There

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Theres So Much More to Medicare, Lets Talk
Humana Medicare Advantage Health and Prescription
Drug Plans
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• Do you know how much Humana is projected to
• save its 4.5 million Medicare Advantage and
• Prescription 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.

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Welcome!

• Theres so much more to Medicare

Lets Talk
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Before we get started

• Make sure youre comfortable
• Pens and pencils ready
• Turn off your cell phones and pagers
• Keep your needs in mind

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Lets talk about

• Humana Experience Behind The Coverage
• Whats Important to YOU
• Your Options Under Medicare
• Coverage Options For 2007
• Specific Plan Benefits
• How To Enroll

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Who is Humana?

• A Company You Can Trust
• Your Healthcare Solution

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Are you eligible?

• Enrolled in Medicare Part B and entitled to Part
  A?
• Permanent resident in service area?
• Do you have End Stage Renal Disease (ESRD)?

• 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.

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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?

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Todays Medicare Environment Includes More
Coverage Choices
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What are Medicare Advantage Health Plans?
Todays Medicare Environment Includes More
Coverage Options for you!
Medicare Advantage health plan only (MA only)
Includes all the benefits of Original
Medicare (Part A - Hospital) (Part B - Medical)
MA only with stand - alone Part D
MAPD - MA health plan with Part D included
1 plan, 1 plan premium, 1 company
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Todays Medicare Environment - More Choices

• 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

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How Can Medicare Advantage Plans Offer More
Coverage
How can Medicare Advantage plans offer
more benefits for little or no monthly plan
premiums
When you choose to receive your Medicare benefits
through a company like Humana
The Company basically becomes Medicare for
you
Medicare pays a company like Humana to provide
your benefits
The company Negotiates to draw down prices that
provide lower premiums and more benefits for you
You must continue to pay applicable Medicare
premiums
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Todays Medicare Environment Offers More Plan
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 doesnt pay
  up to what Medicare allows
• All plans are standardized and can be
• purchased with varying coverage options

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Todays Medicare Environment Offers More Plan
Choices

• 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

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Todays Medicare Environment Offers More Plan
Choices

• 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

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Todays Medicare Environment Offers More Plan
Choices

• So which type of plan is best for me?
• 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

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Todays Medicare Environment Offers More Plan
Choices

• So which type of plan is best for me?
• 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 plans payment terms
• You should check with your providers to make
  certain that they are willing to accept the PFFS
  plans terms
• Out-of-pocket costs may be lower than with
  Original
• Medicare coverage

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Todays Medicare Environment Offers More Plan
Choices

• So which type of plan is best for me?
• 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

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Todays Medicare Environment Offers More Plan
Choices

• 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.

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2007 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.

2007 Medicare Prescription Drug Plan Basic Coverage 2007 Medicare Prescription Drug Plan Basic Coverage 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 3,850.00
Catastrophic Coverage Medicare and Plan 95 5
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
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Heres What is Available in Your Area
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Is a Humana plan suitable for you?
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Basic
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 Benefits
All the benefits of Original Medicare RightSourceSM SmartSummarySM MyHumana www.humana-medicare.com Rx CalculatorSM

Basic Extra Benefits Humana Active Outlook

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Silver Sneakers
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Humana Medicare Advantage Prescription Drug
Plans
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Important 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)
Note This information does not apply to Medicare
Supplement Plans.
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Where 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.

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How do I enroll?

• Application process
• Effective date
• Medicare card
• Emergency contact information
• Understanding your plan
• Verification process

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What happens next?
Silver Sneakers Discuss only in applicable
markets
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When you become a member
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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."

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