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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 Affinity Neurocare and your options under Medi- Medicare Drug Plan? You should also know that if you drop or
care's prescription drug coverage. This information can help you lose your current coverage with Affinity Neurocare medical
decide whether or not you want to join a Medicare drug plan. If you plan and don't join a Medicare drug plan within 63 continuous
are considering joining, you should compare your current cover- days after your current coverage ends, you may pay a higher
age, including which drugs are covered at what cost, with the cover- premium (a penalty) to join a Medicare drug plan later. If you
age and costs of the plans offering Medicare prescription drug cov- go 63 continuous days or longer without creditable prescription
erage in your area. Information about where you can get help to drug coverage, your monthly premium may go up by at least 1%
make decisions about your prescription drug coverage is at the end of the Medicare base beneficiary premium per month for every
of this notice. month that you did not have that coverage. For example, if
you go nineteen months without creditable coverage, your

Please note: If you are not Medicare eligible, and none of your
premium may consistently be at least 19% higher than the
covered family members are Medicare eligible, no action is required
Medicare base beneficiary premium. You may have to pay this
on your part.
higher premium (a penalty) as long as you have Medicare
There are two important things you need to know about your prescription drug coverage. In addition, you may have to wait
current coverage and Medicare's prescription drug coverage: until the following October to join.
• Medicare prescription drug coverage became available in 2006 For more information about this notice or your current
to everyone with Medicare. You can get this coverage if you join a Prescription Drug Coverage: Contact your HR department for
Medicare Prescription Drug Plan or join a Medicare Advantage Plan further information, 214-407-8580 NOTE: You may receive this
(like an HMO or PPO) that offers prescription drug coverage. All notice at other times in the future such as before the next peri-
Medicare drug plans provide at least a standard level of coverage od you can enroll in Medicare prescription drug coverage, and if
set by Medicare. Some plans may also offer more coverage for a this coverage changes. You also may request a copy.
higher monthly premium.
For more information about your options under Medicare
• Affinity Neurocare has determined that the prescription drug Prescription Drug Coverage: More detailed information about
coverage offered by Affinity Neurocare medical plan is, on average Medicare plans that offer prescription drug coverage is in the
for all plan participants, expected to pay out as much as standard "Medicare & You" handbook. You'll get a copy of the handbook
Medicare prescription drug coverage pays and is therefore in the mail every year from Medicare. You may also be
considered Creditable Coverage. Because your existing coverage is contacted directly by Medicare drug plans.
Creditable Coverage, you can keep this coverage and not pay a
For more information about Medicare prescription drug
higher premium (a penalty) if you later decide to join a Medicare
coverage:
drug plan.
• Visit www.medicare.gov.
When can you join a Medicare Drug Plan? You can join a Medicare
drug plan when you first become eligible for Medicare and each • Call your State Health Insurance Assistance Program (see the
year from October 15 through December 7. However, if you lose inside back cover of your copy of the "Medicare & You"
your current creditable prescription drug coverage, through no fault handbook for their telephone number) for personalized help.
of your own, you will also be eligible for a two (2) month Special
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call
Enrollment Period (SEP) to join a Medicare drug plan.
1-877-486-2048.
What happens to your current coverage if you decide to join a
If you have limited income and resources, extra help paying for

Medicare Drug Plan? If you decide to join a Medicare drug plan,
Medicare prescription drug coverage is available. For
your current Affinity Neurocare medical coverage will not be affect- information about this extra help, visit Social Security on the
ed. Participants may keep this coverage if they elect Part D and this web at www.socialsecurity.gov, or call them at 1-800-772-1213
plan will coordinate with Part D coverage. If you decide to join a (TTY 1-800-325-0778).
Medicare drug plan and drop your current Affinity Neurocare medi-
cal plan coverage, be aware that you and your dependents will NOT
be able to get this coverage back.
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