• Overview
• Plan Comparisons
• Medvantage Plan
• Medvantage Plan with Optional Point of Service Benefit
• Medvantage Rx Plan
  • Part D Prescription Benefit
• Medvantage Rx Plan with Optional Point of Service Benefit
  • Part D Prescription Benefits
• Medvantage Rx Plus Plan
  • Part D Prescription Benefit
• Medvantage Rx Plus Plan with Optional Point of Service Benefit
  • Part D Prescription Benefit

Medvantage Rx Plan with Optional Point of Service Benefit 2010

Questions:

If you have questions or require assistance, please call:
FHCP’s Marketing Department at 1-800-232-0578, TTY users please call TTY: TRS Relay 711, Hours of Operation:

• November 15 through March 1 from 8 am to 8 pm – 7 days a week
• March 2 through November 14 from 8 am to 8 pm - Monday through Friday Only.

Enroll on-line today!

Benefits at a glance:

Premium and Other Important Information

Monthly Plan Premium	$37.00 (See Optional Point of Service Details)
Medical Annual Deductible	In- or Out-of-Network: $0
Medical Out-of-Pocket Maximum	In-Network: $0 Out-of-Network: $0
You must continue to pay your Medicare Part B premium.

Physician Services

Doctor Choice	You may go to any provider that accepts Medicare assignment or utilize our HMO Provider Network, without a referral.
Specialist Referral Required	No referral required
Primary Care Provider Office Visit	In-Network: $10 copay per office visit Out-of-Network: 20% coinsurance
Specialist Office Visit	In-Network:$35 copay per office visit Out-of-Network: 20% coinsurance

Hospital/Pharmacy Service

Inpatient Hospital Care	In-Network: For Medicare-covered hospital stays: -Days 1-10: $175 copay per day. Days 11-90: $0 copay per day. $0 copay for additional hospital days. Out-of-Network - $200 per day for days 1-10 $0 each day beginning on day 11
Outpatient Hospital Care	In-Network: - $0 to $175 copay for each Medicare-covered outpatient hospital facility visit - $100 copay for each Medicare-covered ambulatory surgical visit. Out-of-Network: 20% coinsurance
Part D Prescription Benefit	In-Network: Yes - Please see Medvantage Rx with Optional POS Plans' Part D Prescription Benefit Out-of-Network: No

Full Medvantage Plan Details:

Full plan details are available in PDF format.To access the document(s) Adobe Reader® must be installed on your computer. If you do not have Adobe Reader ®, you can download it for free by clicking here.

• 2010 Summary of Benefits
• 2010 Evidence of Coverage
• Optional Point of Service Details
• Provider Directory
• Medicare Formulary

DISCLAIMER: The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. This is an advertisement; for more information contact Florida Health Care Plans.