Page 30 - Hospice Benefits Enrollments Guide

When Can You Join a Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and
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each year from October 15 to December 7 .

However, if you lost your current creditable prescription drug coverage through no fault
of your own, you will also be eligible for a two (2) month Special Enrollment Period
(SEP) to join a Medicare drug plan.

What Happens to Your Current Coverage if You Decide to Join
a Medicare Drug Plan?

If you decide to join a Medicare drug plan, your current Hospice & Palliative
CareCenter coverage will be affected.

The prescription drug plan option available in conjunction with the medical program is
outline below:

Prescription HDHP Plan HRA Plan PPO Plan
Drug Type:
Tier 1 Deductible then 0% $10 $10
50% ($25 minimum up 50% ($25 minimum up
Tier 2 Deductible then 0%
to $115 maximum) to $115 maximum)
50% ($40 minimum up 50% ($40 minimum up
Tier 3 Deductible then 0%
to $130 maximum) to $130 maximum)
50% ($40 minimum up 50% ($40 minimum up
Tier 4 Deductible then 0%
to $130 maximum) to $130 maximum)

If you do decide to join a Medicare drug plan and drop your current Hospice &
Palliative CareCenter coverage, be aware that you and your dependents will be able to
get this coverage back at annual enrollment.

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