Preferred Gold HMO

Preferred Gold — Medicare made easy!

At Preferred Gold, we want to help you understand the ABCs…and Part D, of Medicare.

We’re here to help guide you through the many options to consider when choosing the health coverage that’s best for you.  We put your health care needs first.  Our comprehensive benefits, Medicare prescription drug coverage (Part D), and routine care go beyond Original Medicare benefits.  As a Health Maintenance Organization (HMO), we offer:

• Dedicated, caring service.
• Coverage that’s simple to understand
• People who are easy to work with, on the phone and in person.
• A plan focused on preventive care.

What you get with Preferred Gold:

* Any unused portion of these benefits cannot carry over from one calendar year to the next.
** The products and services described are neither offered nor guaranteed under our contract with Medicare. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Preferred Gold grievance process.

NOTE: If your coverage is through an employer sponsored plan, not all benefits may apply.

Part D coverage
Preferred Gold offers Medicare prescription drug coverage (Part D). If you wish to join our Preferred Gold plan and you also want prescription drug overage, you must select Part D prescription drug coverage from MVP Health Care.

For medically necessary Medicare Part D approved drugs, you pay:

• Generic - $5 for a 30-day supply*
• $0 deductible for generic drugs
• Brand - $40 for a 30-day supply*
• Specialty – 25% for a 30-day supply*
• $275 deductible for brand drugs only

Once your total drug expenses reach $2,700, you will pay for the full cost of the prescriptions. When you have paid $4,350 out of pocket, your cost for prescriptions is reduced to 5% or $2.40 for generics and $6.00 for brand-name drugs, whichever is greater.

*90-day mail-order supply of the prescription drugs: $10/$80/25%
Note: Not all specialty drugs are available through the mail.

To enroll, call a Preferred Gold Advisor
You can ask questions or reserve a seat at a neighborhood information meeting:

Monday – Friday, 8:00 a.m. to 5:00 p.m. Eastern Time
(888) 280-6205
TTY users may call (800) 252-2452

From November 15 – March 1, Gold Advisors are available seven days a week from 8:00 a.m. to 8:00 p.m.

Already a Gold member?
Call MVP Health Care Member Services. Representatives are available to serve you:

Monday – Friday, 7:00 a.m. to 8:00 p.m. Eastern Time
(585) 327-2480 or (800) 665-7924
TTY users may call (800) 662-1220

From November 15 – March 1, representatives also are available weekends from 8:00 a.m. to 8:00 p.m.

Preferred Gold is a product of MVP Health Plan, Inc., a not-for-profit HMO/PPO with a
Medicare Advantage contract serving Albany, Broome, Cayuga, Chenango, Columbia, Cortland, Dutchess, Fulton, Genesee, Greene, Herkimer, Livingston, Madison, Monroe, Montgomery, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Rensselaer, Saratoga, Schenectady, Schoharie, Seneca, Steuben, Tioga, Ulster, Warren, Washington, Wayne, Wyoming and Yates counties. Plan availability and premium rates may vary by county.

H3305 / PCG 886 (Rev. 03/09)

Last updated: April 30, 2009