Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO | Fall 2019 | Your Story

2 Notice of Change packet you received in September to find out about additional changes for 2020. For further questions regarding the benefit changes to your Medicare plan, you may contact the Presbyterian Customer Service Center at (505) 923-6060 or 1-800-797-5343 . You may also visit www.phs.org/Medicare . Money-saving programs for Medicare plans You may qualify for big savings in your Medicare plan and not even know it. If you have limited income and assets, you may qualify for LIS, also called Extra Help. If you do qualify, your plan premium, drug copays and prescription drug deductibles will be lowered. Qualifications are based on your income level and resources, and you must be on a plan that includes prescription drug coverage. Premium Your premium will be reduced based on the LIS level that you qualify for. The table at top right shows the premium you will pay if you qualify for the 100% LIS level. Prescription drugs If you qualify for LIS, your prescription drug deductible and coverage gap (the donut hole) in your drug coverage is eliminated. Depending on the level of LIS you qualify for, your drug copays may be reduced to less than $9 or 15% of the cost of the drug. See the bottom table below. Monthly premium (LIS level 100%) Presbyterian Senior Care HMO Plan 2 $0 Presbyterian Senior Care HMO Plan 3 $96.40 *For premium amounts for Presbyterian MediCare PPO or Presbyterian Dual Plus (D-SNP) plans, contact customer service at the number on the back of your ID card. Qualifying income levels for 2019 To qualify for LIS, your annual income and resources/assets need to be at or below the following: Depending on your LIS level For generic drugs (including brand drugs treated as generic), you pay: For all other drugs, you pay: $0 copay; or $0 copay; or $1.30 copay; or $3.90 copay; or $3.60 copay; or $8.95 copay; or 15% of the cost of the drug 15% of the cost of the drug Find out if you qualify for assistance To find out if you qualify for LIS, you can call My Advocate™, a personal service available to you as a Presbyterian member. My Advocate™ will also help you apply for these —Continued from front page Be sure to review your Annual Notice of Change (ANOC) packet