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Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.


PlanPrescriber utilizes Medicare Part C and Part D plan information provided by the Centers for Medicare & Medicaid Services as well as individual insurance carriers. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2012. Estimated drug costs (if displayed) are based on an estimated nationwide average drug price. PlanPrescriber is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

For Medicare Advantage Plans: Individuals enrolling in Medicare Advantage must have both Part A and B to enroll. For Medicare Advantage Plan enrollment you must continue to pay your Medicare Part B premium. Medicare Advantage members must receive all routine care from plan providers. For PPO plans: It may cost more to get care from out-of-network providers, except in an emergency or urgent care situation.

For plans with Part D Coverage: Estimated costs reflect the use of each Medicare plan's approved pharmacy network. Plan formularies (listing of covered drugs) may change throughout the year. In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, quantity limitation, copayments, 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 (1800-633-4227). 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 Medicaid Office.

For Non-network PFFS Plans: A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your provider is not required to agree to accept the plan's terms and conditions, and thus may choose not to treat you, with the exception of emergencies. If your provider does not agree to accept our payment terms and conditions of payment, they may choose not to provide health care services to you, except in emergencies. If this happens, you will need to find another provider that will accept our payment terms and conditions. Providers can find the plan's terms and conditions on the plan website.

For Network and partial network PFFs Plans: A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. We have network providers (that is, providers who have signed contracts with our plan). Full network PFFS plan provide coverage for all services covered under Original Medicare and partial network PFFS plans may cover certain categories of services for which network providers are available. These providers have already agreed to see members of the plan. If your provider is not one of the network providers, then the provider is not required to agree to accept the plan's terms and conditions, and thus may choose not to treat you, with the exception of emergencies. If your provider does not agree to accept our payment terms and conditions, they may choose not to provide health care services to you, except in emergencies. If this happens, you will need to find another provider that will accept our payment terms and conditions. Providers can find the plan's terms and conditions on the plan website.

For Dual Eligible SNP Plans: Premiums, co-pays, co-insurance and deductibles may vary based on the level of help received.

Other pharmacies are available in our network.


The Humana family has health plans with a Medicare contract, available to anyone enrolled in both Part A and Part B of Medicare. The Humana family has stand-alone prescription drug plans with a Medicare contract, available to anyone entitled to Part A and/or enrolled in Part B of Medicare. Medicare beneficiaries may enroll in the plan only during specific times of the year. You may contact a Humana benefits advisor at 1-800-457-4708 (TTY 711) 7 days a week 8:00 a.m. to 8:00 p.m. for more information. Other plans may be available in the service area. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2012.

For more information about Aetna Medicare plans, contact Aetna Medicare at 1-800-529-5586 (TTY/TDD: 1-888-760-4748), 8 a.m. to 8 p.m., seven days a week. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies (Aetna). A Medicare Advantage organization with a Medicare contract. A Medicare-approved Part D sponsor. Benefits, formulary, network, premium, and/or copayments/coinsurance may change on January 1, 2012. You must be entitled to Medicare Part A and Part B. You must continue to pay your Part B premium and Part A, if applicable.

Anthem Blue Cross and Blue Shield in Nevada is an independent Licensee of the Blue Cross and Blue Shield Association.

You may contact an Anthem Blue Cross and Blue Shield health benefits advisor at 1-877-831-3000 for Medicare Advantage plans or 1-866-892-5343 for Part D Plans (TTY/TDD Users: 1-800-241-6894, 8 am - 8 pm, local time, 7 days a week). Anthem Blue Cross and Blue Shield has Health plans with a Medicare contract. Anthem Blue Cross and Blue Shield has stand-alone prescription drug plans with a Medicare contract available to anyone entitled to Part A and/or enrolled in Part B of Medicare. Visit Anthem online at anthem.com/Medicare.

Care Improvement Plus is a Medicare Advantage organization with a Medicare contract. To be eligible for a Care Improvement Plus Chronic Conditions Special Needs Plan, you must have diabetes and/or heart failure. To be eligible for Care Improvement Plus Dual Advantage, you must be enrolled in state Medicaid and be a dual eligible beneficiary whom the State holds harmless for Part A and Part B cost sharing. If you are a full benefit dual beneficiary and your Part B premium is paid for by the State, you will not be responsible for paying your Part B premium. Premiums, co-pays, co-insurance and deductibles may vary based on the level of help received. It may cost more to get care from out-of-network providers, except in an emergency. If there isn't a network provider available for you to see, you can go to an out-of-network provider but still pay the in-network amounts except for members who live in our Maryland service areas. Those members can only use doctors, specialists, or hospitals in-network.

Group Health Cooperative/Group Health Options, Inc. is a Coordinated Care plan with a Medicare Advantage contract.

PacificSource Community Health Plans, Inc. is a health plan with a Medicare contract. Alternate formats are available, please contact PacificSource Medicare for more information.

WellCare is a Coordinated Care Plan with a Medicare Advantage contract. 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 WellCare/'Ohana will be responsible for the costs. If you meet certain eligibility requirements for both Medicare and Medicaid, your Part B premiums may be covered in full.

WellCare is a Medicare-approved Part D sponsor. To be eligible, you must have Medicare Part A and/or Medicare Part B to enroll in this plan. You must continue to pay your Medicare Part B premium.

'Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona. WellCare is a Coordinated Care Plan with a Medicare Advantage contract.

Plan information provided is accurate as of the 10/3/2011 update to the CMS Formulary, Pharmacy Network and Pricing Information, and this information may be further updated due to new updates to the aforementioned file.