Transcription
Costco has teamed up withAetna to offer a MedicarePart D Prescription Drug PlanWith over 40 years of experience serving people eligible forMedicare, Aetna knows what you’re looking for when it comesto your Medicare Prescription Drug Plan. You want it to beaffordable. You want it to include the prescription drugs thatmatter to you most. And you want it to be easy to understandand easy to use. And with over 30 years of experience indelivering value, Costco knows how to offer exclusivefeatures and savings that its members expect.Get the most value with specialcost savings when you fill yourprescriptions at one of Costco’shundreds of U.S. pharmacies.*In addition, you’ll also haveaccess to Aetna’s pharmacynetwork with morethan 60,000 pharmaciesnationwide. Copays arehigher when you fillyour prescriptions atother Aetna networkpharmacies.Aetna is the brand name used for products and services provided by one ormore of the Aetna group of subsidiary companies (Aetna).The benefit information provided herein is a brief summary, not a compre hensive description of benefits. For more information, contact the plan.Limitations, copayments, and restrictions may apply. Benefits, formulary,pharmacy network, premium and/or copayments/coinsurance may changeon January 1, 2012.You must be entitled to Medicare Part A or B and continue to pay your Part Bpremium and Part A, if applicable. Medicare beneficiaries may enroll in a planonly during specific times of the year. To obtain additional information, pleasecontact Aetna Medicare at 1 800 213 4599 (TTY/TDD 1 888 760 4748), from8 am to 8 pm, 7 days a week.In general, beneficiaries must use network pharmacies to access theirprescription drug benefit, except in non routine circumstances. Pharmacyclinical programs such as prior authorization, step therapy, and quantitylimits may apply to your prescription drug coverage.You may be able to get Extra Help to pay for your prescription drugpremiums and costs. To see if you qualify for Extra Help, call: 1 800 MEDICARE(1 800 633 4227) (TTY users should call 1 877 486 2048), 24 hours a day,7 days a week; the Social Security Office at 1 800 772 1213 between 7 amand 7 pm, Monday through Friday (TTY users should call 1 800 325 0778);or your Medicaid office.This material is for informational purposes only. Not all health servicesare covered. See plan documents for a complete description of benefits,exclusions, limitations and conditions of coverage. Plan features andavailability may vary by location and are subject to change. Aetna receivesrebates from drug manufacturers that may be taken into account indetermining Aetna’s Preferred Drug List. Rebates do not reduce the amounta member pays the pharmacy for covered prescriptions. Providers areindependent contractors and are not agents of Aetna. Provider participationmay change without notice. Aetna does not provide care or guaranteeaccess to health services.Translation of this material into another language may be available. Forassistance, please call Member Services at: 1 800 213 4599 (TTY/TDD1 888 760 4748.Puede estar disponible la traducción de este material en otro idioma.Para ayuda, por favor llame a Servicios al Miembro al: 1 800 213 4599(TTY/TDD: 1 888 760 4748).Medicare Part DPrescription Drug PlanThe value you expectwith exclusiveCostco savings.in a plan that’seasy to use andunderstandThat’s the AetnaMedicare Rx –Costco Plus Plan(PDP)Enroll at www.aetnamedicare.com/costcoA Medicare approved Part D sponsor*Costco Warehousemembership not required. 2010 Aetna Inc.S5810 D PE MM 00723 CMS Approved 08/11/2010Other pharmacies areavailable in our network
Costco has teamed up withAetna to offer a MedicarePart D Prescription Drug PlanWith over 40 years of experience serving people eligible forMedicare, Aetna knows what you’re looking for when it comesto your Medicare Prescription Drug Plan. You want it to beaffordable. You want it to include the prescription drugs thatmatter to you most. And you want it to be easy to understandand easy to use. And with over 30 years of experience indelivering value, Costco knows how to offer exclusivefeatures and savings that its members expect.Get the most value with specialcost savings when you fill yourprescriptions at one of Costco’shundreds of U.S. pharmacies.*In addition, you’ll also haveaccess to Aetna’s pharmacynetwork with morethan 60,000 pharmaciesnationwide. Copays arehigher when you fillyour prescriptions atother Aetna networkpharmacies.Aetna is the brand name used for products and services provided by one ormore of the Aetna group of subsidiary companies (Aetna).The benefit information provided herein is a brief summary, not a compre hensive description of benefits. For more information, contact the plan.Limitations, copayments, and restrictions may apply. Benefits, formulary,pharmacy network, premium and/or copayments/coinsurance may changeon January 1, 2012.You must be entitled to Medicare Part A or B and continue to pay your Part Bpremium and Part A, if applicable. Medicare beneficiaries may enroll in a planonly during specific times of the year. To obtain additional information, pleasecontact Aetna Medicare at 1 800 213 4599 (TTY/TDD 1 888 760 4748), from8 am to 8 pm, 7 days a week.In general, beneficiaries must use network pharmacies to access theirprescription drug benefit, except in non routine circumstances. Pharmacyclinical programs such as prior authorization, step therapy, and quantitylimits may apply to your prescription drug coverage.You may be able to get Extra Help to pay for your prescription drugpremiums and costs. To see if you qualify for Extra Help, call: 1 800 MEDICARE(1 800 633 4227) (TTY users should call 1 877 486 2048), 24 hours a day,7 days a week; the Social Security Office at 1 800 772 1213 between 7 amand 7 pm, Monday through Friday (TTY users should call 1 800 325 0778);or your Medicaid office.This material is for informational purposes only. Not all health servicesare covered. See plan documents for a complete description of benefits,exclusions, limitations and conditions of coverage. Plan features andavailability may vary by location and are subject to change. Aetna receivesrebates from drug manufacturers that may be taken into account indetermining Aetna’s Preferred Drug List. Rebates do not reduce the amounta member pays the pharmacy for covered prescriptions. Providers areindependent contractors and are not agents of Aetna. Provider participationmay change without notice. Aetna does not provide care or guaranteeaccess to health services.Translation of this material into another language may be available. Forassistance, please call Member Services at: 1 800 213 4599 (TTY/TDD1 888 760 4748.Puede estar disponible la traducción de este material en otro idioma.Para ayuda, por favor llame a Servicios al Miembro al: 1 800 213 4599(TTY/TDD: 1 888 760 4748).Medicare Part DPrescription Drug PlanThe value you expectwith exclusiveCostco savings.in a plan that’seasy to use andunderstandThat’s the AetnaMedicare Rx –Costco Plus Plan(PDP)Enroll at www.aetnamedicare.com/costcoA Medicare approved Part D sponsor*Costco Warehousemembership not required. 2010 Aetna Inc.S5810 D PE MM 00723 CMS Approved 08/11/2010Other pharmacies areavailable in our network
Aetna Medicare Rx – Costco Plus Plan (PDP) The Aetna Medicare Rx – Costco Plus plan givesyou the following benefits Medicare Prescription Drug CoverageInitial Coverage LimitTier 1 Preferred generic (mostplan generics are on this tier)Tier 2 Non preferred genericTier 3 Preferred brandTier 4 Non preferred brandTier 5 SpecialtyAmount you pay for covered prescriptions until costs for you and the plan reach 2,840:Special savings when you fill yourprescriptions at a Costco pharmacy*Costs at other Aetna Medicare Rxnetwork pharmaciesMail orderdelivery**1 Month Supply3 Month Supply1 Month Supply3 Month Supply3 Month Supply 2 copay 20 copay 25 copay 60 copay25% coinsurance 5 copay 50 copay 62.50 copay 150 copay25% coinsurance 4 copay 25 copay 30 copay 65 copay25% coinsurance 12 copay 75 copay 90 copay 195 copay25% coinsurance 12 copay 60 copay 75 copay 180 copay25% coinsurance 0 deductible — start saving right awayMore than 90% of covered generics are available at the lowest copayCoverage for most Medicare approved Part D prescription drugsMail order delivery service for your convenienceEnhanced coverage for generic benzodiazepines and barbiturates —prescription drugs not covered by Medicare Part D and offers special cost savings on yourprescription drugs at Costco pharmacies.Enhanced BenefitThe plan includes supplemental benefit coverage for Tier 1 generic benzodiazepines and barbiturates, prescription drugs not covered by Medicare Part D(NOTE: These non Part D drugs do not count toward satisfying your deductible, initial coverage limit, or true out of pocket expenses)Learn more about theAetna Medicare Rx –Costco Plus Plan(PDP) benefits, costs,and covered drugs,and enroll by:Coverage GapAmount you pay after your initial coverage limit and until your true out-of-pocket expenses reach 4,550:Coverage continues for Tier 1 generic benzodiazepines and barbiturates at the same copays shown aboveFor all other covered drugs, you receive a discount on brand name drugs and pay only 93% of the costs of generic drugsCatastrophic CoverageAmount you pay after your true out-of-pocket expenses reach 4,550:The greater of 2.50 copay for generic prescription drugs (including brand drugs treated as generic), 6.30 copay for all other covered prescription drugsOR 5% coinsuranceVisiting our website atwww.aetnamedicare.com/costcoThe Aetna Medicare Rx – Costco Plus Plan (PDP) is available to residentsof Alaska, Arizona, California, Colorado, Florida, Hawaii, Idaho, Illinois,Michigan, Nevada, New Mexico, New York, Ohio, Oregon, Utah, Virginia,and Washington.* Fill your prescriptions at any U.S. Costco pharmacy location for preferredpharmacy savings. Costco Warehouse membership is not required.** Prescription mail order costs are for preferred providers of service,Costco Mail Order Pharmacy or Aetna Rx Home Delivery. Costs maybe more for non preferred providers.Or calling our toll-free number1-888-260-7630(TTY/TDD 1-888-760-4748),8 am to 8 pm, 7 days a week.Medicare beneficiaries mayenroll in the Aetna Medicare Rx –Costco Plus Plan through the CMSMedicare Online Enrollment Centerlocated at http://www.medicare.govor by calling Medicare at1-800-MEDICARE (1-800-633-4227)24 hours a day, 7 days a week.TTY users can call 1-877-486-2048.Enroll at www.aetnamedicare.com/costcoMonthly plan premiums vary by region. Please refer to theplan’s Summary of Benefits for the monthly plan premium inyour service area.Other pharmacies areavailable in our network
Aetna Medicare Rx – Costco Plus Plan (PDP) The Aetna Medicare Rx – Costco Plus plan givesyou the following benefits Medicare Prescription Drug CoverageInitial Coverage LimitTier 1 Preferred generic (mostplan generics are on this tier)Tier 2 Non preferred genericTier 3 Preferred brandTier 4 Non preferred brandTier 5 SpecialtyAmount you pay for covered prescriptions until costs for you and the plan reach 2,840:Special savings when you fill yourprescriptions at a Costco pharmacy*Costs at other Aetna Medicare Rxnetwork pharmaciesMail orderdelivery**1 Month Supply3 Month Supply1 Month Supply3 Month Supply3 Month Supply 2 copay 20 copay 25 copay 60 copay25% coinsurance 5 copay 50 copay 62.50 copay 150 copay25% coinsurance 4 copay 25 copay 30 copay 65 copay25% coinsurance 12 copay 75 copay 90 copay 195 copay25% coinsurance 12 copay 60 copay 75 copay 180 copay25% coinsurance 0 deductible — start saving right awayMore than 90% of covered generics are available at the lowest copayCoverage for most Medicare approved Part D prescription drugsMail order delivery service for your convenienceEnhanced coverage for generic benzodiazepines and barbiturates —prescription drugs not covered by Medicare Part D and offers special cost savings on yourprescription drugs at Costco pharmacies.Enhanced BenefitThe plan includes supplemental benefit coverage for Tier 1 generic benzodiazepines and barbiturates, prescription drugs not covered by Medicare Part D(NOTE: These non Part D drugs do not count toward satisfying your deductible, initial coverage limit, or true out of pocket expenses)Learn more about theAetna Medicare Rx –Costco Plus Plan(PDP) benefits, costs,and covered drugs,and enroll by:Coverage GapAmount you pay after your initial coverage limit and until your true out-of-pocket expenses reach 4,550:Coverage continues for Tier 1 generic benzodiazepines and barbiturates at the same copays shown aboveFor all other covered drugs, you receive a discount on brand name drugs and pay only 93% of the costs of generic drugsCatastrophic CoverageAmount you pay after your true out-of-pocket expenses reach 4,550:The greater of 2.50 copay for generic prescription drugs (including brand drugs treated as generic), 6.30 copay for all other covered prescription drugsOR 5% coinsuranceVisiting our website atwww.aetnamedicare.com/costcoThe Aetna Medicare Rx – Costco Plus Plan (PDP) is available to residentsof Alaska, Arizona, California, Colorado, Florida, Hawaii, Idaho, Illinois,Michigan, Nevada, New Mexico, New York, Ohio, Oregon, Utah, Virginia,and Washington.* Fill your prescriptions at any U.S. Costco pharmacy location for preferredpharmacy savings. Costco Warehouse membership is not required.** Prescription mail order costs are for preferred providers of service,Costco Mail Order Pharmacy or Aetna Rx Home Delivery. Costs maybe more for non preferred providers.Or calling our toll-free number1-888-260-7630(TTY/TDD 1-888-760-4748),8 am to 8 pm, 7 days a week.Medicare beneficiaries mayenroll in the Aetna Medicare Rx –Costco Plus Plan through the CMSMedicare Online Enrollment Centerlocated at http://www.medicare.govor by calling Medicare at1-800-MEDICARE (1-800-633-4227)24 hours a day, 7 days a week.TTY users can call 1-877-486-2048.Enroll at www.aetnamedicare.com/costcoMonthly plan premiums vary by region. Please refer to theplan’s Summary of Benefits for the monthly plan premium inyour service area.Other pharmacies areavailable in our network
Costco has teamed up withAetna to offer a MedicarePart D Prescription Drug PlanWith over 40 years of experience serving people eligible forMedicare, Aetna knows what you’re looking for when it comesto your Medicare Prescription Drug Plan. You want it to beaffordable. You want it to include the prescription drugs thatmatter to you most. And you want it to be easy to understandand easy to use. And with over 30 years of experience indelivering value, Costco knows how to offer exclusivefeatures and savings that its members expect.Get the most value with specialcost savings when you fill yourprescriptions at one of Costco’shundreds of U.S. pharmacies.*In addition, you’ll also haveaccess to Aetna’s pharmacynetwork with morethan 60,000 pharmaciesnationwide. Copays arehigher when you fillyour prescriptions atother Aetna networkpharmacies.Aetna is the brand name used for products and services provided by one ormore of the Aetna group of subsidiary companies (Aetna).The benefit information provided herein is a brief summary, not a compre hensive description of benefits. For more information, contact the plan.Limitations, copayments, and restrictions may apply. Benefits, formulary,pharmacy network, premium and/or copayments/coinsurance may changeon January 1, 2012.You must be entitled to Medicare Part A or B and continue to pay your Part Bpremium and Part A, if applicable. Medicare beneficiaries may enroll in a planonly during specific times of the year. To obtain additional information, pleasecontact Aetna Medicare at 1 800 213 4599 (TTY/TDD 1 888 760 4748), from8 am to 8 pm, 7 days a week.In general, beneficiaries must use network pharmacies to access theirprescription drug benefit, except in non routine circumstances. Pharmacyclinical programs such as prior authorization, step therapy, and quantitylimits may apply to your prescription drug coverage.You may be able to get Extra Help to pay for your prescription drugpremiums and costs. To see if you qualify for Extra Help, call: 1 800 MEDICARE(1 800 633 4227) (TTY users should call 1 877 486 2048), 24 hours a day,7 days a week; the Social Security Office at 1 800 772 1213 between 7 amand 7 pm, Monday through Friday (TTY users should call 1 800 325 0778);or your Medicaid office.This material is for informational purposes only. Not all health servicesare covered. See plan documents for a complete description of benefits,exclusions, limitations and conditions of coverage. Plan features andavailability may vary by location and are subject to change. Aetna receivesrebates from drug manufacturers that may be taken into account indetermining Aetna’s Preferred Drug List. Rebates do not reduce the amounta member pays the pharmacy for covered prescriptions. Providers areindependent contractors and are not agents of Aetna. Provider participationmay change without notice. Aetna does not provide care or guaranteeaccess to health services.Translation of this material into another language may be available. Forassistance, please call Member Services at: 1 800 213 4599 (TTY/TDD1 888 760 4748.Puede estar disponible la traducción de este material en otro idioma.Para ayuda, por favor llame a Servicios al Miembro al: 1 800 213 4599(TTY/TDD: 1 888 760 4748).Medicare Part DPrescription Drug PlanThe value you expectwith exclusiveCostco savings.in a plan that’seasy to use andunderstandThat’s the AetnaMedicare Rx –Costco Plus Plan(PDP)Enroll at www.aetnamedicare.com/costcoA Medicare approved Part D sponsor*Costco Warehousemembership not required. 2010 Aetna Inc.S5810 D PE MM 00723 CMS Approved 08/11/2010Other pharmacies areavailable in our network
prescriptions at one of Costco’s hundreds of U.S. pharmacies.* In addition, you’ll also have access to Aetna’s pharmacy network with more than 60,000 pharmacies nationwide. Copays are higher when you fill your prescriptions at other Aetna network pharmacies. Aetna is the bra
