1. Secondary Information Here Care Improvement Plus- Making the Right Choice for You 2012 Plan Options Y0072_OE12_6211_A _GA SC_CMS Approved 09262011

2. Making the Right Choice for You Medicare and You Welcome to Care Improvement Plus –Selecting the Plan That’s Right for You –Prescription Drug Overview –Additional Services How to Enroll 2

3. Medicare and You 3

4. Who Qualifies for Medicare? You or your spouse worked for at least 10 years (40 quarters) Citizen or permanent resident of the U.S. Age 65 Under age 65 and disabled Living with ESRD (end stage renal disease) 4

5. Original Medicare Part A – hospital insurance Part B – doctor and medical insurance Part D – prescription drug coverage 5

6. Medicare Advantage Plans Health plan options that are part of the Medicare program –Also known as “Part C” Must offer all benefits of Original Medicare and most include Part D prescription drug coverage In most plans – including Care Improvement Plus– there are generally extra benefits and lower out-of-pocket costs than with Original Medicare 6

7. Medicare Advantage Plans It is important to note –If you join a Medicare Advantage plan, you are still in the Medicare program. –These plans are part of the Medicare program. –Medicare approves health plans such as Care Improvement Plus and pays them to provide your benefits. –Your Medicare coverage does not go away! 7

8. Welcome to Care Improvement Plus 8

9. Care Improvement Plus Is dedicated to caring for the health and well-being of chronically ill and other underserved Medicare beneficiaries Provides a variety of plan options to fit the health and financial needs of Medicare beneficiaries Offers comprehensive medical and prescription drug benefits 9

10. Complete Health Coverage Hospital (Medicare Part A) Medical (Medicare Part B) Prescription Drugs (Medicare Part D) –Most Medicare-approved generic drugs included –Full or partial coverage through the gap Depending on your level of subsidy 10

11. An Open Access Provider Network No referrals required for Medicare-covered services Go to any Medicare-approved provider who accepts payment from our plan –Check to make sure your provider accepts the plan 11

12. Benefits Beyond Original Medicare Offering you additional benefits and services –Vision benefits for eyewear and eye exams –Preventive dental coverage –Transportation –Routine Podiatry 12

13. Unique Programs Exclusive to Members HouseCalls PharmAssist Social Service Coordinators Comprehensive Care Management and more... 13

14. Selecting the Plan That’s Right for You 14

15. Available Where You Live The Care Improvement Plus service area includes the entire states of Georgia and South Carolina. 15

16. “Best Fit Plan Options” 16 If You Are: Then You Should Consider: Diabetes &/or Heart Failure + Full Dual (Medicare & Full Medicaid) Silver Rx (CSNP) Diabetes &/or Heart Failure + Not Full DualGold Rx (CSNP) No Chronic Condition Required + Medicare & Full MedicaidDual Advantage (DSNP) * No Chronic Condition Required + Medicare OnlyMedicare Advantage *where available

17. Silver Rx If you have diabetes and/or heart failure and full Medicaid, consider Silver Rx (Regional PPO SNP) or (PPO SNP). To be eligible for this plan, you must: –Live in the service area –Have both Medicare Part A and Part B; and –Have been diagnosed with diabetes and/or heart failure 17

18. Silver Rx Highlights $33.60 monthly plan premium and cost sharing that is similar to Original Medicare For those with full Medicaid, monthly plan premium and cost sharing as low as $0 Vision and transportation benefits Dental benefits (including dentures; referral required) Over-the-Counter benefit – monthly allowance for drugs and other health purchases via mail order 18

19. Silver Rx – Georgia & South Carolina (RPPO) 19 Benefits What You Pay With Silver Rx What You Pay if You Are Medicare & Full Medicaid Monthly Plan Premium$33.60$0 Maximum Out-of-Pocket$6,700 Primary Care Physician Visit Specialist Visit 20% coinsurance $0 copay Inpatient Hospital Deductible: Days 1-60 Days 61-90 Days 91-150 In 2011 the rates are: $1,132 $0 $283 per day $566 per lifetime reserve day $0 Retail Pharmacy (30 day supply) $10 generic; $45 preferred brand; $95 non-preferred brand; 29% specialty $0/$1.10/$2.60 – generic $0/$3.30/$6.50 for all other drugs Preventive Dental Routine office visit includes: annual exam, cleaning, x-rays $15 routine office visit that includes denture adjustments $0 in-network/20% out-of-network for dentures $0 routine office visit that includes denture adjustments $0 in-network/20% out-of-network for dentures Transportation$0 copay for 24 one way trips Vision $0 in-network/20% out-of network for routine eye exam every year $200 yearly toward eyewear $0 in-network/20% out-of network for routine eye exam every year $200 yearly toward eyewear Over-The-Counter$6 monthly allowance, accumulates throughout the year

20. Gold Rx If you are a Medicare beneficiary with diabetes and/or heart failure, and do NOT receive full Medicaid, consider Gold Rx (Regional PPO SNP) or (PPO SNP). To be eligible for this plan, you must: –Live in the service area. –Have both Medicare Part A and Part B; and –Have been diagnosed with diabetes and/or heart failure 20

21. Gold Rx Highlights $0 monthly plan premium and low, predictable cost sharing Vision and transportation benefits Dental benefits (including denture adjustments) 21

22. Gold Rx – Georgia & South Carolina (RPPO) 22 BenefitsWhat You Pay with Gold Rx Plan Monthly Plan Premium$0 Maximum Out-of-Pocket$6,700 Primary Care Physician Copay Specialist Copay $30 $50 Inpatient Hospital Days 1-15/ 16-90: Days 91-150: No deductible $165 /$0 per day $0 per lifetime reserve day Retail Pharmacy (30-day supply) $8 generic; $45 preferred brand; $95 non-preferred brand; 33% specialty Preventive Dental Routine office visit includes: annual exam, cleaning, x-rays $10 routine office visit that includes denture adjustments Transportation$0 copayment for 10 one way trips Vision$25 for routine exam every year $150 yearly toward eyewear

23. Dual Advantage Dual Advantage (PPO SNP) is a Special Needs Plan designed specifically for those who have both Medicare and full Medicaid. To be eligible for this plan, you must: –Live in the service area –Have both Medicare Part A and Part B; and –Have your Medicare Parts A and B cost sharing covered by the State 23

24. Dual Advantage Highlights $0 monthly plan premium and $0 cost sharing options for Medicare-covered services Vision and transportation benefits Dental benefits (including dentures; referral required) 24

25. Dual Advantage – select counties 25 BenefitsWhat You Pay With Dual Advantage if You Are Medicare & Full Medicaid Monthly Plan Premium$0 Maximum Out-of-Pocket$6,700 Physician Copay Specialist Copay $0 Inpatient Hospital$0 Retail Pharmacy (30-day supply) $0 deductible $0/$1.10/$2.60 – for generic $0/$3.30/$6.50 for all other drugs Preventive Dental Routine office visit includes: annual exam, cleaning, x-rays $0 routine office visit that includes denture adjustments $0 in-network/20% out-of-network for dentures Transportation$0 copayment for 20-22 one way trips Vision$0 in-network/20% out-of-network for routine exam $200 yearly toward eyewear

26. Medicare Advantage Medicare Advantage (Regional PPO) or (PPO) was specifically designed for beneficiaries with Medicare only –Such as caregivers and spouses of our Special Needs Plan members To be eligible for this plan, you must: –Live in the service area –Have both Medicare Part A and Part B 26

27. Medicare Advantage Highlights Affordable monthly plan premium and predictable cost sharing Vision and transportation benefits Dental benefits (including denture adjustments) Convenience of one health plan for everyone in your household 27

28. Medicare Advantage – Georgia & South Carolina (RPPO) 28 Basic and Additional BenefitsWhat You Pay With the Medicare Advantage Plan Monthly Plan Premium$70 Maximum Out-of-Pocket$6,700 Physician Copay Specialist Copay $35 $50 Inpatient Hospital Days 1-15 /16-90: Days 91-150: No deductible $175 /$0 per day $0 per lifetime reserve day Retail Pharmacy (30-day supply) $10 generic; $45 preferred brand; $95 non-preferred brand; 27% specialty Preventive Dental Routine office visit includes: annual exam, cleaning, x-rays $10 routine office visit that includes denture adjustments Transportation$0 copayment for 12 one way trips Vision$25 routine exam every year $150 yearly toward eyewear

29. Prescription Drug Overview 29

30. Part D Benefit Comprehensive, low-cost Part D coverage Covers most generics and the common branded medications that are not excluded by Medicare Accepted at nearly 60,000 network pharmacies nationwide, including many national and local chains Mail-order pharmacy service is available for added convenience and savings 30

31. Part D Benefit A formulary (list of covered drugs) chosen by our pharmacy experts to meet our member’s healthcare needs –Mailed to all members and available online www.careimprovementplus.com –Use the formulary to: See if your medications are covered Determine the copayment for your medications 31

32. “Extra Help” People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. 32

33. “Extra Help” cont... Many people are eligible for these savings and don’t even know it. To see if you qualify for Extra Help, contact: –1-800-MEDICARE (1-800-633-4227), (TTY: 1- 877-486-2048), 24 hours per day, 7 days per week. –Social Security: 1-800-772-1213, 7 a.m. – 7 p.m., Monday-Friday. (TTY: 1-800-325-0778) –Your State Medicaid Office 33

34. Low Income Subsidy Beneficiaries with Low Income Subsidy (LIS) receive help paying their drug costs –Various levels depending on individual factors –$0-$2.60 or 15% for generics or $0 - $6.50 or 15% for others –Coverage through the gap (“donut hole”) 34

35. Coverage Gap Most Medicare drug plans have a coverage gap (“donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs. Not everyone will enter the coverage gap. The coverage gap begins after you and the plan have spent a certain amount for covered drugs. 35

36. Coverage Gap cont… The member reaches the coverage gap once they have spent $2,930 in drug spend – what the members plus (+) what the plan pays Once a member enters the coverage gap, they pay 50% of the cost of brands and 86% for generics until the total amount paid reaches the out-of-pocket limit. Members who receive LIS still have coverage during the coverage gap. 36

37. Additional Services 37

38. Our Commitment Care Improvement Plus remains committed to our members and to the Medicare Community at-large. Care Improvement Plus members receive the extra help they need through valuable programs such as: –Comprehensive Care Management –24/7 Nurse Hotline –HouseCalls –PharmAssist 38

39. Care Management Supports, helps, and assists people living with long-term chronic illnesses Provides personalized care to meet individual needs of members –Nursing support –Medication monitoring/counseling –Health education –Tools to help manage your health in-home monitoring equipment (if needed) 39

40. Care Coordination The management of healthcare between doctor visits coordinated among multiple providers. Making sure you are getting the right care at the right time. 40

41. 24/7 Nurse Hotline Information and support when you need it –Nurses are available 24 hours a day to answer health-related questions Communicate better with your provider –Call before or after you see your doctor to make the most of your appointment. Guidance for difficult decisions –The more you know, the better decision you can make. 41

42. Social Service Coordinators Available to help determine your eligibility for state, local and federal programs that can assist with expenses such as –Medical costs –Prescription drugs –Heating and electric bills –Housing/rent –Meals –Legal 42

43. HouseCalls In-person visit with a physician or nurse practitioner who performs a health assessment to: –Gather information to help Care Improvement Plus provide additional health education and care coordination –Identify urgent health problems or health risks –Provide advice on health-related topics to discuss at the next appointment with provider No additional cost to members All members are eligible for this program 43

44. PharmAssist Specialist Pharmacists are available for personalized, private counseling –Review of medications to avoid duplication –Educate members about their medications –Ensure medications are being taken as prescribed –Assess needs for any new drugs –Discuss any issues with physician 44

45. How to Enroll 45

46. So...How Do You Choose? Factors to consider when choosing your plan: –Health needs- How often and for what services will you use the plan most often? –Cost- Compare your current out of pocket costs including monthly premium, copayment and coinsurance amounts. –Providers- Are your providers (doctors and hospitals) Medicare-approved? And are they willing to accept payment from the plan? –Benefits- Does the plan offer you the coverage and benefits you need including valuable extras at no additional cost? 46

47. Keep in Mind No matter which Care Improvement Plus plan you choose to join, you are still part of the Medicare program and you must continue to pay your applicable Medicare premiums. Care Improvement Plus is not a “stand- alone” Part D plan (PDP) Care Improvement Plus is not a Medicare Supplement plan (Medigap) 47

48. Keep in Mind If you currently have a Medicare Supplement or Medigap plan, you should not cancel or stop paying your premiums until your enrollment in Care Improvement Plus has been confirmed by Medicare. If you currently have Medicare Advantage (MA), Medicare Advantage Part D (MAPD) or Part D coverage you will be automatically disenrolled from your plan by Medicare upon your effective date with Care Improvement Plus. 48

49. Important Dates 49 In 2011DescriptionIn 2012 October 15 – December 7Annual Enrollment Period (AEP) begins. You can enroll or dis-enroll in a Medicare Advantage health plan. Annual Disenrollment Period (ADP) begins. January 1 – February 14

50. Special Election Period If you have diabetes, heart failure or Medicaid/Low Income Subsidy (LIS), you may enroll in a Care Improvement Plus Special Needs Plan ANYTIME during the year by exercising a “Special Election Period”. There are other times you are eligible for a special election period; for example: –If you permanently move to another service area –Other Medicare-approved circumstances 50

51. How to Enroll Four Easy Steps 1.Decide which plan is best for you. 2.Complete the enrollment application and other applicable paperwork. 3.Receive an education call. 4.Become a Care Improvement Plus member! 51

52. What Happens Next? 52

53. Temporary Proof of Coverage Once you complete the enrollment application, you will have a Temporary Proof of Coverage document in the Enrollment Guide. –This provides you with proof of your application for enrollment and important contact information until your Care Improvement Plus ID card and Welcome Kit arrives. 53

54. Temporary Proof of Coverage 54

55. Enrollment Verification Call You will receive a phone call from Member Services within 15 days of Care Improvement Plus receiving your completed enrollment application verifying your choice to participate in our plan. We will also discuss our unique programs that are available to you as a member of our plan. 55

56. Member ID & Welcome Kit Within 10 days of Care Improvement Plus receiving your completed enrollment application, you will receive: –A copy of your completed enrollment application –Your new Member ID Card Upon Medicare confirming your enrollment in Care Improvement Plus, you will receive your new Member Welcome Kit 56

57. Member ID Card 57 Front Back

58. Benefit Notes You must continue to pay your Medicare Part B premium. If the State pays your Part B premium, you will not be responsible for paying your Part B premium. In 2011, the annual Part B deductible was $162 and may change for 2012. Cost sharing may vary based on the level of help that beneficiaries may receive. 58

59. Benefit Notes cont... Care Improvement Plus is a Medicare Advantage organization with a Medicare contract. The Care Improvement Plus contract with CMS is renewed annually and coverage availability beyond the end of the current contract year is not guaranteed. The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. For more information, contact the plan. Benefits, formulary, pharmacy network, premium and/or co-payments/coinsurance may change on January 1, 2013. Benefit limitations, copayments and restrictions may apply. 59

60. Benefit Notes cont... Members must use network pharmacies to access their prescription drug benefit, except under non- routine circumstances. Quantity limitations and restrictions may apply. If there is no network provider available for you to see, you may visit an out-of-network provider that is contracted with Medicare and willing to accept payment from Care Improvement Plus. Except for emergency or urgent care situations, it may cost more to get care from out-of-network providers. Contact the plan for details. 60

61. Plan Eligibility Status Change Care Improvement Plus may end your membership in the plan if you do not meet the plan’s eligibility requirements: –CSNP: If we are unable to confirm with your doctor that you have diabetes or heart failure, you will have 60 days to confirm your eligibility before we end your membership. –DSNP: If you no longer have full Medicaid (your A/B cost sharing is no longer covered by the State), you will have 6 months to regain eligibility before we end your membership. 61

62. Thank You! 62 For more information: “Medicare and You 2012” handbook www.medicare.gov Your local State Health Insurance Program (SHIP) Visit us at: www.careimprovementplus.com Contact us at: info@careimprovementplus.com info@careimprovementplus.com Prospective Members: 1-800-711-1656 (TTY: 711) Member Services: 1-800-204-1002 (TTY: 711) 8:00 am – 8:00 pm, 7 days a week Send completed applications to: Care Improvement Plus P.O. Box 691350 San Antonio, TX 78269-1350 Attn: Enrollment Department For overnight applications: Care Improvement Plus 4350 Lockhill-Selma Road San Antonio, TX 78249 Attn: Enrollment Department (210) 587-2111

63. Care Improvement Plus Specialized Care for Medicare Beneficiaries 63 Y0072_OE12_6211_A_GA SC_CMS Approved 09262011