there’s so much more to medicare, let’s talk

There’s So Much More to Medicare, Let’s TalkThere’s So Much More to Medicare, Let’s Talk

Humana Medicare Advantage Health and Prescription Drug Plans

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Do you know how much Humana is projected tosave its 4.5 million Medicare Advantage andPrescription Drug Plan members in 2006?

$3.8 Billion

*This number is based on CMS published average savings per member per year of $1,100. In the first six months of 2006 Humana saved its Medicare Advantage and Prescription Drug Plans members over

$1.5 billion dollars.

Welcome!Welcome!

There’s so much more to Medicare…

Let’s Talk

Before we get startedBefore we get started

Make sure you’re comfortable

Pens and pencils ready

Turn off your cell phones and pagers

Keep your needs in mind

Let’s talk about…Let’s talk about…

Humana – Experience Behind The Coverage

What’s Important to YOU

Your Options Under Medicare

Coverage Options For 2007

Specific Plan Benefits

How To Enroll

Who is Humana?Who is Humana?

A Company You Can Trust Your Healthcare Solution

Enrolled in Medicare Part B and entitled to Part A?

Permanent resident in service area?

Do you have End Stage Renal Disease (ESRD)?

Are you eligible?Are you eligible?

Federal law will not allow us to accept anyone who has end stage renal disease (kidney failure), unless you: (1) Are a member of another health plan or offered by Humana within the same state, or (2) Were enrolled in a Medicare Advantage plan which was terminated or discontinued after December 31, 1998 and this is your first election following that

plan termination or discontinuance.

How Do I Choose The Right Plan for My Needs?How Do I Choose The Right Plan for My Needs?

What type of plan do I currently have? What do I like about my current coverage? If I could, what would I change about my current coverage? Do I need a Part D prescription drug plan or does my current

plan include RX? What are my goals?

– Comprehensive Coverage, including other services

– Reduce my out-of-pocket expenses

– Freedom to choose my own physician

– Coverage while I travel

– Services outside of traditional health benefits Do I rely on anyone to assist me in these types of decisions?

Today’s Medicare Environment Includes More Today’s Medicare Environment Includes More Coverage ChoicesCoverage Choices

What are Medicare Advantage Health What are Medicare Advantage Health Plans?Plans?

Includes all the benefits of:Original Medicare(Part A - Hospital)(Part B - Medical)

Today’s Medicare EnvironmentIncludes More Coverage Options for you!

Medicare Advantage health plan only (MA only)

MA only with stand - alone Part D

MAPD - MA health plan with Part D included

1 plan, 1 plan premium, 1 company

Today’s Medicare Environment - More Today’s Medicare Environment - More ChoicesChoices

What are Medicare Advantage (MA) health plans?

They are health plan options that are part of the Medicare program

Medicare pays the plan a set amount every month for

your care

MA plans must offer all benefits of Original Medicare and coverage can include Part D prescription drug coverage

You may have to use providers that participate with the plan

In most plans, there are generally extra benefits and out-of-pocket costs that are lower that with Original Medicare

How Can Medicare Advantage Plans Offer More Coverage

How can Medicare Advantage plans offer morebenefits for little or no monthly plan premiums*

When youchoose to receiveyour Medicarebenefits througha company like Humana

The Companybasically becomes“Medicare” for you

Medicare pays acompany like Humanato provide yourbenefits

The companyNegotiates to draw down prices that provide lowerpremiums andmore benefits for you

* You must continue to pay applicable Medicare premiums

Today’s Medicare Environment Offers More Today’s Medicare Environment Offers More Plan ChoicesPlan Choices

Original Medicare Coverage Fee-for-service – you receive a service, you pay a fee Access to any doctor or provider that accepts Medicare Out-of-pocket costs may be significantly higher as more

services are used May want to purchase separate supplemental insurance to

cover gaps

Medicare Supplement Insurance Purchased separately from private insurance companies Supplements Original Medicare coverage Covers costs that Original Medicare doesn’t pay up to what

Medicare allows All plans are standardized and can be purchased with varying coverage options


Types of Medicare Advantage (MA) Plans Health Maintenance Organization (HMO) Preferred Provider Organization (PPO) Private Fee-For-Service (PFFS)

Plus, Medicare Prescription Drug Coverage – Part D May be purchase as a stand-alone plan As a part of an MAPD plan


So which type of plan is best for me?

Health Maintenance Organization (HMO) Defined network of providers Primary Care Physician (PCP) manages all of

your care You must have a referral from your PCP to see a

Specialist You must use network providers for all

scheduled care Out-of-pocket costs may be significantly lower

with an HMO plan



Preferred Provider Organization (PPO) Defined network of providers Allows flexibility to use providers who are not part of

the network No referral needed to see any doctor However, out-of-pocket costs increase significantly

when out-of-network providers are used Greatest saving for use of network providers because

the plan pays a larger share of the cost



Private Fee-For-Service (PFFS) No plan network Plan works similar to Original Medicare except the

insurance company pays for your services, not Medicare Freedom to use any provider that accepts Medicare and,

agrees to the plan’s payment terms You should check with your providers to make certain that

they are willing to accept the PFFS plan’s terms Out-of-pocket costs may be lower than with Original

Medicare coverage



Medicare Prescription Drug Plans - Part D (PDP) Plans offered by insurance companies May be offered as stand-alone plan or, as part of

an MAPD plan All plans must meet minimum coverage level set

by Medicare Companies may offer plans with increased

coverage You should evaluate your prescription drug

needs in relation to those covered by the plan, and your cost for those drugs


So… how do I choose?

There are three basic factors to weigh when choosing a plan: Cost – Compare the out-of-pocket costs for the plan with what you

are currently paying including plan premium and copayment and coinsurance amounts.

Providers – Will the plan allow me to see the providers I need or want to see?

Benefits – Does the plan offer you the coverage and benefits you need?

Keep In Mind:

No matter which plan you choose to join, you are still a part of the Medicare program. With all of these plans you must continue

to pay your applicable Medicare premiums.

2007 Prescription Drug Plan2007 Prescription Drug Plan

By law, all plans must offer at least the basic benefits required by Medicare, outlined below. Any plan can offer more benefits, but no plan can offer less.

*You pay the greater of $2.15 for generic (including brand-name drugs treated as generic drugs) and $5.35 for all other drugs,OR 5% coinsurance

2007 Medicare Prescription Drug Plan Basic Coverage

2007 Basic Benefits You Pay

Deductible $265 100% of first $265

Initial Coverage Limit $2,400 25% of the next $2,135 ($533.75)

Coverage Gap $3,051.25 100% of next $3,051.25

Annual Out-of-Pocket Amount $3,850.00

Catastrophic Coverage Medicare and Plan 95% 5%*

Here’s What is Available in Your Area

Is a Humana plan suitable for you?

BasicBasic

• All the benefits of Original Medicare

• Part D Coverage (Majority of Humana plans include this)

• Unlimited doctor/specialist/hospital visits

• Emergency service & ER/Ambulance availability

• Affordable premiums

Basic + Extra BenefitsBasic + Extra Benefits

• All the benefits of Original Medicare

• RightSourceSM

• SmartSummarySM

• MyHumana

• www.humana-medicare.com & Rx CalculatorSM

Basic + Extra Benefits + Humana Active OutlookBasic + Extra Benefits + Humana Active Outlook

++

+

Silver SneakersSilver Sneakers

Humana Medicare Advantage & Humana Medicare Advantage & Prescription Drug PlansPrescription Drug Plans

Note: This information does not apply to Medicare Supplement Plans.

Important Dates for 2007Important Dates for 2007

For 2007 Description In 2006

Oct 1st - Nov 14th Plans can begin to share new benefits

for coming year

Nov 15th - May 15th

(180 days)

January 1st New plan coverage begins

January 1st

Jan 1st - March 31st

(3 months)

Can make one change - Medical

portion only

Jan 1st - Jun 30th

(6 months)

Where To Find More InformationWhere To Find More Information

“Medicare and You 2007” handbook (available in October or November 2006)

www.medicare.gov

Your local State Health Insurance Program (SHIP)

www.humana.com

Humana 1-800-337-0953 Seven days a week, 8 a.m. to 8 p.m. local time. If you have a speech or hearing impairment and use a TTY, call 1-877-833-4486 seven days a week, 8 a.m. to 8 p.m. local time.

How do I enroll?How do I enroll?

Application process

Effective date

Medicare card

Emergency contact information

Understanding your plan

Verification process

Silver Sneakers* Discuss only in applicable markets

What happens next?What happens next?

When you become a memberWhen you become a member

HUMANA Guidance When You Need It Most

Medicare approved HMO, PPO, and PFFS plans available to anyone enrolled in both Part A and Part B of Medicare through age or disability. A Medicare approved Prescription Drug Plan available to anyone entitled to Part A and/or enrolled in

Part B of Medicare through age or disability. Copayment, service area, and benefit limitations may apply. You must continue to pay your Medicare applicable premiums. A sales representative will be present with information and

applications. You must use network providers and pharmacies.

"This presentation is also available in alternative formats."M0006_GH210S6RR KC0906

there’s so much more to medicare, let’s talk

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