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Private Fee-for-Service Plan
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Medi-Pak Advantage (PFFS), a Medicare Advantage Private Fee-for-Service plan, works differently than a Medicare supplement plan as well as other Medicare Advantage plans. If your doctor or hospital does NOT participate in the Medi-Pak Advantage (PFFS) network, the doctor or hospital isn’t required to agree to accept our plan’s payment terms or conditions, and may choose not to treat you, except in emergencies. You should verify that your provider(s) will accept Medi-Pak Advantage (PFFS) before each visit. Providers can find the plan’s terms and conditions on our Web site at arkansasbluecross.com/MedicarePlans.
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Pharmacy Access Statement
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Medi-Pak Advantage MA-PD (PFFS) members must use in-network pharmacies to receive plan benefits, except under emergency care circumstances.
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Eligibility
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To be eligible for Medi-Pak Advantage MA-PD (PFFS) and Medi-Pak Advantage MA (PFFS), you must be entitled to Medicare Part A and enrolled in Medicare Part B, reside in the service area (Arkansas) and not have End-Stage Renal Disease (unless you are a member of our organization and have been since your dialysis began).
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Benefit and Plan Premium Information
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You must continue to pay your Medicare Part B premium even if your Medi-Pak Advantage (PFFS) premium is $0.
If a beneficiary decides to switch to premium withhold or move from premium withhold to direct bill, it could take up to three months for it to take effect and you will be held responsible for those premiums.
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Enrollment Limitations
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Medicare beneficiaries enroll in a plan only during specific times of the year. For more information, see Enrollment Guidelines.
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Availability of Alternative Formats
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Material is available in alternative formats for the visually impaired by calling 1-877-233-7022 (TTY/TDD users should call 1-800-370-5869), 8 a.m. to 8 p.m.,
Monday-Friday.
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Online Enrollment Center
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Medicare beneficiaries may enroll in Medi-Pak Advantage (PFFS) through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.cms.gov. For more information on Medi-Pak
Advantage (PFFS) call 1-877-233-7022 (TTY/TDD 1-800-370-5869), 8 a.m. to 8 p.m.,
Monday-Friday.
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Medicare Helpline
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People on Medicare may contact 1-800-MEDICARE (1-800-633-4227) (24 hours a day, 7 days a week) and TTY/TDD users should call 1-877-486-2048 for more information about Medicare benefits and services including general information regarding Medicare Prescription Drug Insurance.
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Hours of Operation
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Call us at 1-877-233-7022, 8 a.m. – 8 p.m., Monday-Friday (TTY: 1-800-370-5869).
You may qualify for extra help with your monthly premium and drug costs.
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H4213_Advantage_REV Website Submission (12/03/09)
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