampshire | | | HNE Medicare Freedom (HMO-POS) | HMO | $203.00 | Yes | Plan Doctors Only | Berkshire Franklin Hampden Hampshire | January 2014 | | Plan Name | Plan Type | Monthly Premium | Drugs | Doctor Choice | Counties | | --- | --- | --- | --- | --- | --- | --- | | Tufts Health Plan Phone: 1-877-218-4835 TTY: 1-888-899-8977 | Medicare Preferred HMO Basic | HMO | $30.00 | No | Plan Doctors Only | Worcester | | | Medicare Preferred HMO Basic | HMO | $31.00 | No | Plan Doctors Only | Essex Suffolk | | | Medicare Preferred HMO Basic | HMO | $30.00 | No | Plan Doctors Only | Worcester | | | Medicare Preferred HMO Basic Rx | HMO | $0.00 | Yes | Plan Doctors Only | Hampden Hampshire | | | Medicare Preferred HMO Basic Rx | HMO | $35.90 | Yes | Plan Doctors Only | Barnstable Bristol Middlesex Norfolk Plymouth | | | Medicare Preferred HMO Basic Rx | HMO | $55.90 | Yes | Plan Doctors Only | Essex Suffolk | | | Medicare Preferred HMO Basic Rx | HMO | $66.10 | Yes | Plan Doctors Only | Worcester | | | Medicare Preferred HMO Prime | HMO | $127.00 | No | Plan Doctors Only | Barnstable Bristol Middlesex Norfolk Plymouth | | | Medicare Preferred HMO Prime | HMO | $49.00 | No | Plan Doctors Only | Hampden Hampshire | | | Medicare Preferred HMO Prime | HMO | $151.00 | No | Plan Doctors Only | Essex Suffolk | | | Medicare Preferred HMO Prime | HMO | $145.00 | No | Plan Doctors Only | Worcester | | | Medicare Preferred HMO Prime Rx | HMO | $151.90 | Yes | Plan Doctors Only | Barnstable Bristol Middlesex Norfolk Plymouth | January 2014 | Plan Name | Plan Type | Monthly Premium | Drugs | Doctor Choice | Counties | | --- | --- | --- | --- | --- | --- | | Medicare Preferred HMO Prime Rx | HMO | $73.90 | Yes | Plan Doctors Only | Hampden Hampshire | | Medicare Preferred HMO Prime Rx | HMO | $175.90 | Yes | Plan Doctors Only | Essex Suffolk | | Medicare Preferred HMO Prime Rx | HMO | $181.10 | Yes | Plan Doctors Only | Worcester | | Medicare Preferred HMO Prime Rx Plus | HMO | $185.70 | Yes | Plan Doctors Only | Barnstable Bristol Middlesex Norfolk Plymouth | | Medicare Preferred HMO Prime Rx Plus | HMO | $107.70 | Yes | Plan Doctors Only | Hampden Hampshire | | Medicare Preferred HMO Prime Rx Plus | HMO | $209.70 | Yes | Plan Doctors Only | Essex Suffolk | | Medicare Preferred HMO Value | HMO | $93.00 | No | Plan Doctors Only | Barnstable Bristol Middlesex Norfolk Plymouth | | Medicare Preferred HMO Value | HMO | $19.00 | No | Plan Doctors Only | Hampden Hampshire | | Medicare Preferred HMO Value | HMO | $114.00 | No | Plan Doctors Only | Essex Suffolk | | Medicare Preferred HMO Value | HMO | $106.00 | No | Plan Doctors Only | Worcester | | Medicare Preferred HMO Value Rx | HMO | $117.90 | Yes | Plan Doctors Only | Barnstable Bristol Middlesex Norfolk Plymouth | | Medicare Preferred HMO Value Rx | HMO | $43.90 | Yes | Plan Doctors Only | Hampden Hampshire | January 2014 | | Plan Name | Plan Type | Monthly Premium | Drugs | Doctor Choice | Counties | | --- | --- | --- | --- | --- | --- | --- | | | Medicare Preferred HMO Value Rx | HMO | $138.90 | Yes | Plan Doctors Only | Essex Suffolk | | | Medicare Preferred HMO Value Rx | HMO | $142.10 | Yes | Plan Doctors Only | Worcester | | | Medicare Preferred HMO Saver Rx | HMO | $0.00 | Yes | Plan Doctors Only | Barnstable Bristol Essex Middlesex Norfolk Plymouth Suffolk Worcester | | Universal American Phone: 1-800-996-8867 TTY: 1-800-974-8089 | Today's Options Premier 900 | PFFS | $58.00 | No | Any Willing Doctor | Berkshire Nantucket | | | Today's Options Premier 600 | PFFS | $35.00 | No | Any Willing Doctor | Dukes | | | Today's Options Premier Plus 350A | PFFS | $188.00 | Yes | Any Willing Doctor | Berkshire Nantucket | | | Today's Options Premier Plus 350A | PFFS | $110.00 | Yes | Any Willing Doctor | Dukes | | | Today's Options Premier 600 | PFFS | $105.00 | No | Any Willing Doctor | Berkshire Nantucket | | | Today's Options Premier 900 | PFFS | $14.00 | No | Any Willing Doctor | Dukes | | | Today's Options Premier Plus 950G | PFFS | $104.00 | Yes | Any Willing Doctor | Berkshire Nantucket | | | Today's Options Premier Plus 950B | PFFS | $53.00 | Yes | Any Willing Doctor | Dukes | January 2014 **HMO = Health Maintenance Organization** A type of plan in which you can only go to doctors, hospitals and other providers that belong to the plan network, except in an emergency. **MSA = Medical Savings Account** A plan that has two parts. The first part is a high-deductible Medicare Advantage MSA Health Plan. This health plan won't begin to pay covered costs until you have met the annual deductible, which varies by plan. The second part is a Medical Savings Account into which Medicare deposits money that you may use to pay health care costs. **PPO = Preferred Provider Organization** A type of plan in which you pay less if you use doctors, hospitals, and other providers that belong to the plan network. You can use doctors, hospitals, and other providers outside of the network for an additional cost. **PFFS = Private Fee for Service** A type of Medicare Health Plan in which you may go to any Medicare-approved doctor or hospital that accepts the plan's payment. The insurance plan, rather than the Medicare Program, decides how much it will pay and how much you will pay for the services you have. Under this type of plan you may pay more or less for Medicare-covered benefits and you may have extra benefits that Original Medicare Plan doesn't cover. **SCO = Senior Care Option** A voluntary program that combines health care services with social support services to help low-income seniors maintain their health and stay in their own homes. With SCO, a team of medical professionals works together to provide you with care that is individually tailored to meet your needs. You must be 65 years of age or older and eligible for MassHealth (Medicaid) to join; you may also have Medicare. **SNP = Special Needs Plan** A special type of Medicare Advantage Plan that provides all Medicare Part A and Part B health care and services to people who can benefit the most from things like special care for chronic illnesses, care management of multiple diseases, and focused care management. These plans may limit membership to people in certain institutions (like a nursing home), eligible for both Medicare and Medicaid, or with certain chronic or disabling condition. January 2014 # Medicare Prescription Drug Plans ## Offered in Massachusetts in 2014 | Company | Prescription Drug Plan | Monthly Premium | Annual Deductible | Customer Service Phone Number | | --- | --- | --- | --- | --- | | Aetna | • CVS/pharmacy Prescription Drug Plan | $26.30 | $310 | Phone: 1-800-832-2640 | | | • Medicare Rx Premier | $120.50 | $0 | TTY/TDD: 711 | | Blue Cross Blue Shield of Massachusetts | • Blue MedicareRx Value Plus | $33.30 | $225 | Phone: 1-877-479-2227 | | | • Blue MedicareRx Premier | $99.70 | $0 | TTY: 1-866-236-1069 | | CIGNA Medicare Rx | • CIGNA Medicare Rx Secure | $27.60 | $310 | | | | • CIGNA Medicare Rx Secure Max | $113.80 | $0 | Phone: 1-800-735-1459 | | | • Cigna Medicare Rx Secure Xtra | $58.20 | $0 | TTY: 1-800-322-1451 | | | • Cigna Medicare Health Spring Rx | $33.40 | $310 | | | Envision RxPlus | • Envision Rx Plus Silver | $48.80 | $310 | Phone: 1-866-250-2005 TTY/TDD: 711 | | Express Scripts Medicare | • Express Scripts Medicare Choice | $49.50 | $0 | Phone: 1-866-477-5704 | | | • Express Scripts Medicare Value | $44.20 | $310 | TTY: 1-800-716-3231 | January 2014 | Company | Prescription Drug Plan | Monthly Premium | Annual Deductible | Customer Service Phone Number | | --- | --- | --- | --- | --- | | First Health Part D | • First Health Part D Essentials | $48.40 | $310 | Phone: 1-855-893-4696 TTY/TDD: 711 | | | • First Health Part D Premier Plus | $99.30 | $0 | | | | • First Health Part D Value Plus | $45.90 | $0 | | | HealthMarkets Medicare | • Health Markets Value Rx | $25.30 | $310 | Phone: 1-888-625-5531 TTY/TDD: 711 | | Humana Insurance Company | • Humana Walmart – Preferred RX Plan | $12.60 | $310 | Phone: 1-800-706-0872 TTY/TDD: 711 | | | • Humana Preferred Rx Plan | $22.80 | $310 | | | | • Humana Enhanced | $46.90 | $0 | | | Stonebridge Life Insurance Company | • Transamerica MedicareRx Choice | $51.70 | $0 | Phone: 1-877-527-1958 TTY/TDD: 711 | | | • Transamerica MedicareRx Classic | $40.90 | $310 | | January 2014 | Company | Prescription Drug Plan | Monthly Premium | Annual Deductible | Customer Service Phone Number | | --- | --- | --- | --- | --- | | Unicare | • Medicare RX Rewards Standard | $51.10 | $310 | Phone: 1-877-541-7382 TTY/TDD: 711 | | United American Insurance Company | • Enhanced • Select | $61.20 $38.80 | $120 $310 | Phone: 1-877-723-1662 TTY: 1-866-524-4170 | | United HealthCare Insurance Company | • AARP Medicare Rx Saver Plus • AARP Medicare Rx Preferred • AARP Medicare Rx Enhanced | $21.50 $40.60 $100.70 | $310 $0 $0 | Phone: 1-888-867-5564 TTY/TDD: 711 | | WellCare | • WellCare Classic • WellCare Extra | $22.30 $50.90 | $0 $0 | Phone: 1-888-293-5151 TTY: 1-888-816-5252 | January 2014