Welcome to America's 1st Choice!

We want to thank you for considering America's 1st Choice for your Medicare coverage.

America’s 1st Choice is a Medicare Advantage Private Fee For Service (PFFS) Plan approved in all counties in the State of North Carolina.

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What We’ll Discuss Today America's 1st Choice:

Who we areWhat we offer (What is a PFFS?)

Service Area in North Carolina

Eligibility to enroll

How a PFFS works

Explain the benefits of the America's 1st Choice plans

Your questions are important to us. If you have questions during the presentation, please hold them.

Show you how to enroll today!

Who is America's 1st Choice?

We are a physician owned (Medicare Advantage) insurance company which sets us apart from the competition

We are locally-operated to ensure that we understand your healthcare concerns

We are committed to excellence

What is a Medicare Advantage Plan?

“You can get your coverage through the Original Medicare Plan or Medicare Advantage Plans. Congress created the Medicare Advantage program to provide you with more choices and sometimes extra benefits by letting private companies offer you your Medicare benefits.”

Source: Medicare & You 2005, Centers for Medicare and Medicaid Services

What is a Private Fee-For-Service plan? PFFS is a type of Medicare Advantage plan

offered by a private insurance company like America’s 1st Choice Insurance Company of North Carolina, Inc.

It is not the same as the Original Medicare plan that is offered by the Federal Government

It is not a Medicare supplement, Medigap, Medicare Select, or Prescription Drug Plan

Are you Eligible?

Do you have Medicare Parts A & B?

Is your permanent residence here in this county?

Do you have end stage renal disease?

Medicare Advantage Plan Guarantees:

“If you join a Medicare Advantage Plan:

You are still in the Medicare program

You still have Medicare rights and protections

You still get all your regular Medicare-covered services

You may be able to get extra benefits…”Source: Medicare & You 2005, Centers for Medicare and Medicaid Services .

Added Benefits of our Medicare Advantage PFFS Plans

All the benefits that you currently receive from Medicare, plus much more including…

No Medicare deductibles

Routine physicals

Brand and generic Rx coverage (only on insert plan name)

Nationwide emergency/ urgent care

Physicians and Specialists without Referral

No need to pay supplemental monthly premiums*

Additional services including dental, vision and hearing

* varies by plan

Department of Health & Human ServicesCenters for Medicare and Medicaid Services

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MEDICARE ADVANTAGE -Covers all benefits of

Original Medicare -No Medicare Deductibles -No supplement needed -Provides additional benefits

ORIGINAL MEDICARE -Limited coverage -Deductibles -Co-insurance -Supplement needed

MEDICARE BENEFICIARY(YOU)

Compare Your Healthcare Choices

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This table is a brief overview comparing Medicare alone, a popular Medicare supplement and America's 1st Choice plans. The Summary of Benefits will go into

more detail about benefits.

Medicare alone

Office visits when you aresick

Hospitalization

* Certain Plans do not cover Rx * Limitations and co-payments may apply

A common Medicaresupplement - Plan CCoverage for all Medicare

deductibles and co-insurance

America's 1st ChoicePrescription Drug Benefits**

Routine Physical Exams

Additional Services: Dental, Vision, Hearing*

How does PFFS work? A Medicare Advantage Private Fee-for-

Service plan works differently than a Medicare supplement plan.

Your doctor or hospital is not required to agree to accept the plans terms and conditions, and thus may choose not to treat you, with the exception of emergencies.

How does PFFS work?

If your doctor or hospital does not agree to accept our payment terms and conditions, they may not provide healthcare services to you, except in emergencies.

Providers can find the Plan’s terms and conditions on our website. www.americas1stchoice.com

How does it work?

America’s 1st Choice pays instead of Medicare. You will pay amounts that the PFFS Plan does not pay, which are called co-payments and/or co-insurance.

Original Medicare will not pay for your healthcare while you are enrolled in a Private Fee-for-service plan.

How do you obtain services from a PFFS Plan?

You may receive healthcare services from any provider allowed to bill Medicare who agrees to accept the Private Fee-for-service plan’s payment terms and conditions.

You must use network pharmacies to obtain prescription drugs, except in emergencies or urgent situations.

Before seeing a provider, you should …

Verify that your provider will accept the America’s 1st Choice PFFS Plans (<insert plan name).

Your healthcare providers have the right to choose whether to accept a Private Fee-for-service plan’s payment terms and conditions every time you see your providers.

When you go to the doctor or hospital:

Show your America’s 1st Choice ID card and tell them that you have chosen either the youPatriot Plan 004Presidential Plan 006Ambassador Plan 020Patriot Plus Plan 005Presidential Plus Plan 007

Do not show your red, white and blue Medicare card

Pay any America’s 1st Choice co-payments or co-insurance at the time of service.

What if? If your provider decides not to accept the plan,

you will need to find another provider that will.

They should not provide services to you except in an emergency.

If they choose to provide services, they may not bill you. They must bill the Private Fee-for-service plan for your covered healthcare services. You must pay the appropriate co-payments and co-insurance.

Don’t worry about payments

The doctor or hospital will bill America’s 1st Choice for the rest.

Healthcare providers must bill the Private Fee-for-service plan (America’s 1st Choice).

You are in control with a Medicare Advantage

Private Fee For Service (PFFS)

YOU:BENEFICIARY

Freedom of Primary Care Physicians

Freedom of Specialty Physicians& Hospitals

No Referrals Necessary

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Plan Benefits Plan Benefits For the next few minutes,

your America's 1st Choice

Representative will present the specifics of the

America's 1st Choice Medicare Advantage plan benefits,

using the Medicare Approved Summary of Benefits booklet.

QUESTIONS?

Before we finish……

Would you like to enroll today?To enroll, we need to complete an

enrollment form today.

Once you are approved on the Plan, you will receive a welcome package and your member identification card

Your (proposed) effective date will be: The 1st of the following

month.

Thank You and Share the Good News

Many of our members have been referred by their friends. Who do you

know that could benefit from our Plan?

Call Toll Free: 866-321-3947TTY/TDD: 800-735-2962<Monday thru Sunday>

<8:00 am – 8:00 pm>www.americas1stchoice.com