Page 31 - Phil Chai - Benefit Guide Corporate Revised 102220 LR

Medicare Part D Notice: Prescription

Drug Coverage and Medicare

This notice has information about your current prescription drug When will you pay a higher premium (penalty) to join a
coverage with Phil Chai Healthcare Management, LLC and your op- Medicare Drug Plan? You should also know that if you drop or
tions under Medicare's prescription drug coverage. This information lose your current coverage with Phil Chai Healthcare Manage-
can help you decide whether or not you want to join a Medicare ment, LLC Healthcare & Rehabilitation medical plan and don't
drug plan. If you are considering joining, you should compare your join a Medicare drug plan within 63 continuous days after your
current coverage, including which drugs are covered at what cost, current coverage ends, you may pay a higher premium (a penal-
with the coverage and costs of the plans offering Medicare prescrip- ty) to join a Medicare drug plan later. If you go 63 continuous
tion drug coverage in your area. Information about where you can days or longer without creditable prescription drug coverage,
get help to make decisions about your prescription drug coverage is your monthly premium may go up by at least 1% of the Medi-
at the end of this notice. care base beneficiary premium per month for every month that
you did not have that coverage. For example, if you go nine-

Please note: If you are not Medicare eligible, and none of your
teen months without creditable coverage, your premium may
covered family members are Medicare eligible, no action is required
consistently be at least 19% higher than the Medicare base
on your part.
beneficiary premium. You may have to pay this higher premium
There are two important things you need to know about your (a penalty) as long as you have Medicare prescription drug cov-
current coverage and Medicare's prescription drug coverage: erage. In addition, you may have to wait until the following
October to join.
• Medicare prescription drug coverage became available in 2006 to
everyone with Medicare. You can get this coverage if you join a For more information about this notice or your current
Medicare Prescription Drug Plan or join a Medicare Advantage Plan Prescription Drug Coverage: Contact your HR department for
(like an HMO or PPO) that offers prescription drug coverage. All further information, 917-817-4771. NOTE: You may receive

Medicare drug plans provide at least a standard level of coverage this notice at other times in the future such as before the next
set by Medicare. Some plans may also offer more coverage for a period you can enroll in Medicare prescription drug coverage,
higher monthly premium. and if this coverage changes. You also may request a copy.

• Phil Chai Healthcare Managementhas determined that the pre- For more information about your options under Medicare
scription drug coverage offered by Phil Chai Healthcare Manage- Prescription Drug Coverage: More detailed information about
ment, LLC medical plan is, on average for all plan participants, ex- Medicare plans that offer prescription drug coverage is in the
pected to pay out as much as standard Medicare prescription drug "Medicare & You" handbook. You'll get a copy of the handbook
coverage pays and is therefore UNITED HEALTHCARE is considered in the mail every year from Medicare. You may also be
Creditable Coverage. Because your existing coverage is Creditable contacted directly by Medicare drug plans.
Coverage, you can keep this coverage and not pay a higher premi-
For more information about Medicare prescription drug
um (a penalty) if you later decide to join a Medicare drug plan.
coverage:
When can you join a Medicare Drug Plan? You can join a Medicare
• Visit www.medicare.gov.
drug plan when you first become eligible for Medicare and each
year from October 15 through December 7. However, if you lose • Call your State Health Insurance Assistance Program (see the
your current creditable prescription drug coverage, through no fault inside back cover of your copy of the "Medicare & You"
of your own, you will also be eligible for a two (2) month Special handbook for their telephone number) for personalized help.
Enrollment Period (SEP) to join a Medicare drug plan.
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call
What happens to your current coverage if you decide to join a 1-877-486-2048.

Medicare Drug Plan? If you decide to join a Medicare drug plan,
If you have limited income and resources, extra help paying for
your current Phil Chai medical coverage will not be affected. Partici-
Medicare prescription drug coverage is available. For
pants may keep this coverage if they elect Part D and this plan will information about this extra help, visit Social Security on the
coordinate with Part D coverage. If you decide to join a Medicare web at www.socialsecurity.gov, or call them at 1-800-772-1213
drug plan and drop your current Phil Chai ’s medical plan coverage, (TTY 1-800-325-0778).
be aware that you and your dependents will NOT be able to get this
coverage back.
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