MyPlan A

MyPlan A combines the benefits of Medicare Advantage with prescription drug coverage. MyPlan A  ensures that you can keep your current Part D plan while combining the benefits of a low premium Medicare Advantage plan. MyPlan A members pay $50 YEARLY deductible for medical care, $0 annual wellness visit, and $0 co-pay for diabetic supplies. FamilyCare realizes the importance of protecting your assets against the rising costs of health care. With MyPlan A your out-of-pocket costs for covered care are capped annually. In addition, MyPlan A members are covered anywhere in the world for emergency and urgent care.

MyPlan A

• Combines the benefits of Medicare Advantage with prescription drug coverage
• $50 annual deductible for medical care
• Low drug out-of-pocket expense
• Routine vision coverage
• Protection from rising health care costs
• Covered anywhere in the world for emergency and urgent care.

MyPlan A - one simple plan for those individuals who want the combined benefits of Medicare Advantage abd prescription drug coverage.

If you have questions concerning your plan or your coverage, please contact us. We are here to assist you Monday through Friday, 8 am-8 pm, so please don't hesitate to call us at 1-866-798-CARE (2273), TTY 1-800-735-2900.

$74 monthly premium

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SUMMARY OF BENEFITS

EVIDENCE OF COVERAGE

DRUG FORMULARY

STEP THERAPY

PRIOR AUTHORIZATION

2012 PLAN INFORMATION

PLAN RATING INFORMATION

LOW-INCOME SUBSIDY (LIS) PREMIUMS

• The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan.
• Limitations, co-payments and restrictions may apply.
• Benefits, formulary, pharmacy network, premiums and/or co-payments/co-insurance may change on January 1 of each year.
• You must continue to pay your Medicare Part B premium.
• Medicare beneficiaries may also enroll in MyPlan Medicare option plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.