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Introducing AmeriHealth 65® Preferred HMO

September 28, 2012

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We are pleased to announce that for 2013, AmeriHealth is introducing AmeriHealth 65 Preferred HMO, an enhanced, affordably priced Medicare Advantage HMO plan. Members receive all the benefits of Original Medicare, plus many more when they use providers in the AmeriHealth New Jersey provider network. The plan is available to the Medicare-eligible population residing in Burlington, Camden, Cumberland, Gloucester, and Salem Counties. The premium for AmeriHealth 65 Preferred HMO is $24.30 for the medical-only plan, and $74.90 for the medical and prescription drug plan. The plan has a $6,700 out-of-pocket maximum for 2013.

AmeriHealth 65 Preferred is an alternative to the AmeriHealth 65 NJ HMO plan, which will be discontinued for individuals only, beginning January 1, 2013. In addition to comprehensive medical coverage and vision, dental, and hearing services, AmeriHealth 65 Preferred features an extensive provider network with more than 3,000 primary care physicians, 50,000 specialist sites, and 100 hospitals, including Philadelphia-area providers.

Members receive access to the SilverSneakers? Fitness Program; preventive care; health resources and wellness programs; and support for managing chronic conditions, such as asthma, diabetes, and chronic obstructive pulmonary disease (COPD).

Medicare Part D prescription drug coverage is optional.

AmeriHealth 65 Preferred HMO benefit highlights

Service

Cost to member

Primary care physician (PCP) visits

$15 copay per visit

Specialist visits

$35 copay per visit

Emergency department

$65 copay per visit (not waived if admitted)

Urgent care

$15 or $35 copay per visit

Outpatient surgery

$350 copay (per date of service) for Hospital; $100 copay for Ambulatory Surgical Centers (per date of service)

Inpatient hospital

$245 per day for days 1-7 ($1,715 per stay maximum); unlimited days each benefit period

Fitness program

SilverSneakers?

Preventive dental

$10 every six months exams and cleanings

Eyewear

$100 every 2 years ($65 frames, $35 lenses); $40 copay for eye exam every 2 years

Hearing aids and exams

Up to $500 for hearing aids (two aids) every 3 years; routine hearing exam ($40 every 3 years)

Please contact your Network Coordinator or Hospital/Ancillary Services Coordinator if you have any questions.

Limitations, copayments, and restrictions may apply to certain benefits. AmeriHealth 65 Preferred HMO is a Medicare Advantage plan with a Medicare contract and is offered by AmeriHealth HMO, Inc. Prescription benefits are administered by FutureScripts® Secure, a pharmacy benefit management program.

SilverSneakers® is a registered mark of Healthways, Inc.

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