Monthly Renewal Rates Effective January 1st, 2006
Prices include $6.00 Administration Fee.

Part D Drug Plan

The Medicare prescription drug program is one of the most important changes to Medicare since it was created in 1965. If you’re one of the 42 million Medicare beneficiaries across the country, you’re eligible to participate in the Medicare prescription drug program.

Here’s a look at the Prescription Drug Program’s general eligibility rules:

	Anyone who is eligible for Medicare Part A or enrolled in Part B is eligible to enroll in the new Medicare prescription drug program.
	You must live in the service area of the Medicare prescription drug plan.
	You may enroll in only one Medicare Prescription Drug plan at a time.
	Individuals enrolled in an MA Plan may not enroll in a PDP, unless they are a member of a Private Fee-for-Service Medicare Advantage (MA) Plan (PFFS) that does not provide Medicare prescription drug coverage, a Medical Savings Account MA Plan(MSA), or an 1876 Cost Plan.

The Prescription Drug plan selected for you includes coverage of both generic and brand name drugs. Understanding the difference between generic and brand-name drugs may save you money. The brand name drugs you’re currently taking may be available in generic versions that do the same but cost less. Another important factor in choosing a plan is which pharmacies you’ll be able to use. PacifiCare has a nationwide network of more than 47,000 pharmacies.

We also give you the savings and convenience of home delivery through our Mail Service Pharmacy. Questions about Prescription Solutions from PacifiCare?

Just call 1-888-538-9333, 8 a.m – 5 p.m., Monday through Friday.

You can find a complete formulary listing on www.prescriptionsolutions.com. If the formulary changes, you will be notified in writing, before the change. Only Medicare Part D covered drugs will impact your Medicare Prescription Drug Plan annual out-of-pocket spending. Certain prescription drugs will have maximum quantity limits. Your provider must get prior authorization from PacifiCare for certain prescription drugs.

Please contact PacifiCare for details.

For more information on your plan, please call 1-888-538-9333, 8 a.m. – 5 p.m. PST, Monday through Friday, for the hearing impaired, please call TTY: 1-800-387-1074.

Prescription Solutions from PacifiCare Medicare Prescription Drug Plans are offered by PacifiCare Life and Health Insurance Company (PacifiCare Insurance Company in the State of New York), which contracts with the federal government. The PacifiCare Prescription Drug Insurance Plan is underwritten by PacifiCare Life and Health Insurance Company and provides coverage for outpatient prescription drugs only. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.

Members may be enrolled in only one Part D Plan at a time. Members must reside in the service area to be eligible to enroll. Prescription Solutions from PacifiCare Medicare Part D plans cover both brand name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Contact PacifiCare for more information. Enrollees must use network pharmacies to receive Plan benefits except under emergency circumstances. Our network includes retail mail service, long-term care, I/T/U and Home Infusion pharmacies. If you would like additional information about our mail service pharmacy, please contact PacifiCare at the number above, or write to us at P.O. Box 509075, San Diego, CA 92150-9075.

People who have low incomes, who live in long-term care facilities, or who have access to Indian/Tribal/Urban (Indian Health Service) facilities may have different out-of-pocket drug costs. Please contact PacifiCare for more details. If members have qualified for additional assistance for Medicare Prescription Drug Plan costs, the amount of your premium and cost at the pharmacy will be less. Once you have enrolled in a Prescription Solutions from PacifiCare Plan, Medicare will tell us how much assistance you are receiving, and we will send you information on the amount you will pay.

If you are not receiving this additional assistance, you should contact 1-800-MEDICARE (TTY/TDD users should call 1-877-486-2048), your State Medicaid Office, or the Social Security Administration at 1-800-772-1213, or the toll-free TTY/TDD number: 1-800-325-0778, between 7 a.m. and 7 p.m., Monday through Friday, to see if you might qualify.

* You have a special type of plan that uses a Medicare Prescription Drug plan as a foundation and has additional benefits to give you even more drug coverage. When you take your prescription to the pharmacy to fill, your pharmacist will first check if your drug is on our Medicare Prescription Drug plan formulary. If it is, your drug costs will count toward your Medicare Prescription Drug Plan out-of-pocket limit. If your drug is not listed on the formulary, your drug may still be covered under your Prescription Drug Insurance Plan, and you only pay the required copay; however, your copay will not count toward your Medicare Prescription Drug Plan out-of-pocket limit.


The chart below shows how your enhanced benefit works with the Medicare Prescription Drug Plan:

Prescription Drug Plan - Shaklee Rates

Monthly Renewal Rates Effective January 1st, 2006
Prices include $46.90 Prescription Drug Plan

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Seniors Choice Preferred Plan