H5820_UHC2042REV (11/07) Welcome to Universal “Hassle Free Healthcare ” “Hassle Free Healthcare  ”

“Hassle Free Health Care  ” We want to thank you for considering Universal Health Care for your Medicare coverage. Choosing the Medicare plan that is right for you is very important, not only for your health but your peace of mind. Our goal today is to provide you with the information you need so you can make the best informed decision possible. If you decide to use Universal Health Care for your Medicare coverage, you will have access to quality healthcare, it will be comprehensive, convenient and affordable. H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” PFFS Disclaimer A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your doctor or hospital must agree to accept the plan’s terms and conditions prior to providing healthcare services to you, with the exception of emergencies. If your doctor or hospital does not agree to accept our payment terms and conditions, they may not provide healthcare services to you, except in emergencies. Providers can find the plan’s terms and conditions on our website at: H5820_UHC2042REV (11/07)

What is a PFFS Plan? A PFFS plan is a type of Medicare Advantage plan offered by a private insurance company like Universal Health Insurance Company. It is not the same as the Original Medicare plan that is offered by the Federal Government. It is not a Medicare supplement, Medigap, Medicare Select, or Prescription Drug Plan.

PFFS Plan Options PFFS Plan options available to beneficiaries may include: PFFS plan offering only medical benefits; PFFS plan that combines medical benefits and Part D prescription drug benefits (MA- PD plan); or PFFS plan in combination with a stand- alone Part D prescription drug plan (PDP).

PFFS Plan - Eligibility Beneficiaries must be enrolled in Part A and Part B. Beneficiary must live in the PFFS plan’s service area. PFFS plans must enroll any eligible beneficiary who applies regardless of health status, except Beneficiaries with end stage renal disease are not eligible to enroll unless special rules are met.

PFFS Plans - Premiums Beneficiaries must continue to pay their Part B premiums to remain eligible to join a PFFS plan. Generally, beneficiaries pay a monthly premium for a PFFS plan in addition to their monthly Part B premium. If the PFFS plan includes a Part D benefit, low income beneficiaries may be eligible for extra help from Medicare that covers all or part of the part D portion of the PFFS plan premium. Beneficiaries should be encouraged to apply by contacting the Social Security Administration (SSA) at or applying online at

PFFS Plan - Providers Enrollees may receive covered services from any provider who participates in Medicare and agrees to accept the plan’s terms and conditions of payment. Enrollees must inform providers before receiving services that they are PFFS plan members so that the providers can decide whether to accept the plan’s terms and conditions. Providers may, on a patient-by-patient and visit-by visit basis, decide whether to treat the beneficiary. Some providers that accept Original Medicare may not accept PFFS plan enrollees.

PFFS Plan – Providers (cont’d) PFFS Plans generally pay providers the same amount Medicare would pay them. Providers are not permitted to charge the beneficiary more than the cost sharing specified in the PFFS plan’s benefits. Cost sharing may include a deductible and copayments or coinsurance. Cost sharing may include balance billing up to 15% of Medicare rate.

PFFS Plans and Dual Eligible Beneficiaries Unique PFFS plan issues exist for Medicare/Medicaid eligible (dual eligible) beneficiaries. Categories of dual eligible beneficiaries and out-of-pocket costs that must be paid by Medicaid: QMB (only) (Qualified Medicare Beneficiary) – Medicare Part B Premium; cost sharing for Part A & B benefits. QMB Plus – Medicare Part B premium; cost sharing for Part A & B benefits; coordinates Medicaid benefits with Medicare. SLMB(only) (Specified Low-Income Medicare Beneficiary) – Medicare Part B premium. SLMB Plus – Medicare Part B premium; coordinates Medicaid benefits with Medicare. QI (Qualifying Individual) – Medicare Part B premium. Other FBDE (Full Benefit Dual Eligible) – Coordinates Medicaid benefits with Medicare. QDWI (Qualified Disabled and Working Individual) – Part A premium.

PFFS Plans and Dual Eligible Beneficiaries (cont’d) Key issues that are important to dual eligible beneficiaries considering PFFS plan enrollment include: Whether the beneficiary is eligible for medical benefits under Medicaid. Medicaid may provide additional benefits, but Medicaid will coordinate benefits only with Medicaid participating providers. How cost sharing will be different under the PFFS plan compared to Medicaid benefits. What is the cost sharing under the PFFS plan benefits? Medicaid will pay cost sharing assistance only for services provided from Medicaid participating providers. Whether the beneficiary will need help to find providers who accept both Medicare and Medicaid.

How Does a PFFS Plan Work? The PFFS plan pays instead of Medicare. The beneficiary will pay amounts that the PFFS plan does not pay, which are called copayments and coinsurance. A PFFS plan does not pay after Medicare pays its share. Original Medicare will not pay for the beneficiary’s health care while enrolled in a PFFS plan.

How Do You Obtain Services from a PFFS Plan? You may receive health care services from any provider allowed to bill Medicare who agrees to accept the Private Fee-for-service plan’s payment terms and conditions. You must use network pharmacies to obtain prescription drugs, except in emergencies or urgent situations.

Before Seeing a Provider, You Should … Verify that your provider will accept the Any, Any, Any Plan. Your health care providers have the right to choose whether to accept a Private Fee-for-service plan’s payment terms and conditions every time you see your providers. If your provider decides not to accept the plan, you will need to find another provider that will. They should not provide services to you, except in an emergency. If they choose to provide services, they may not bill you. They must bill the Private Fee-for-service plan for your covered health services. You must pay the appropriate copayments and coinsurance.

When You Go to the Doctor or Hospital Show your Any, Any, Any Plan ID card and tell them that you have chosen Any, Any, Any for your Medicare health plan. Do not show your red, white, and blue Medicare card. Pay the Any, Any, Any copayments or coinsurance at the time of service.

“Hassle Free Health Care  ” What We’ll Talk About Today ■Universal Health Care: Who We Are ■Review Your Current Coverage ■Explain the Benefits of the Any, Any, Any Plan ■Answer Your Questions ■Show You How to Enroll If you have questions during the presentation, please hold them until the end of the presentation. H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Who is Universal Health Care? Physician Managed & Operated Corporate HQ in St. Petersburg, FL Medicare Advantage in Florida – 2003 Florida Medicaid introduced – 2005 Expanded to South & Central Florida Expanded to 8 States with the Any, Any, Any health plans H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Our Mission Statement We are an innovative and dynamic organization dedicated to delivering personal, professional and proactive health care to our members. Our commitment is to partner with our members in their journey toward a healthy, fulfilling and meaningful life. H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” What Is Your Current Coverage? Do you have any health insurance in addition to Medicare Parts A and B? Do you pay a premium or does someone else pay it for you? If you could change anything about your coverage, what would it be? H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Added Benefits of a Medicare Advantage Plan All the benefits that you currently receive from Medicare, plus much more including: Plans with no Health Plan Premiums No Medicare Deductibles Go to the doctor of your choice who accepts the plan’s terms and conditions Brand & Generic Rx Coverage* World Wide Coverage ( i.e. Emergency and Urgently Needed Care) * …and more * Limitations & Co-payments may apply H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Extra Benefits for Dental, Vision and Hearing * 24-hour Medical Consultation Line Opportunity to see any physician without referrals who accepts the plan’s terms and conditions * No need for a Medicare supplement * Limitations & Co-payments may apply Added Benefits of a Medicare Advantage Plan More benefits from the Any, Any, Any Plan, including: H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” WHO IS ELIGIBLE TO JOIN UNIVERSAL HEALTH CARE ?  You can join Universal Health Care if you are entitled to Medicare Part A and enrolled in Medicare Part B  Live in the service area.  Individuals with End Stage Renal Disease are not eligible to enroll in the Universal Health Care.* * There are Exceptions to Eligibility Rule for persons who have ESRD H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Compare Your Health Care Options This table is a brief overview comparing Original Medicare, a popular Medicare supplement and Universal Healthcare Medicare Advantage plans. The Summary of Benefits will go into more detail about benefits. Original Medicare Office visits when you are sick Hospitalization A common Medicare supplement - Plan C Coverage for all Medicare deductibles and coinsurance Any, Any, Any Medicare Advantage Plan You keep all of your Original Medicare benefits, plus a plan that is Hassle Free, innovative proactive healthcare, and partnering with our members to create healthy, fulfilling, and meaningful lives.

“Hassle Free Health Care  ” US Federal Government Provides Funds for Original MedicareMedicare Advantage Limited coverage Limited preventive care benefits Deductibles Coinsurance Supplemental policy may be necessary Join a Prescription Drug Plan (PDP) for Part D coverage Covers all benefits of original Medicare + no Medicare deductibles Part D included No supplement needed Can Include additional benefits Medicare Beneficiary H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” How the Any, Any, Any Plan is Reimbursed Medicare Part A Financed in part by payroll taxes paid by workers and employers Medicare Part B Financed in part by deductions from your monthly Social Security check. US Government Medicare Funds Hospitals Administration Doctors Additional Benefits Other Health Care ProvidersUniversal H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” The Benefits of the Any, Any, Any Medicare Advantage Plan For the next few minutes, your Universal Representative will present the specifics of your Any, Any, Any Medicare Advantage plan benefits, using the Summary of Benefits booklet. H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Top Reasons to Join the Any, Any, Any Plan You have the Ultimate Freedom to see Any Doctor, Any Time, Any Where that accepts the plan’s terms and conditions No need for Medicare supplement Plans with Part B reimbursement** World Wide Coverage ( i.e. Emergency and Urgently Needed Care) * * Limitations & Co-payments may apply ** In Some Locations H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Top reasons to Join the Any, Any, Any Plan Hassle free with virtually no paperwork (No referrals, no paper claims to file, etc.) Brand & Generic Rx Coverage* Extra Coverage for Dental, Vision & Hearing* 24-Hour Medical Consultation Hotline Affordable, Predictable Prescription Drug Copayments Access to see Specialists Without Referrals that accept the plan’s term and conditions * Limitations & Co-payments may apply H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ”Enrollment Complete an enrollment form. You will receive a new member packet including your welcome letter, evidence of coverage and identification card. Your proposed effective date will be… H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ”Orientation Go over new member packet How to set up Rx by mail Review membership benefits Customer service contact numbers Answer questions H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” PFFS Disclaimer A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your doctor or hospital must agree to accept the plan’s terms and conditions prior to providing healthcare services to you, with the exception of emergencies. If your doctor or hospital does not agree to accept our payment terms and conditions, they may not provide healthcare services to you, except in emergencies. Providers can find the plan’s terms and conditions on our website at: H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Questions? H5820_UHC2042REV (11/07)

“Hassle Free Health Care  ” Thank You! If you have found value in this seminar, please do us the courtesy, and your friends the favor, of telling them about Universal Health Care’s Any, Any, Any Plan. Call Toll Free: (866) TTY/TDD: Monday – Friday 8:00AM – 8:00PM EST H5820_UHC2042REV (11/07)