Choose the plan that best suits your needs...and your budget
Following are brief descriptions of the Samaritan Advantage plans available to you for 2012.
All of these options provide coverage for routine and specialty care you need, with full access to our extensive provider network (see our list of providers). You’ll also see plan options that offer the Medicare Part D prescription coverage you may need.
The Medicare Annual Enrollment Period for 2012 benefits ends on December 7, 2011. To have Medicare Part D prescription coverage or other Medicare Advantage benefits on January 1, 2012, you must enroll in a plan by December 7, 2011.
EXCEPTIONS: You may apply for Samaritan Advantage coverage within 3 months of your 65th birthday, no matter when that birthday occurs. Additionally, some beneficiaries, including those that are disabled as defined by Medicare, are allowed to enroll in or switch plans at other times. Contact us for details.
P L A N O P T I O N S F O R 2 0 1 2
Samaritan Advantage Conventional Plan HMO — $67 per month
The Conventional Plan offers you some of the most generous medical benefits available in your area. With a monthly plan premium of only $67, this plan offers low co-pays to help you pay some of the out-of-pocket costs Original Medicare won’t cover.
Samaritan Advantage Premier Plan HMO*— $99 per month
With the Premier Plan you get all the benefits of the Conventional Plan described above—plus the Medicare Part D prescription drug coverage you may need.
Samaritan Advantage Premier Plan Plus HMO*— $121 per month
Our most benefit-rich plan, the Premier Plan Plus offers you all the benefits of both the Conventional and Premier Plans—PLUS coverage for generic drugs through the Medicare prescription drug gap, dental coverage, coverage for hearing aids, and more.
Samaritan Advantage Special Needs Plan HMO*
This plan is designed for Medicare beneficiaries who meet specific enrollment criteria. For example, you may be eligible to join this plan if you receive assistance from the state. The plan provides the same benefit coverage as the Premier Plan for those needing extra help. Please contact Samaritan Advantage to determine if you are eligible for this plan.
If you’d like to know more about any of our plans, see the benefit details contained in the
Plan Documents.
* This plan includes Medicare Part D prescription drug coverage. Click here for more information about the Samaritan Advantage prescription drug benefit.
Last modified: October 1, 2011
H3811_MA4003_2012 CMS Approved 10/14/2011