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

Your story for Presbyterian Senior Care (HMO/HMO-POS), Presbyterian MediCare PPO, and Presbyterian Dual Plus (HMO SNP) members Fall 2019 Presbyterian Health Plan, Inc. P.O. Box 27489 Albuquerque, NM 87125-7489 Important plan information Standard U.S. Postage PAID Presbyterian Health Plan Tips to avoid the flu 6 INSIDE Protect yourself from fraud 8 MC Learn more about changes to your 2020 plans! Beginning in 2020, your premiums for Senior Care Plan 2 and Plan 3 will remain the same. There are also decreased copays for your hearing exams and vision office visit copays. Your Part B coinsurance is increasing. Costs for your diabetic supplies will decrease. Some changes for the specific plans are as follows: Presbyterian Senior Care HMO Plan 1 (does not include prescription drug coverage) ● ● Your premium stays at $0. ● ● Your hearing exam is decreasing from $45 to $0. ● ● Your vision specialist copay is going down from $50 to $10. ● ● Diabetic test strips and lancets are going down from $10 to $0. Presbyterian Senior Care HMO Plans 2 and 3 with Rx (includes prescription drug coverage) ● ● There will be no increase in your premium. ● ● Your Tier 1 generic medications are now $0. ● ● Your hearing exam is decreasing from $45 to $0. ● ● Your vision specialist copay is going down from $50/$40 to $10. ● ● Diabetic test strips and lancets are going down from $10 to $0. ● ● On Plan 2, if you qualify for a low-income subsidy (LIS), your premium may be $0. ● ● On Plan 3, if you qualify for a LIS, your premiums may be as low as $96.40. Please refer to your Presbyterian member ID card as a reminder of your plan. Hearing aid benefit for Presbyterian Senior Care (HMO/HMO-POS) and Medicare PPOmembers Members are offered routine Medicare- covered hearing exams again in 2020. Contact customer service to learn more about your hearing benefits that make improved hearing more affordable. Hearing aids can average as much as $2,400 per aid, but this benefit makes improved hearing more affordable. Your plan covers one hearing aid per ear, per year, through TruHearing ® . You can choose from the Advanced Hearing Aid for $699 and the Premium Hearing Aid for $999. Call TruHearing ® to learn more and schedule an appointment at 1-866-202-0132 , Monday through Friday from 8 a.m. to 8 p.m. (Mountain Time). TTY users call 711 . Alternative therapies Chiropractic care We will also continue to offer routine chiropractic care! Under this benefit, you will be covered for up to 25 visits a year. Your plan will also continue to provide coverage to correct subluxation of the spine. Acupuncture care Presbyterian Medicare Advantage plan members will continue to have acupuncture coverage in 2020. Our plans offer a range from 12 to 25 sessions per year. How can I get a LOWER premium? As a Medicare beneficiary, you may qualify for money-saving programs based on your income to help you pay your plan premiums and drug costs. If you qualify for LIS, your plan premium and drug costs will be reduced. Your premium will be reduced based on the LIS level you qualify for. The gap in your prescription drug coverage, also known as the donut hole, is also eliminated. See pages 2 and 3 for more information on how you may qualify for these money-saving programs. All of these benefit changes will go into effect on Jan. 1, 2020. Refer to the Annual —Continued on page 2