Premium help - Rx plan

Help with PriorityMedicare premiums

You may be eligible for assistance with your Medicare prescription drug costs. This includes the Part D plan portion of your PriorityMedicare^SM premium and the costs of your prescriptions. To see if you qualify

for getting extra help, call:

• 1-800 MEDICARE (1-800-633-4227), (TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week)
• The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778.
• Your Medicaid Office
• If you have any questions, please call Customer Service, current members call toll-free 888 389-6648 (TTY/TDD toll-free 888 551-6761. Prospective members please call toll-free at 888 389-6676 (TTYTDD toll-free 888 551-6761, 7 days a week, 8:00 a.m. - 8:00 p.m. Eastern Standard Time (EST)

Do you qualify?

You automatically qualify for this assistance if you're eligible for:

• Medicaid
• Supplemental Security Income (SSI), or
• A Medicare savings program

If you automatically qualify for assistance, you don't have to apply. You may receive (or may have received) a letter from Medicare or the Social Security Administration (SSA) about your eligibility for 2009. Read this important information carefully.

If you need proof that you qualify for assistance, see the policies on the Best Available Evidence at the Centers for Medicare and Medicaid Services website.
Go to the CMS website now.
Note: This link will take you away from the PriorityMedicare website.

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How much assistance can you receive?

• If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. the amount of extra help you get will determine your total monthly plan premium as a member of our plan.
• Once you enroll in one of our plans for 2009, Medicare will tell us how much assistance you are receiving. We will send you information on the amount you will pay.
• The premiums listed in the table below do not include any Medicare Part B premium you may have to pay.

Medicare MONTHLY Plan Premium Costs
Plans available in all counties in Michigan	Monthly Premium based on % of subsidy:
	100% subsidy	75% subsidy	50% subsidy	25% subsidy
PriorityMedicare Rx	$6.30	$14.30	$22.40	$30.40

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