2024 Disclaimers

Welcome to SilverEdge Advisors (“the Company”). The information contained on this website and any associated materials are for general informational purposes only. By accessing and using this website, you agree to the terms and conditions outlined in this disclaimer. If you do not agree with these terms, please refrain from using this website.

Aetna 

Plan Disclosures

The Medicare Supplement Insurance Plans are insured by Continental Life Insurance Company of Brentwood, Tennessee (Aetna), American Continental Insurance Company (Aetna), Aetna Health and Life Insurance Company (Aetna), or Aetna Health Insurance Company (Aetna).

Not connected with or endorsed by the U.S. Government or the Federal Medicare Program. This is a solicitation of insurance. Contact may be made by a Licensed Insurance Agent or Insurance Company. The Medicare Supplement Insurance Plans are guaranteed renewable as long as the required premium is paid by the end of each grace period. The policies have exclusions, limitations, terms under which the policy may be continued in force or discontinued. Plans do not pay benefits for any service and supply of a type not covered by Medicare, including but not limited to dental care or treatment, eyeglasses and hearing aids. Premium rates are subject to change and may vary based on the effective date of coverage, and information provided by you. See Plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. In some states, Medicare Supplement Insurance Plans are available to under age 65 individuals that are eligible for Medicare due to disability or ESRD (end stage renal disease). Plans not available in all States.

In Virginia: Aetna does not provide benefits under the Medicare Supplement Policies for the following:

  1. Services and supplies not eligible under Medicare.
  2. Services and supplies which are not determined by Medicare to be Medically Necessary.
  3. Payment of services and supplies which duplicate those covered by Medicare.
  4. Services and supplies You receive free of charge.
  5. Services and supplies You receive from a member of Your Immediate Family.
  6. Services and supplies You could have obtained under Medicare but did not.
  7. Services and supplies for the treatment of mental or nervous disorders beyond the number of days approved by Medicare.
  8. Services and supplies not specifically listed as a Covered Service.
  9. Services and supplies for the treatment of any injury or illness if charges for that treatment are payable under the requirements of a Worker’s Compensation or Occupational Disease law.
  10. Services and supplies provided by a governmental agency or facility to the extent this does not conflict with federal or state law.
  11. Services and supplies deemed to be not Medically Necessary when We are the primary payor.
  12. Services and supplies deemed to be Experimental/Investigative when We are the primary payor. Page 13 of 14 Medicare Supplement Website Carrier Carrier Product or Brand Disclaimer Content
  13. Expense incurred while this Policy is not in force, except as provided in Extension of Benefits. Pre-existing Condition Limitation: This Policy does not provide benefits for losses You incur during the first six (6) months after the Policy Effective Date if caused by or resulting from a Pre-existing Condition.
    This Pre-existing Condition limitation does not apply if
    1. The Policy Effective Date is no more than six (6) months after Your 65th birth date; or
    2. You submit an Application prior to or during the six (6) month period beginning with the first day of the month in which You are 65 years or older and enrolled for benefits under Medicare Part B; or
    3. You are an eligible person coming from a Medicare Advantage, Medicare Select, Medicare Supplement, or an Employee Welfare Benefit Plan as defined in the Employee Retirement Income Security Act of 1974 (29 USC § 1002), and You apply to enroll not later than 63 days from the date of the terminate on of enrollment in the previous plan, and You submit evidence of termination or disenrollment from that plan with the Application for this Policy.

Important Notice In Colorado: All Medicare Supplement standardized plans are offered to qualified individuals under 65.

Policy forms issued in OR include CLIMSP10A OR, CLIMSP10B OR, CLIMSP10F OR, CLIMSP10HF OR, CLIMSP10G OR, and CLIMSP10N OR. In ID, include AHLMSP17A ID, AHLMSP17B ID, AHLMSP17F ID, AHLMSP17HF ID, AHLMSP17G ID, and AHLMSP17N ID. In OK, include AHIMSP18A OK, AHIMSP18B OK, AHIMSP18F OK, AHIMSP18HF OK, AHIMSP18G OK, and AHIMSP18N OK. In TN, include CLIMSP19A TN, CLIMSP19B TN, CLIMSP19F TN, CLIMSP19G TN, CLIMSP19HG TN, and CLIMSP19N TN. In FL, include CLIMSP19A FL, CLIMSP19B FL, CLIMSP19F FL, CLIMSP19G FL, and CLIMSP19N FL. In OH, include CLIMSP19A OH, CLIMSP19B OH, CLIMSP19F OH, CLIMSP19G OH, CLIMSP19HG OH, and CLIMSP19N OH. In MO, AHLMSP18A MO, AHLMSP18B MO, AHLMSP18F MO, AHLMSP18G MO, AHLMSP18HF MO, and AHLMSP18N MO. In MD, AHIMSP19A MD, AHIMSP19B MD, AHIMSP19F MD, AHIMSP19G MD, AHIMSP19HG MD, and AHIMSP19N MD. IN NH, AHLMSP18A NH, AHLMSP18B NH, AHLMSP18F NH, AHLMSP18HF NH, AHLMSP18G NH, AHLMSP18N NH. In VA, CLIMSP19A VA, CLIMSP19B VA, CLIMSP19F VA, CLIMSP19G VA, CLIMSP19HG VA, CLIMSP19N VA. In TX: AHIMSP18A TX, AHIMSP18B TX, AHIMSP18F TX, AHIMSP18HF TX, AHIMSP18G TX, and AHIMSP18N TX. In PA: AHIMSP19A PA, AHIMSP19B PA, AHIMSP19F PA, AHIMSP19HG PA, AHIMSP19G PA, AHIMSP19N PA. In MN: CLIMSP10BP, CLIMSP10CP, CLIMSP10EB, CLIMSP19EB, CLIMSP10HD, CLIMSP19HD.

Plan F is available only to those first eligible before 2020.

Medicare Supplement rates based on issue age are valid only for enrollments with coverage starting before March 1, 2022.

Aetna Non-discrimination Notice

Aetna 

Plan Disclosures

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our DSNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in: Suburban Arizona, Rural California, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North Dakota, Suburban West Virginia. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at http://www.aetnamedicare.com/pharmacyhelp.

Participating health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.

The formulary and/or pharmacy network may change at any time. You will receive notice when necessary.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Every year, Medicare evaluates plans based on a 5-star rating system.

Allina 

Plan Disclosures

Allina Health | Aetna Medicare is a PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal.

The Allina Health | Aetna Medicare pharmacy network includes limited lower cost preferred pharmacies in: Suburban Arizona, Rural California, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North Dakota, Suburban West Virginia. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711)  or consult the online pharmacy directory at https://enroll.allinahealthaetnamedicare.com/s/shopping-tools/pharmacy

Participating health care providers are independent contractors and are neither agents nor employees of Allina Health Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.

The formulary and/or pharmacy network may change at any time. You will receive notice when necessary.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Every year, Medicare evaluates plans based on a 5-star rating system.

Anthem | MaineHealth 

Plan Disclosures

AMH Health Plans Of Maine, Inc. is an LPPO plan with a Medicare contract. Enrollment in AMH Health Plans Of Maine, Inc. depends on contract renewal. Plans offered by AMH Health Plans Of Maine, Inc, a joint venture between MaineHealth and Anthem Partnership Holding Company, LLC. AMH Health Plans Of Maine, Inc is an independent licensee of the Blue Cross Blue Shield Association.

Anthem I MaineHealth, LLC. is an HMO plan with a Medicare contract. Enrollment in Anthem I MaineHealth, LLC. depends on contract renewal. Plans offered by AMH Health, LLC, a joint venture between MaineHealth and Anthem Partnership Holding Company, LLC. AMH Health, LLC is an independent licensee of the Blue Cross Blue Shield Association.

Anthem I MaineHealth, LLC. is an HMO-POS plan with a Medicare contract. Enrollment in Anthem I MaineHealth, LLC. depends on contract renewal. Plans offered by AMH Health, LLC, a joint venture between MaineHealth and Anthem Partnership Holding Company, LLC. AMH Health, LLC is an independent licensee of the Blue Cross Blue Shield Association.

Anthem I MaineHealth, LLC.is an HMO D-SNP plan with a Medicare contract and a contract with the Maine Medicaid program. Enrollment in Anthem I MaineHealth, LLC. depends on contract renewal. Plans offered by AMH Health, LLC, a joint venture between MaineHealth and Anthem Partnership Holding Company, LLC. AMH Health, LLC is an independent licensee of the Blue Cross Blue Shield Association.

Anthem Blue Cross 

Plan Disclosures

Anthem Blue Cross is an HMO D-SNP plan with a Medicare contract and a contract with the California Medicaid program. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California Partnership Plan LLC. Independent licensee of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross is an HMO D-SNP plan with a Medicare contract and either a contract or a coordination of benefits agreement with the New York State Department of Health. Enrollment in Anthem Blue Cross depends on contract renewal. Services provided by Anthem HealthChoice HMO, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Services provided by Anthem HealthChoice HMO, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Services provided by Anthem HealthChoice Assurance, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross Life and Health Insurance Company is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross Life and Health Insurance Company depends on contract renewal. Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross Life and Health Insurance Company is an LPPO D-SNP plan with a Medicare contract and a contract with the California Medicaid program. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross Life and Health Insurance Company is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross Life and Health Insurance Company depends on contract renewal. Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross Partnership Plan is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross Partnership Plan depends on contract renewal. Anthem Blue Cross is the trade name for Blue Cross of California. Anthem Blue Cross and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield 

Plan Disclosures

Anthem Blue Cross and Blue Shield HP is an HMO D-SNP plan with a Medicare contract and either a contract or a coordination of benefits agreement with the New York State Department of Health. Enrollment in Anthem Blue Cross and Blue Shield HP depends on contract renewal. Services provided by Anthem HP, LLC. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a D-SNP plan with a Medicare contract and a contract with the Connecticut Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc., independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Maine, Inc. and Anthem Health Plans of New Hampshire, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., and Anthem Health Plans of Kentucky, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare) and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield is an independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Colorado Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Georgia Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Indiana Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Kentucky Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Missouri Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Nevada Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Ohio Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Wisconsin Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare) and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and either a contract or a coordination of benefits agreement with the New York State Department of Health. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Services provided by Anthem HealthChoice HMO, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc., independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare) and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Services provided by Anthem HealthChoice HMO, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO D-SNP plan with a Medicare contract and a contract with the Connecticut Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc., independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO D-SNP plan with a Medicare contract and a contract with the Georgia Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO D-SNP plan with a Medicare contract and a contract with the Virginia Medicaid plan. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield is an independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of New Hampshire, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc., independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare) and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield is an independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an RPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is an RPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Anthem Blue Cross and Blue Shield is the trade name of in Indiana: Anthem Insurance Companies, Inc. and in Kentucky: Anthem Health Plans of Kentucky, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

HealthKeepers, Inc. is an HMO plan with a Medicare contract. Enrollment in HealthKeepers, Inc. depends on contract renewal. HealthKeepers, Inc., an independent licensee of the Blue Cross Blue Shield Association, serves all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Anthem HealthKeepers 

Plan Disclosures

HealthKeepers, Inc. is an HMO D-SNP plan with a Medicare contract and a contract with the Virginia Medicaid program. Enrollment in HealthKeepers, Inc. depends on contract renewal. HealthKeepers, Inc., an independent licensee of the Blue Cross Blue Shield Association, serves all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

HealthKeepers, Inc. is an HMO plan with a Medicare contract. Enrollment in HealthKeepers, Inc. depends on contract renewal. HealthKeepers, Inc., an independent licensee of the Blue Cross Blue Shield Association, serves all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Blue Cross and Blue Shield of Illinois 

Plan Disclosures

Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

HMO, HMO-POS and PPO plans provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). HMO plan provided by Illinois Blue Cross Blue Shield Insurance Company (ILBCBSIC). HCSC and ILBCBSIC are Independent Licensees of the Blue Cross and Blue Shield Association. HCSC and ILBCBSIC are Medicare Advantage organizations with a Medicare contract. Enrollment in HCSC’s and ILBCBSIC’s plans depends on contract renewal.

HMO and HMO-POS plans provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). HMO plan provided by Illinois Blue Cross Blue Shield Insurance Company (ILBCBSIC). HCSC and ILBCBSIC are Independent Licensees of the Blue Cross and Blue Shield Association. HCSC and ILBCBSIC are Medicare Advantage organizations with a Medicare contract. Enrollment in HCSC’s and ILBCBSIC’s plans depends on contract renewal.

PPO plans provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract. Enrollment in HCSC’s plans depends on contract renewal.

Prescription drug plans provided by Blue Cross and Blue Shield of Illinois, which refers to HCSC Insurance Services Company (HISC), an Independent Licensee of the Blue Cross and Blue Shield Association. A Medicare-approved Part D sponsor. Enrollment in HISC’s plans depends on contract renewal.

Click Here for Important Anti-Discrimination Notice.

Cigna 

Plan Disclosures

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation.

The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc.

Cigna contracts with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans (PDP) in select states, and with select State Medicaid programs. Enrollment in Cigna depends on contract renewal. For PPO and POS plans, out-of-network/non-contracted providers are under no obligation to treat Cigna members, except in emergency situations. Please call our Customer Service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. You must live in the plan’s service area.

Call Customer Service at 1-800-668-3813 (TTY 711), 8 a.m. to 8 p.m. local time, 7 days a week October 1 to March 31, Monday to Friday April 1 to September 30. Our automated phone system may answer your call during weekends, holidays and after hours.

Individuals may enroll in a plan only during specific times of the year and must have Medicare Parts A and B. Prior authorization and/or referrals are required for certain services. This information is not a complete description of benefits, which vary by individual plan. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Cigna Health and Life Insurance Company 

Plan Disclosures

AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We’ll provide an outline of coverage to all persons at the time the application is presented.

Neither Cigna nor its agents/producers are connected with or endorsed by the U.S. Government or the federal Medicare program. This is a solicitation for insurance. An insurance agent may contact you. Premium and benefits vary by plan selected. Plan availability varies by state. Medicare Supplement policies are underwritten by Cigna National Health Insurance Company, Cigna Health and Life Insurance Company, American Retirement Life Insurance Company or Loyal American Life Insurance Company. Each insurer has sole responsibility for its own products.

The following Medicare Supplement Plans are available to persons eligible for Medicare due to disability: Plan A in Arkansas, Connecticut, Indiana, Maryland, Oklahoma, Texas, and Virginia; Plans A, F, and G in North Carolina; and Plans C and D in New Jersey for individuals aged 50-64. Medicare Supplement policies contain exclusions, limitations, and terms under which the policies may be continued in force or discontinued. For costs and complete details of coverage, contact the company.

This website is designed as a marketing aid and is not to be construed as a contract for insurance. It provides a brief description of the important features of the policy. Please refer to the policy for the full terms and conditions of coverage.

American Retirement Life Insurance Company, Cigna National Health Insurance Company and Loyal American Life Insurance Company do not issue policies in New Mexico.

For residents of all states except for Minnesota and Wisconsin

Exclusions and Limitations:

  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare eligible expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plan F);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy;
  • (7) confinement that begins or expenses incurred while your policy is not in force; or
  • (8) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the Pre-existing Conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months prior to the policy effective date.

For residents of Arizona, Connecticut, Georgia, Illinois, Iowa, Kentucky, Mississippi, Missouri, Ohio, and Virginia: 

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Form:
  • Plan A: CHLIC-MS-AA-A-GN, CHLIC-MS-IA-A-GN, CHLIC-MS-CR-A-GN
  • Plan F: CHLIC-MS-AA-F-GN, CHLIC-MS-IA-F-GN, CHLIC-MS-CR-F-GN
  • Plan High Deductible F (HDF): CHLIC-MS-AA-HDF-GN, CHLIC-MS-IA-HDF-GN, CHLIC-MS-CR-HDF-GN
  • Plan G: CHLIC-MS-AA-G-GN, CHLIC-MS-IA-G-GN, CHLIC-MS-CR-G-GN
  • Plan N: CHLIC-MS-AA-N-GN, CHLIC-MS-IA-N-GN, CHLIC-MS-CR-N-GN
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plans F & HDF);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy
  • and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a Physician within six (6) months prior to the policy effective date.

For residents of California 

Medicare Supplement Policy Forms: Plan A: CHLIC-MS-AA-A-CA; Plan F: CHLIC-MS-AA-F-CA; Plan HDF: CHLIC-MS-AA-HDF-CA; Plan G: CHLIC-MS-AA-G-CA; Plan N: CHLIC-MS-AA-N-CA

Exclusions and Limitations:

  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare eligible expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plans F and HDF);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medi-Cal or Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: These policies will not pay for any expenses incurred for care or treatment of a Pre-existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a Physician within six (6) months prior to the policy effective date.

For residents of Florida

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CHLIC-MS-IA-A-FL, CHLIC-MS-DI-A-FL; Plan F: CHLIC-MS-IA-F-FL, CHLIC-MS-DI-F-FL; Plan HDF: CHLIC-MS-IA-HDF-FL, CHLIC-MS-DI-HDF-FL; Plan G: CHLIC-MS-IA-G-FL, CHLIC-MS-DI-G-FL; Plan N: CHLIC-MS-IA-N-FL, CHLIC-MS-DI-N-FL
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plans F & HDF);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a Physician within six (6) months prior to the policy effective date.

For residents of Idaho

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Form Series: Plan A: CHLIC-MS-IA-A.v2-ID; Plan F: CHLIC-MS-IA-F.v2-ID; Plan High Deductible F (HDF): CHLIC-MS-IA-HDF.v2-ID; Plan G: CHLIC-MS-IA-G.v2-ID and Plan N: CHLIC-MS-IA-N.v2-ID
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible; (Not Applicable in Plans F & HDF)
  • (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre- existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a Physician within six (6) months before the effective date of coverage.

For residents of Minnesota

  • Medicare Supplement Policy and Rider Form Numbers: Basic Medicare Supplement Policy: CHLIC-MS-BASIC-MN; Extended Basic Medicare Supplement Policy: CHLIC-MS-EXTENDED-MN; Medicare Supplement Policy with $20 and $50 Copayment Medicare Part B Coverage: CHLIC-MS-COPAYMENT-MN; High Deductible Coverage Medicare Supplement Policy: CHLIC-MS-HIGHD-MN; Medicare Part A Deductible Rider: CHLIC-MS-PTAD-MN; Medicare Part B Deductible Rider: CHLIC-MS-PTBD-MN; Medicare Part B Excess Charge: CHLIC-MS-PTBEXC-MN; Preventive Medical Care Benefit Rider: CHLIC-MS-PC-MN.
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1a) Basic Medicare Supplement Policy: The Medicare Part A & Part B Deductibles;
  • (b) Medicare Supplement Policy with $20 and $50 Copayment Medicare Part B Coverage: the Medicare Part B Deductible;
  • (c) High Deductible Coverage Medicare Supplement Policy: the Medicare Part B Deductible.
  • (2) Any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) Any services that are not medically necessary as determined by Medicare;
  • (4) Any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid);
  • (5) Any type of expense not a Medicare Eligible Expense except as provided previously in this policy; or
  • (6) Any Deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy;
  • (7) Expense resulting from a Pre-existing Condition is not covered unless it is incurred 6 months or more after the Coverage Effective Date. A Pre-existing Condition is one: (a) for which medical advice was given or treatment was recommended by or received from a Physician within 90 days or less before Your Coverage Effective Date; and (b) which would not have caused Us to deny issuing Your policy had it been named on Your application.
  • This provision does not apply if, as of the date of application, You had a Continuous Period of Creditable Coverage or had prior coverage under a Medicare Supplement policy for at least six (6) months. If, as of the date of application, You had less than six (6) months prior Creditable Coverage, the Pre-existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. This provision does not apply if You applied for and were issued this policy under guaranteed issue status.

For residents of New Hampshire

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CHLIC-MS-IA-A-NH; Plan F: CHLIC-MS-IA-F-NH; Plan HDF: CHLIC-MS-IA-HDF-NH; Plan G: CHLIC-MS-IA-G-NH; Plan N: CHLIC-MS-IA-N-NH
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plan F);
  • (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
  • (6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Pre-existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of New Jersey

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CHLIC-MS-AA-A-NJ; Plan C: CHLIC-MS-AA-C-NJ; Plan F: CHLIC-MS-AA-F-NJ; Plan High Deductible F (HDF): CHLIC-MS-AA-HDF-NJ; Plan G: CHLIC-MS-AA-G-NJ; Plan N: CHLIC-MS-AA-N-NJ.
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plans F and HDF);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as an additional benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a Physician within six (6) months prior to the policy effective date.

For residents of New Mexico

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CHLIC-MS-AA-A-NM; Plan F: CHLIC-MS-AA-F-NM; Plan HDF: CHLIC-MS-AA-HDF-NM; Plan G: CHLIC-MS-AA-G-NM; Plan N: CHLIC-MS-AA-N-NM
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plans F & HDF);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a Physician within six (6) months prior to the policy effective date.

For residents of New Mexico

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CHLIC-MS-AA-A-ND, CHLIC-MS-AO-A-ND; Plan F: CHLIC-MS-AA-F-ND, CHLIC-MS-AO-F-ND; Plan HDF: CHLIC-MS-AA-HDF-ND, CHLIC-MS-AO-HDF-ND; Plan G: CHLIC-MS-AA-G-ND, CHLIC-MS-AO-G-ND; Plan N: CHLIC-MS-AA-N-ND, CHLIC-MS-AO-N-ND
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible;
  • (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
  • (6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of New Mexico

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CHLIC-MS-AA-A-OK; Plan F: CHLIC-MS-AA-F-OK; Plan High Deductible F (HDF): CHLIC-MS-AA-HDF-OK; Plan G: CHLIC-MS-AA-G-OK; Plan N: CHLIC-MS-AA-N-OK.
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plans F and HDF);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as an additional benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a Physician within six (6) months prior to the policy effective date.

For residents of Rhode Island

  • Cigna Health and Life Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CHLIC-MS-AA-A-RI; Plan F: CHLIC-MS-AA-F-RI; Plan High Deductible F (HDF): CHLIC-MS-AA-HDF-RI; Plan G: CHLIC-MS-AA-G-RI; and Plan N: CHLIC-MS-AA-N-RI.
  • Exclusions and Limitations:
  • The benefits of a policy will not duplicate any benefits paid by Medicare. The combined benefits of a policy and the benefits paid by Medicare may not exceed one hundred percent (100%) of the Medicare Eligible Expenses incurred. A policy will not pay benefits for the following:
  • (1) the Medicare Part B deductible (not applicable for Plans F and C);
  • (2) any expense which you are not legally obligated to pay or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid) or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in the policy;
  • (6) any deductible, coinsurance, or copayment not covered by Medicare, unless such coverage is listed as a benefit in the policy; or
  • (7) Pre-Existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-Existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued a policy under guaranteed issue status; if on the date of application for a policy you had at least six (6) months of prior Creditable Coverage; or if the policy is replacing another Medicare Supplement policy and a six (6) 

Cigna National Health Insurance Company 

Plan Disclosures

AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We’ll provide an outline of coverage to all persons at the time the application is presented.

Neither Cigna nor its agents/producers are connected with or endorsed by the U.S. Government or the federal Medicare program. This is a solicitation for insurance. An insurance agent may contact you. Premium and benefits vary by plan selected. Plan availability varies by state. Medicare Supplement policies are underwritten by Cigna National Health Insurance Company, Cigna Health and Life Insurance Company, American Retirement Life Insurance Company or Loyal American Life Insurance Company. Each insurer has sole responsibility for its own products.

The following Medicare Supplement Plans are available to persons eligible for Medicare due to disability: Plan A in Arkansas, Connecticut, Indiana, Maryland, Oklahoma, Texas, and Virginia; Plans A, F, and G in North Carolina; and Plans C and D in New Jersey for individuals aged 50-64. Medicare Supplement policies contain exclusions, limitations, and terms under which the policies may be continued in force or discontinued. For costs and complete details of coverage, contact the company.

This website is designed as a marketing aid and is not to be construed as a contract for insurance. It provides a brief description of the important features of the policy. Please refer to the policy for the full terms and conditions of coverage.

American Retirement Life Insurance Company, Cigna National Health Insurance Company and Loyal American Life Insurance Company do not issue policies in New Mexico.

 For residents of all states except for Minnesota and Wisconsin

Exclusions and Limitations:

  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare eligible expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable in Plan F);
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy;
  • (7) confinement that begins or expenses incurred while your policy is not in force; or
  • (8) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the Pre-existing Conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. A pre-existing condition is a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months prior to the policy effective date.

For residents of Alabama

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: Plan A: CNHIC-MS-AA-A-AL; Plan F: CHNIC-MS-AA-F-AL; Plan G: CNHIC-MS-AA-G-AL; Plan N: CNHIC-MS-AA-N-AL
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible;
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as an additional benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of Colorado

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-CO; Plan F: CNHIC-MS-AA-F-CO; Plan G: CNHIC-MS-AA-G-CO; Plan N: CNHIC-MS-AA-N-CO
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible;
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs(except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of Indiana

  • National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-IN; Plan F: CNHIC-MS-AA-F-IN; Plan G: CNHIC-MS-AA-G-IN; Plan N: CNHIC-MS-AA-N-IN
  • Exclusions and Limitations:
  • The benefits of a policy will not duplicate any benefits paid by Medicare. The combined benefits of a policy and the benefits paid by Medicare may not exceed one hundred percent (100%) of the Medicare Eligible Expenses incurred. A policy will not pay benefits for the following:
  • (1) the Medicare Part B deductible (not applicable for Plan F);
  • (2) any expense which you are not legally obligated to pay or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid) or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in the policy;
  • (6) any deductible, coinsurance, or copayment not covered by Medicare, unless such coverage is listed as a benefit in the policy; or
  • (7) Pre-Existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-Existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued a policy under guaranteed issue status; if on the date of application for a policy you had at least six (6) months of prior Creditable Coverage; or if the policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for a policy. If you had less than six (6) months prior Creditable Coverage, the Pre-Existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If the policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. 

For residents of Indiana

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-KS, CNHIC-MS-AO-A-KS; Plan F: CNHIC-MS-AA-F-KS, CNHIC-MS-AO-F-KS; Plan G: CNHIC-MS-AA-G-KS, CNHIC-MS-AO-G-KS; Plan N: CNHIC-MS-AA-N-KS, CNHIC-MS-AO-N-KS
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible;
  • (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
  • (6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of Louisiana

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A:CNHIC-MS-AA-A-LA; Plan F: CNHIC-MS-AA-F-LA; Plan G: CNHIC-MS-AA-G-LA; Plan N: CNHIC-MS-AA-N-LA
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) The Medicare Part B Deductible;
  • (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
  • (6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as an additional benefit in this policy; or
  • (7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of Maryland

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A:CNHIC-MS-AA-A-MD; Plan F: CNHIC-MS-AA-F-MD; Plan G: CNHIC-MS-AA-G-MD; Plan N: CNHIC-MS-AA-N-MD
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • 1) The Medicare Part B Deductible;
  • 2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • 3) any services that are not medically necessary as determined by Medicare;
  • 4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
  • 5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
  • 6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • 7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of Michigan

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-MI; Plan F: CNHIC-MS-AA-F-MI; Plan G: CNHIC-MS-AA-G-MI; Plan N: CNHIC-MS-AA-N-MI
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) The Medicare Part B Deductible;
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as an additional benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Pre-existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of Nevada

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-NV; Plan F: CHNIC-MS-AA-F-NV; Plan G: CNHIC-MS-AA-G-NV; Plan N: CNHIC-MS-AA-N-NV
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible;
  • (2) any expense which you are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare eligible expense except as provided previously in this policy;
  • (6) any deductible, coinsurance or co-payment not covered by Medicare, unless such coverage is listed as an additional benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a pre-existing condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy you had at least six (6) months of prior creditable coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If you had less than six (6) months prior creditable coverage, the pre-existing conditions limitation will be reduced by the aggregate amount of creditable coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of North Carolina

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-NC; Plan F: CNHIC-MS-AA-F-NC; Plan G: CNHIC-MS-AA-G-NC; Plan N: CNHIC-MS-AA-N-NC
  • Exclusions and Limitations:
  • The benefits of a policy will not duplicate any benefits paid by Medicare. The combined benefits of a policy and the benefits paid by Medicare may not exceed one hundred percent (100%) of the Medicare Eligible Expenses incurred. A policy will not pay benefits for the following:
  • (1) the Medicare Part B deductible (not applicable for Plans F and C);
  • (2) any expense which you are not legally obligated to pay or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid) or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in the policy;
  • (6) any deductible, coinsurance, or copayment not covered by Medicare, unless such coverage is listed as a benefit in the policy; or
  • (7) Pre-Existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-Existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued a policy under guaranteed issue status; if on the date of application for a policy you had at least six (6) months of prior Creditable Coverage; or if the policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for a policy. If you had less than six (6) months prior Creditable Coverage, the Pre-Existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If the policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of Pennsylvania

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AO-A-PA; Plan B: CNHIC-MS-AO-B-PA; Plan F: CNHIC-MS-AO-F-PA; Plan G: CNHIC-MS-AO-G-PA; Plan N: CNHIC-MS-AO-N-PA
  • Exclusions and Limitations:
  • The benefits of a policy will not duplicate any benefits paid by Medicare. The combined benefits of a policy and the benefits paid by Medicare may not exceed one hundred percent (100%) of the Medicare Eligible Expenses incurred. A policy will not pay benefits for the following:
  • (1) the Medicare Part B deductible (not applicable for Plan F);
  • (2) any expense which you are not legally obligated to pay or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid) or for which payment would have been made by Medicare if you were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in the policy;
  • (6) any deductible, coinsurance, or copayment not covered by Medicare, unless such coverage is listed as a benefit in the policy; or
  • (7) Pre-Existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-Existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if you applied for and were issued a policy under guaranteed issue status; if on the date of application for a policy you had at least six (6) months of prior Creditable Coverage; or if the policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for a policy. If you had less than six (6) months prior Creditable Coverage, the Pre-Existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If the policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. 

For residents of South Carolina

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-SC; Plan F: CNHIC-MS-AA-F-SC; Plan G: CNHIC-MS-AA-G-SC; Plan N: CNHIC-MS-AA-N-SC
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) the Medicare Part B Deductible (not applicable for Plan F);
  • (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
  • (6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Pre-existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

For residents of South Dakota

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700
  • Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-SD; Plan F: CNHIC-MS-AA-F-SD; Plan G: CNHIC-MS-AA-G-SD; Plan N: CNHIC-MS-AA-N-SD
  • Exclusions and Limitations:
  • The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
  • (1) The Medicare Part B Deductible;
  • (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
  • (3) any services that are not medically necessary as determined by Medicare;
  • (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
  • (5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
  • (6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
  • (7) Pre-existing Conditions: We will not pay for any expenses incurred for care or treatment of a Pre-existing Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Pre-existing Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied. 

For residents of Tennessee

  • Cigna National Health Insurance Company
  • PO Box 5700
  • Scranton, PA 18505-5700

Empire BlueCross BlueShield 

Plan Disclosures

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by HEALTHPLUS HP, LLC. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans.

Empire BlueCross BlueShield is an LPPO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice Assurance, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross Blue Shield plans.

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans.

Empire BlueCross BlueShield is an HMO-POS plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans.

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield plans.

Florida Blue 

Plan Disclosures

Florida Blue Medicare is an Independent Licensee of the Blue Cross and Blue Shield Association.
Silveredge Insurance Advisors is an Independent Broker of Florida Blue Medicare.

Florida Blue is a PPO, RPPO and Rx (PDP) Plan with a Medicare contract. Florida Blue Medicare is an HMO Plan with a Medicare contract. Enrollment in Florida Blue or Florida Blue Medicare depends on contract renewal.

Health coverage is offered by Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue. HMO coverage is offered by Florida Blue Medicare, Inc., DBA Florida Blue Medicare. These companies are affiliates of Blue Cross and Blue Shield of Florida, Inc., and Independent Licensees of the Blue Cross and Blue Shield Association. 

La cobertura de salud es ofrecida por Blue Cross and Blue Shield of Florida, Inc., cuyo nombre comercial es Florida Blue. La cobertura HMO es ofrecida por Florida Blue Medicare, Inc., cuyo nombre comercial es Florida Blue Medicare. Estas empresas son afiliadas de Blue Cross and Blue Shield of Florida, Inc., y Licenciatarias Independientes de Blue Cross and Blue Shield Association.

Highmark 

Plan Disclosures

Highmark Choice Company, Highmark Senior Health Company, and Highmark Senior Solutions Company are Medicare Advantage plans with a Medicare contract. HM Health Insurance Company is a PDP plan with a Medicare contract. Enrollment in Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, and HM Health Insurance Company depends on contract renewal.

Health benefits or health benefit administration may be provided by or through Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, or Highmark Health Insurance Company, all of which are independent licensees of the Blue Cross Blue Shield Association. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.

Humana 

Plan Disclosures

Humana is a Medicare Advantage (HMO, PPO and PFFS) organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.

Other Pharmacies/Physicians/Providers are available in our network.

Humana Prescription Drug Plan (PDP) pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of CT, DE, IA, MA, MD, ME, MI, MN, MO, MS, MT, ND, NH, NJ, NY, PA, RI, SD, WY; suburban areas of CA, CT, DE, HI, IL, MA, MD, ME, MN, MT, ND, NH, NJ, NY, PA, PR, RI, VT, WV; and rural areas of AK, IA, MN, MT, ND, NE, SD, VT, WY. There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: DE, MA, ME, MN, MS, ND, NY; suburban areas of: MT and ND; and rural areas of: ND. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call Customer Care at 1-800-281-6918 (TTY: 711) or consult the online pharmacy directory at  Humana.com.

Humana Non-Discrimination Notice

Independence Blue Cross 

Plan Disclosures

Independence Blue Cross offers PPO, HMO-POS, and HMO Medicare Advantage plans with a Medicare contract. Enrollment in Independence Blue Cross PPO, HMO-POS, and HMO Medicare Advantage plans depends on contract renewal. 

Keystone 65 offers HMO plans with a Medicare contract. Enrollment in Keystone 65 Medicare Advantage plans depends on contract renewal.

Personal Choice 65 offers PPO plans with a Medicare contract. Enrollment in Personal Choice 65 Medicare Advantage plans depends on contract renewal.

AmeriHealth offers PPO Medicare Advantage plans with a Medicare contract. Enrollment in AmeriHealth PPO Medicare Advantage plans depends on contract renewal.

Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and Southeastern Pennsylvania.

Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company — independent licensees of the Blue Cross and Blue Shield Association.

We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at 1-800-275-2583 (TTY: 711). Someone who speaks English/Language can help you. This is a free service.

Tenemos servicios de intérprete sin costo alguno para responder cualquier pregunta que pueda tener sobre nuestro plan de salud o medicamentos. Para hablar con un intérprete, por favor llame al 1-800-275-2583 (TTY: 711). Alguien que hable español le podrá ayudar. Este es un servicio gratuito.

我们提供免费的翻译服务,帮助您解 答关于健康或药物保险的任何疑 问。如果您需要此翻 译服务,请致电 1-800-275-2583 (TTY: 711)。我们的 中文工作人员很乐意帮助您。 这是一项免费服务。

SilverScript 

Plan Disclosures

SilverScript is a Prescription Drug Plan with a Medicare contract marketed through Aetna Medicare. Enrollment in SilverScript depends on contract renewal.

Participating health care providers are independent contractors and are neither agents nor employees of SilverScript. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.

The formulary and/or pharmacy network may change at any time. You will receive notice when necessary.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Every year, Medicare evaluates plans based on a 5-star rating system.

Simply Healthcare 

Plan Disclosures

Simply Healthcare is an LPPO plan with a Medicare contract underwritten by Wellpoint Life & Health Insurance Company, a licensed Florida Health insurer. Enrollment in Simply Healthcare depends on contract renewal. 

Simply Healthcare Plans, Inc. is an HMO D-SNP Medicare-contracted coordinated care plan that has a Medicaid contract with the State of Florida Agency for Health Care Administration to provide benefits or arrange for benefits to be provided to enrollees. Enrollment in Simply Healthcare Plans, Inc. depends on contract renewal. 

Simply Healthcare Plans, Inc. is an HMO Medicare-contracted coordinated care plan that has a Medicaid contract with the State of Florida Agency for Health Care Administration to provide benefits or arrange for benefits to be provided to enrollees. Enrollment in Simply Healthcare Plans, Inc. depends on contract renewal. 

UPMC for Life 

Plan Disclosures

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., UPMC Health Benefits Inc., and UPMC Health Coverage Inc.

Silveredge Insurance Advisors is contracted with UPMC for Life and may be compensated based on your enrollment in a plan.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

See Multi Language Insert for information about obtaining plan information in a foreign language.

Wellcare / Centene 

Plan Disclosures

Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal. 

‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc. .

Every year, Medicare evaluates plans based on a 5-star rating system.

Our plans use a formulary.

Out-of-network/non-contracted providers are under no obligation to treat Wellcare members, except in emergency situations.

Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of MO and NE. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use.

For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-833-444-9088 (TTY 711) for Wellcare No Premium (HMO) and Wellcare Giveback (HMO) in MO or consult the online pharmacy directory at www.wellcare.com/medicare, and 1-833-542-0693 (TTY 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare No Premium Open (PPO) in NE or consult the online pharmacy directory at www.wellcare.com/NE

For Arizona D-SNP plans: Contract services are funded in part under contract with the State of Arizona.

For New Mexico D-SNP plans: Such services are funded in part with the state of New Mexico.

For Louisiana D-SNP members: As a WellCare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through WellCare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid.

Learn more about providers who participate in Louisiana Medicaid by visiting https://www.myplan.healthy.la.gov/myaccount/choose/find-provider. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaidand select the “Learn about Medicaid Services” link.

For Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid.

For Tennessee D-SNP plans: Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits.

†Other Pharmacies/Physicians/Providers are available in our network.
Please contact your plan for details.

ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711).ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711).

Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

“Every year, Medicare evaluates plans based on a 5-star rating system. Our plans use a formulary.

For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

†Other Pharmacies/Physicians/Providers are available in our network.Please contact your plan for details.

ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711).ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711).”

Ascension Complete is contracted with Medicare for HMO and PPO plans. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in Ascension Complete depends on contract renewal.

“Every year, Medicare evaluates plans based on a 5-star rating system.Our plans use a formulary.

Out-of-network/non-contracted providers are under no obligation to treat Ascension Complete members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.†Other Pharmacies/Physicians/Providers are available in our network.Please contact your plan for details.

ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711).ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711).

Washington residents: “Wellcare” is issued by Wellcare of Washington, Inc.

Washington residents: “Wellcare” is issued by WellCare Health Insurance Company of Washington, Inc.

Washington residents: “Wellcare” is issued by WellCare Prescription Insurance, Inc.

Wellpoint 

Plan Disclosures

Wellpoint Insurance Company is an HMO D-SNP plan with a Medicare contract with a contract with the Texas Medicaid Program. Enrollment in Wellpoint Insurance Company depends on contract renewal. Services provided by Wellpoint Insurance Company.

Wellpoint Insurance Company is an HMO plan with a Medicare contract. Enrollment in Wellpoint Insurance Company depends on contract renewal. Services provided by Wellpoint Insurance Company.

Wellpoint Iowa, Inc. is an HMO D-SNP plan with a Medicare contract and a contract with the Iowa Medicaid program. Enrollment in Wellpoint Iowa, Inc. depends on contract renewal. Services provided by Wellpoint Iowa, Inc.

Wellpoint New Jersey, Inc. is a D-SNP plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellpoint New Jersey, Inc. depends on contract renewal. Coverage provided by Wellpoint New Jersey, Inc.

Wellpoint New Jersey, Inc. is an HMO plan with a Medicare contract. Enrollment in Wellpoint New Jersey, Inc. (HMO) depends on contract renewal. Coverage provided by Wellpoint New Jersey, Inc.

Wellpoint Ohio, Inc. is an HMO plan with a Medicare contract. Enrollment in Wellpoint Ohio, Inc. depends on contract renewal. Services provided by Wellpoint Ohio, Inc.

Wellpoint Tennessee, Inc. is an HMO D-SNP plan with a Medicare contract and a contract with the Tennessee Medicaid program.. Enrollment in Wellpoint Tennessee, Inc. depends on contract renewal. Services provided by Wellpoint Tennessee, Inc.

Wellpoint Tennessee, Inc. is an HMO plan with a Medicare contract. Enrollment in Wellpoint Tennessee, Inc. depends on contract renewal. Services provided by Wellpoint Tennessee, Inc.

Wellpoint Tennessee, Inc. is an HMO-POS plan with a Medicare contract. Enrollment in Wellpoint Tennessee, Inc. depends on contract renewal. Services provided by Wellpoint Tennessee, Inc.

Wellpoint Texas, Inc. is an HMO D-SNP plan with a Medicare contract and a contract with the Texas Medicaid program. Enrollment in Wellpoint Texas, Inc. depends on contract renewal. Services provided by Wellpoint Texas, Inc.

Wellpoint Washington, Inc. is an HMO D-SNP plan with a Medicare contract and a contract with the Washington Medicaid program. Enrollment in Wellpoint Washington, Inc. depends on contract renewal. Services provided by in Wellpoint Washington, Inc.

Zing Health 

Plan Disclosures

Zing Health is a Medicare Advantage Plan with a Medicare contract. Enrollment in Zing Health depends on contract renewal.

General Disclosures

SEinsurance.com is operated by WWIA LLC, a licensed health insurance agency, also doing business as Silveredge Insurance Advisors.

Silveredge Insurance Advisors is a licensed and certified representative of Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal.

The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan’s nondiscrimination policy, please click any of the Nondiscrimination links above in the Health plan disclaimers section.

This information is not a complete description of benefits. Call 1-(855) 958-3721(TTY: 711) for more information.  Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Medicare beneficiaries may also enroll in the plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Every year, Medicare evaluates plans based on a 5-star rating system.

Other Pharmacies, Physicians, and Providers are available in the plan’s network. Pharmacies, Physicians, and Providers may also contract with other Plan Sponsors.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call the Plan’s customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Total annual cost is calculated by adding up the total annual cost of any monthly premiums, applicable plan deductible(s) and estimates for all co-pay and co-insurance amounts that will be due for the medications and health benefits used throughout the year. Costs for medications and health benefits vary across pharmacies and health systems, so the costs provided are only estimates. Actual costs could vary.

Estimated savings are calculated by the following:

    1. Finding a cohort of people similar to you based on their age, gender, geography, healthcare utilization and prescription medications.
    2. Evaluating data related to the cohort to assess utilization of healthcare.
    3. Based on this utilization, calculate what your total estimated annual out of pocket costs (premiums, RX costs, copays, deductibles, cost sharing) would be for each plan on our website, including all Medicare Advantage, Medicare Supplement and Prescription Drug Plans.
    4. Subtract the total annual out of pocket cost for each plan from the total annual out of pocket costs for Original Medicare alone to determine the estimated savings.
  •  

Please note that the estimated savings we show to you are contingent upon your utilization and are an estimate, and therefore not a guarantee.

For plans with Part D Coverage: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778 or consult www.socialsecurity.gov; or your Medicaid Office.

You must have both Part A and B to enroll in a Medicare Advantage plan. Members may enroll in the plan only during specific times of the year. Contact the plan for more information.