Questions? YOUR CARE. YOUR COVERAGE. CONNECTED. · coverage. Access to quality care. PLUS, you have access to the Advantage MD Care Team. Choose from three affordable all-in-one plans

1 | ADVANTAGE MD – Plan Highlights

YOUR CARE.YOUR COVERAGE.CONNECTED.

One plan brings it all together for you.

Y0124_PEKBRO20819_M Accepted 9343(10/19)BRO

Questions? Want to enroll by phone?Connect with one of our local Medicare Specialists today. We’re ready to help you.

Call toll free 1-888-403-7662 (TTY: 711)8 a.m. to 8 p.m., 7 days a week8 a.m. to 8 p.m., Monday – Friday between April 1 and September 30§


to find the plan that’s right for you.It’s easy to find a Medicare plan that exceeds your expectations. Advantage MD members can enjoy life with greater confidence and security, knowing the expertise, strength and knowledge of a highly rated global leader in health care is behind their Medicare plan.

LEARNwhat’s missing from your current Medicare coverage.

What’s missing from my Medicare plan? ............................................................. p. 3

Am I paying too much for my Medicare Supplement plan? .............................. p. 3

DISCOVERthe advantages of Johns Hopkins Medicare Advantage plans and compare our plans to your current coverage.

What’s better about Johns Hopkins Medicare Advantage plans? ..................... p. 4

What will the Advantage MD Care Team do for me? ...................................... p. 4

Which plan is right for me? .................................................................................. p. 5

ENROLLin the Advantage MD plan that’s right for you!

How extensive is the Advantage MD network? ................................................ p. 7

I have more questions! ........................................................................................ p. 8

With Johns Hopkins Advantage MD (HMO and PPO), you’re getting more than a typical Medicare plan. You’re connecting with a comprehensive health care plan that combines your coverage and your care, which includes the Advantage MD Care Team.

You’ll also have a choice of plan options that help protect you from rising health care costs. With low monthly premiums, low copays and $0 medical deductibles.

And, it’s all from Johns Hopkins, a Maryland health care leader.* For over 125 years, we’ve been taking care of our neighbors. We’re ready to take care of you, too.


To enroll in Advantage MD, you must have Medicare Part A and Part B and live in one of these counties: Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico or Worcester. *Best Regional Hospitals Rankings, U.S. News & World Report.

Why Advantage MD is my choice:It’s nice knowing this plan comes from a name I know and trust. People who care about Maryland residents.

Why Choose Advantage MD for my Medicare plan?

3 Easy Steps

1

2

3

When you’re ready to enroll, we’re here to help!Call toll free 1-888-403-7662 (TTY: 711)8 a.m. to 8 p.m., 7 days a week (8 a.m. to 8 p.m., Monday – Friday between April 1 and September 30§)

Or enroll online today at HopkinsMedicare.com.

3 | ADVANTAGE MD – Plan Highlights 4 | ADVANTAGE MD – Plan Highlights

You pay for Medicare. You pay for your supplement. You pay for your drug plan.

Here is one example of how you may be overpaying for health insurance:

• Premiums for popular Medicare Supplement Plan F in Maryland range from $151 to $344 a month.* Add to that Medicare’s Part B premium of $134 a month.

• Plus, as with Medicare, Medicare Supplement plans won’t pay for prescription drugs or other health care — like preventive dental, routine vision or hearing care.

There is a better, less costly answer, and one that still gives you the freedom to see the providers you want.**

* Monthly premiums for Medicare Supplement Plan F in MD range from $151 – $344. Based on available 2018 premium information on medicare.gov.

** Out-of-network costs are slightly higher for the PPO plans. HMO plan members must use in-network providers.

† Applicable to HMO, PPO Plus and PPO Premier only.‡ Annual coverage/savings based on combined cost of Medicare Part A deductible ($1,364) and Medicare Part B deductible ($185).

Did you know Original Medicare pays just 80% of the costs for covered expenses? You pay the rest!

As good as it is, Medicare was never meant to cover all your medical, prescription and wellness expenses. On average, Medicare covers about 80%, leaving the other 20% for you to pay. That 20% can add up to thousands of dollars in a year.

Medicare also does not pay for prescription drugs. There are no benefits for routine dental, vision or hearing care either.

Simply put, relying on Medicare alone to provide for all your health and well-care cannot give you the well-rounded benefits you need, and you could find it puts your finances at risk.

What will the Advantage MD Care Team do for me?RxBIN 1235678

RxBIN 1235678

RxPCN 1235678

RxGRP XYZRX1

MedicareRx Plan

Having three plans is costly and inconvenient.

What’s Missing from my Medicare plan?

Am i paying too much for my Medicare supplement plan?

You’ll have access to a team of professionals dedicated to providing personalized support at no extra cost. From setting up appointments and medication guidance, to managing a health condition — we’re here for you!

There’s even a 24/7 Nurse Chat service — by phone or online — for medical advice and answers to health questions. It’s a complete suite of personalized care services to help you live your best life.

Why Advantage MD is my choice:I like having an Advantage MD Care Team so I can get personalized care when I need it.

LEARN DISCOVER

What’s BETTER About:

More benefits. Built-in savings. Prescription drug coverage. Access to quality care. PLUS, you have access to the Advantage MD Care Team.

Choose from three affordable all-in-one plans that offer you:

Medical and hospital benefits beyond Original Medicare

100% coverage for Medicare Parts A and B deductibles — save up to $1,549 a year‡

Prescription drug coverage with low copays

Low copays for Urgent and Emergency Care

Dental, hearing and vision benefits

Annual eyewear reimbursement†

Access to over 10,000 doctors and hospitals across Maryland — including Johns Hopkins providers

Comprehensive. Cost-conscious. Connected. Johns Hopkins Advantage MD connects you to what you need to stay healthy and save money.

There’s a lot Original Medicare doesn’t cover.

20%MEDICARE PAYS

80%YOU PAY

1 2


This is not a complete description of plan benefits. Please see the Summary of Benefits and the Evidence of Coverage.*Optional benefits available for additional premiums. **Out-of-network costs are slightly higher for the PPO plans. HMO plan members must use in-network providers. †Advantage MD (HMO) $25 premium for the following counties: Anne Arundel, Baltimore, Calvert, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico and Worcester.

DISCOVER2

Compare Advantage MD HMO and PPO plans:

All our plans connect expert care and

quality coverage — including Rx benefits

— all in one. Our popular, budget-

friendly HMO plan has a $0 monthly

premium† and predictable low copays.

Prefer more freedom? Our PPO plans

have higher monthly costs, but you

enjoy lower copays and are free to see

any doctors you want.** Use the plan

comparison chart to help you decide.

Which plan is right for me? Review your plan options below.

Medical Benefits (Partial listing; In-network)

Johns Hopkins Advantage MD (HMO)

Johns Hopkins Advantage MD (PPO)

Johns Hopkins Advantage MD Plus (PPO)

NEW! Johns Hopkins Advantage MD Premier (PPO)

Monthly Plan PremiumBaltimore City: $0 Other cities/counties in Advantage MD Service Area:† $25

$75 not available in Montgomery County

$105 not available in Montgomery County

$350 Montgomery County only

Medical Deductible $0 $0 $0 $0

Primary Care Provider Visit $5 copay $10 copay $5 copay $0 copay

Specialist Visit $50 copay $50 copay $50 copay $10 copay

Referrals Required Not required Not required Not required

Urgent Care $40 copay $40 copay $40 copay $20 copay

Eyewear Allowance up to $150 allowance for eyewear every two years Not covered up to $150 allowance for

eyewear every two yearsup to $300 allowance for eyewear every two years

Preventive Dental Services $15 – $25 copay, depending on service

$15 – $25 copay, depending on service

$10 – $20 copay, depending on service $0 coinsurance

Routine Chiropractic Care Not covered Not covered $20 copay; up to 12 annually $10 copay; up to 12 annually

Hearing Aid Coverage Two options available, $699 or $999 copay per aid

Two options available, $699 or $999 copay per aid



Silver&Fit® Fitness Program Optional* Optional* Included Included

Supplemental Comprehensive Dental Optional* (see separate brochure for more information) Included

Prescription Drug Benefits (30-day supply)

Deductible $0 $350 (for Tiers 3, 4 and 5) $350 (for Tiers 3, 4 and 5) $0

Preferred generic Generic Preferred brand Non-preferred drug Specialty

$0 copay $10 copay $47 copay $100 copay 33% of the cost





(Continued on next page)

Other providers are available in our network.


Use the application enclosed and return by mail.

Visit HopkinsMedicare.com to enroll online.

Call today to enroll right over the phone.

**Medicare Supplement plans K and L offer an out-of-pocket limit.

Your primary doctor is the key to coordinating your health care.

It’s why Advantage MD gives you access to over 10,000 providers —

all connected to the services you need to stay healthy. Q: Are Medicare Advantage and Medicare Supplement plans the same thing?

A: Medicare Advantage (MA) plans are offered by private companies, contracted through the federal Medicare program, to administer your health plan and pay your health care bills. MA plans often include prescription drug coverage and extra benefits like dental, vision and wellness benefits to help keep you healthy while also protecting you against expenses that Medicare doesn’t cover. MA plans typically cap your annual out-of-pocket costs and are also well-regarded for ease of use, convenience and affordability.

Medicare Supplement plans work in conjunction with your traditional Medicare coverage to help offset some of the expenses that Original Medicare doesn’t cover. You would need to purchase a separate Medicare prescription drug plan, however, as Medicare Supplement plans do not cover prescription drugs, nor do they include the kinds of extra benefits that MA plans do. There is also no cap on your annual out-of-pocket spending with Medicare and a Medicare Supplement plan.**

Q: What does it cost to have this coverage?

A: Advantage MD (HMO) is $25 a month ($0 in Baltimore City). Advantage MD (PPO) is $75 a month. Advantage MD Plus (PPO) is $105 a month. Advantage MD Premier (PPO) is $350 a month. However, you must also continue to pay your Medicare Part B premium.

Q: How can I pay my Advantage MD premium?

A: You can pay your premium by using electronic funds transfer (EFT) from your bank account or automatically deducting it from your Social Security or Railroad Retirement Board (RRB) benefit check. You can also receive a monthly statement. If you enroll in EFT, Social Security or RRB you don’t have to wait on monthly statements or write checks. The EFT enrollment process usually takes 4–5 weeks. Enrolling in automatic withdraw from Social Security takes a minimum of 90 days. While you are waiting for EFT or Social Security withdraw to start, you will receive monthly statements. You must pay your premium directly to Advantage MD.

Q: What benefits does Advantage MD cover that Original Medicare doesn’t?

A: You’ll want to review the enclosed Summary of Benefits to see all of the benefits covered under Advantage MD. To summarize, Johns Hopkins Advantage MD covers doctor, specialist and hospital care, medical services, prescription drugs, preventive dental, routine vision and hearing care.

ENROLL

Better care begins with your doctor.

You have questions. We have answers.

Adventist HealthCare

Anne Arundel Medical Center

Frederick Regional Health System

Johns Hopkins Medicine

LifeBridge Health

Mercy Medical Center

Peninsula Regional Medical Center

Ready to enroll in Advantage MD?

3

Call toll free 1-888-403-7662 (TTY: 711)8 a.m. to 8 p.m., 7 days a week8 a.m. to 8 p.m., Monday – Friday between April 1 and September 30§


§From April 1 – September 30, you will need to leave a message on holidays and weekends.

Johns Hopkins Advantage MD is a Medicare Advantage Plan with a Medicare contract offering HMO and PPO products. Enrollment in Johns Hopkins Advantage MD HMO or PPO depends on contract renewal.

To join a Johns Hopkins Advantage MD plan, you must have Medicare Part A and Part B, and live in the service area (Anne Arundel, Baltimore, Baltimore City, Calvert, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico and Worcester counties). Please contact the plan for more details.

Silver&Fit® is a registered trademark of American Specialty Health Incorporated.

Out-of-network/non-contracted providers are under no obligation to treat Johns Hopkins Advantage MD members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Advantage MD products are offered by Hopkins Health Advantage, Inc., a Maryland health insurer.

Johns Hopkins Advantage MD (PPO) and Johns Hopkins Advantage MD (HMO) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. Johns Hopkins Advantage MD does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Foreign Language Assistance; Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-293-5325 (TTY: 711); Chinese: 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-403-7662 (TTY: 711)。

(Continued from previous page)

Q: What’s the difference between a PPO plan and an HMO plan?

A: The monthly cost and copays of an HMO plan are usually lower because you need to use in-network doctors and hospitals. You also need a referral from your primary care physician (PCP) to see specialists when you have an HMO plan. If you go to a provider outside of our HMO network for non-emergency care, you will be responsible for the entire cost.

With a PPO plan, you don’t need a referral from your PCP to see specialists — and you can go in and out of network for care. Going out of network can result in a slightly higher cost — unless you enroll in Advantage MD Premier (PPO), which offers the same costs in or out of network.

Q: Do I need to go to Baltimore for my health care?

A: No. While Baltimore County and Baltimore City are included in our service area, you can choose any of our 10,000+ participating providers located in your community and across Maryland. With both Advantage MD PPO plans, you also have the freedom to use any other doctor or hospital you want. Please note that out-of-network costs are slightly higher unless enrolled in Advantage MD Premier (PPO).

Q: When are the Medicare Enrollment Periods?

A: Those already on Medicare must enroll during the Annual Election Period (AEP), which takes place every year from October 15 to December 7.

If you’re new to Medicare, you have a 7-month window in which to enroll (this is your Initial Enrollment Period): three months before you turn 65, the month of your birthday and three months after the month you turn 65. If you don’t enroll during these seven months, you’re subject to a possible penalty.

Why Advantage MD is my choice:I like having coverage beyond Original Medicare — I save money every time I fill my prescriptions.

Have a Question? Ask A local Medicare Specialist. Call toll free 1-888-403-7662 (TTY: 711)8 a.m. to 8 p.m., 7 days a week8 a.m. to 8 p.m., Monday – Friday between April 1 and September 30§

Documents

Questions? YOUR CARE. YOUR COVERAGE. CONNECTED. · coverage. Access to quality care. PLUS, you have access to the Advantage MD Care Team. Choose from three affordable all-in-one plans