Transcript 25.304.1(10-08)_PDP_Sales_Presentation_G2

Welcome to
Medicare Prescription
Drug Coverage
Discussion Topics
 What is Medicare?
 What is the Medicare Prescription Drug
Plan benefit?
 Can I also get Medical coverage?
 How do I enroll?
The Aetna AnswerSM
S5810_7D_80805 (03/2009)
What is Medicare?
 A federal health insurance program
 Available to those age 65 and older:
 who are entitled to monthly Social Security benefits
 widows or widowers who are entitled to monthly Social Security benefits
 Available to those under age 65:
 who have been entitled to Social Security disability benefits for at least 24 months
 with ALS (Amyotrophic Lateral Sclerosis), known as Lou Gehrig’s disease, the first month
they are entitled to Social Security benefits
 who are entitled to Social Security benefits and need maintenance kidney dialysis or a
kidney transplant
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Which “Parts” of Medicare are you interested in?
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Part A – is primarily for hospitalization.
Part B – pays doctor bills as well as outpatient costs, including preventive services.
Part C – is also known as the Medicare Advantage program. Medicare Advantage plans are
offered by private insurance companies that have a contract with the federal government.
Part D – is the Medicare prescription drug benefit, which provides coverage for prescription
drugs. This benefit is only available through private insurance companies.
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What is the Medicare
Prescription Drug
Plan benefit?
Understand the benefit
2009 Federal Medicare Prescription Drug Base Benefit
Total
Drug
Expenditures
95% Medicare / Plan Contribution
5%
Enrollee
Coinsurance
$6,153.75
Enrollee
Out-of-Pocket
Expenditures
$4,350+
100% Enrollee Payment at
Aetna Discounted Rate
All Medicare
prescription drug
plans must be at
least as good as or
better than the
federal base benefit.
Coverage Gap
$2,700
$896.25
75% Plan Contribution
25% Enrollee
Co-insurance
$295
$0
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$295
$295 Enrollee Deductible
$0
Aetna Medicare Prescription Drug Plans (PDP)
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Aetna Medicare prescription drug plans are open formulary, meaning they cover all Medicare Part D drugs*
All plans have $0 deductibles for preferred generic prescription drugs
The variety of prescription drug features in our plans may include:
 No deductible
▪ Aetna Rx Home Delivery®*
 Specialty Pharmacy ▪ Coverage gap protection*
The Aetna Medicare Rx PlusSM Plan is currently available through Costco in these states: AK, AZ, CA, CO, FL, HI, ID, IL,
MI, NM, NV, NY, OH, OR, UT, VA, WA
Aetna Medicare Rx
EssentialsSM Plan
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Aetna Medicare Rx
PlusSM Plan
Alternative to Medicare base
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$0 deductible
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$0 deductible
drug benefit
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Predictable cost-sharing with $0
preferred generic copay
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Predictable cost-sharing with $0
preferred generic drug copay
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$10 preferred generic copay in the
gap; other Part D prescription
drugs discounted in the
coverage gap
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$10 preferred generic, $25 nonpreferred generic copay in the
coverage gap
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Discounted brand prescription
drugs in the coverage gap
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All Part D prescription drugs
covered by Medicare
are available*
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Generic Benzodiazepines
and Barbiturates
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$0 generic tier deductible
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Predictable cost-sharing with
$0 or low generic prescription
drug copay
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Discounted generic and brand
prescription drugs within the
coverage gap
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All Part D prescription drugs
covered by Medicare
are available*
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* Subject to precertification, step therapy, and quantity limits.
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Aetna Medicare Rx
PremierSM Plan
All Part D prescription drugs
covered by Medicare
are available*
Generic Benzodiazepines
and Barbiturates
Aetna Medicare Prescription Drug Plans (PDP)
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You can find the Aetna drug plan that best meets your needs at www.aetnamedicare.com
 Compare plan options
 Check for nearby pharmacies that accept Aetna negotiated discounts for prescription drugs
Over 59,000 pharmacies throughout the United States
Aetna Specialty Pharmacy provides access to highly specialized drugs and clinical advice
from pharmacists
Aetna Home Delivery® mails prescription drugs to your door at a savings
 Pay a 2-month copay for a 3-month supply of covered prescription drugs
 Pharmacists available at toll-free line for clinical advice
Detailed prescription drug list (also called a formulary):
 Find our printable formulary guide at www.aetnamedicare.com
 Request a printed version
Access to discounts on services and value-added benefits
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Aetna ExtrasSM
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Aetna ExtrasSM at no extra cost:
 Vision discounts. Up to 40% off the retail prices of eyeglass frames, savings on all types
of lenses and up to 15% off Lasik procedures.
 Aetna Weight ManagementSM Program. Discounts on weight-loss programs and products
from Jenny Craig®, one of the largest weight management firms worldwide.
 Aetna Natural Products and ServicesSM Program. Discounts on over-the-counter
vitamins, herbal and nutritional supplements and natural products and reduced rates from
chiropractors, acupuncturists, massage therapists and nutritional consultants.
Online tools such as:
 Aetna NavigatorTM helps you understand how your coverage is working for you.
 Aetna InteliHealth® provides helpful wellness and healthy lifestyle information.
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Can I also get medical
coverage?
The Aetna AnswerSM
Aetna Medicare Advantage Plans (MA)
Medicare
Advantage
Plans
(MA)
Medicare
Advantage
Prescription
Drug Plans
(MA-PD)
Medicare
Prescription
Drug Plans
(PDP)
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You may find our Medicare Advantage plans cost less than Medicare supplements
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Aetna also offers Medicare Advantage plans that combine medical and prescription drug coverage in
one, easy-to-use plan (MA-PD)
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You may find our Medicare Advantage medical plans with prescription drug benefits (MA-PD) are cost
effective, compared to paying for separate Medicare supplement and prescription drug plans
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All of our Medicare Advantage plans are administered by one company, with one number to call
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The Aetna AnswerSM
2009 Medical & Prescription Drug Coverage Choices
What do you want in a
health plan?
Medical Coverage
Extra Medical Coverage
Original
Medicare
Med
Supp*
X
MA
MA-PD
X
X
X
X
X
X
Prescription Drug Coverage*
PDP
Optional Dental Coverage
Aetna ExtrasSM
Total Integrated Solution

X
X
X
X
X
X
The Aetna AnswerSM is an integrated Medicare Advantage plan with
prescription drug coverage. With this plan you will receive medical and
prescription drug coverage, plus more benefits than you typically get with the
Original Medicare Plan alone.
* Prescription drug coverage available only to H, I, or J Medicare supplement policy
holders who enrolled prior to December 31, 2005.
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X
X
Why Aetna Medicare?
Low or No
Monthly Plan
Premium
Prescription
Drug
Coverage
Leading
Customer
Service
Simple Plan
Designs
Get all the
coverage you
need from
Aetna Medicare.
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Over 150
Years of
Experience
Aetna
ExtrasSM
Predictable
Copayments
How do I enroll?
Enrolling is as simple
as 1 – 2 – 3.
Enrollment Process
Enrollment 1 –2 – 3
Enrolling is as simple as 1–2–3. Once you know that you are eligible for the plan, follow the
steps below. You can also enroll online at www.aetnamedicare.com.
Step 1
Step 2
Step 3
Hand in your
application, or…
Review your enrollment
kit and select a plan.
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Complete the
enrollment form.
Mail your completed form
to Aetna.
Important dates to remember
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Initial Enrollment Period (IEP) – the 7-month period surrounding your Medicare eligibility, including the three
months prior to your 65th birthday, the month of your 65th birthday, and the 3 months after your 65th birthday.
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Annual Election Period (AEP) – Nov. 15 through Dec. 31
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Enroll in the plan of your choice for a Jan. 1 effective date
Annual Election Period
November 2008
11/15
AEP begins
December 2008
12/31
AEP ends*
*You may qualify for a Special Election Period (SEP) – ask your Aetna Representative.
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Do you have any
questions?
Thank you, we look forward to serving you.
For additional information, you can also
contact Medicare at 1-800-MEDICARE
or Medicare.gov.
Welcome to Aetna
Benefits coverage is provided through Aetna Life Insurance Company, a Medicare Prescription Drug Plan Sponsor with a
Medicare contract and benefits, limitations, service areas and premiums are subject to change on January 1 of each year.
This material is for informational purposes only. Not all health services are covered. See plan documents for a complete
description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and
are subject to change. Pharmacy clinical programs such as pre-certification, step therapy, and quantity limits may apply to your
prescription drug coverage. Providers are independent contractors and are not agents of Aetna. Aetna does not provide care or
guarantee access to health services. Health information programs provide general health information and are not a substitute
for diagnosis or treatment by a physician or other health care professional. Discount programs provide access to discounted
prices and are not insured benefits.
You must be entitled to Medicare Part A and continue to pay your Part B premium and Part A, if applicable, if not otherwise paid
for under Medicaid or by another third-party. You must reside in the Aetna Medicare Prescription Drug Plan service area.
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© 2008 Aetna Inc.
18.25.304.1 (10/08)