Molina Healthcare Medicare Advantage Plan Details

Molina Healthcare Benefits Presentation Molina Medicare Choice Care (HMO) Molina Medicare Choice Care Select (HMO) Date: Presented by: Phone Number: Email:

Agenda Introduction Molina Healthcare Medicare and HMO Overview Why Molina Healthcare? Summary of Benefits Supplemental Benefits Overview What about my prescription drugs? 2023 Molina Healthcare Medicare Star Rating Questions Enroll Now Next Steps

Introduction Molina Healthcare For the health care you need now, lean onMolina. No matter how the world may change, one thing remains the same: at Molina Healthcare, our highest priority is our members good health. We design our plans around your needs, just like we have since the beginning. To ensure you get exactly the right health plan for your needs, our team of experienced Medicare Trusted Advisors is here to guide you every step of the way. We re happy to answer every question and make it easy for you to get the most from your health plan. After all, the reason we re here is to help you feel your best.

What is Medicare? Medicare is the largest health insurance program offered by the U.S. government. Medicare is divided into Parts A, B, C and D. Parts A and B are known as Original Medicare Medicare covers Americans 65 and older or those who qualify due to disability Parts What it is Medicare Part A Hospital insurance Part A - hospital or skilled nursing facility coverage. Including hospice care and home healthcare. Part B - doctor s visits and outpatient care. Including services Part A doesn t cover. Covers some preventive care and usually has a premium. Medicare Part B Medical Insurance Medicare Part C Medicare Advantage Includes Parts A & B and can also cover additional benefits not covered by Original Medicare, like vision, hearing, and/or dental. Optional prescription drug coverage for beneficiaries with Medicare. Medicare Part D

Are you eligible for a Medicare Advantage Plan? Molina Medicare Choice Care (HMO) H7678-004 Molina Medicare Choice Care Select (HMO) H7678-005 Must permanently reside in the Medicare Advantage Plan service area for Texas Counties: Anderson, Angelina, Atascosa, Austin, Bandera, Bexar, Brazoria, Cameron, Camp, Cass, Chambers, Cherokee, Collin, Comal, Cooke, Dallas, Delta, Denton, Duval, El Paso, Ellis, Fannin, Fort Bend, Franklin, Galveston, Grayson, Gregg, Guadalupe, Hardin, Harris, Harrison, Henderson, Hidalgo, Hood, Hopkins, Houston, Hudspeth, Hunt, Jasper, Jefferson, Jim Hogg, Johnson, Kaufman, Kendall, Lamar, Liberty, Marion, Matagorda, Maverick, McMullen, Medina, Montague, Montgomery, Morris, Nacogdoches, Navarro, Newton, Orange, Panola, Parker, Polk, Rains, Red River, Rockwall, Rusk, San Augustine, San Jacinto, Shelby, Smith, Starr, Tarrant, Titus, Trinity, Tyler, Upshur, Van Zandt, Walker, Waller, Webb, Wharton, Willacy, Wilson, Wise, Wood, and Zapata

What is a Medicare Advantage, Prescription Drug Plan? Must be entitled and enrolled in Medicare Part A and Medicare Part B Must live in the plan s service area Must use providers, pharmacy and services within the Plan Network

Medicare Advantage Open Enrollment Period (MA-OEP) Annual Election Period (AEP) Enrollment Enrollment Opportunities Opportunities Initial Coverage Election Period (ICEP)/Initial Election Period (IEP) Special Election Period (SEP)

Why Molina Healthcare? It's simple, really... Additional benefits above what is currently covered under Original Medicare Access to providers! Part A, B and D, all with one card The Summary of Benefits explains what is covered by your plan: - Medicare Part A & B benefits - Part D benefits - Supplemental benefits - Your cost share

Added Benefits for 2023 Supplemental Benefits Overview MyChoice Card Dental Vision - Over-the-Counter (OTC) -SSBCI* In-Home Support Services Hearing Transportation Fitness Meals

What about my prescription drugs? Molina Healthcare has a "formulary" a list of drugs which are covered at different levels: Tier 1Preferred Generic Tier 2Generic Tier 3Preferred Brand Tier 4Non-Preferred Brand Tier 5Specialty Tier Drugs Tier 6Select Care

Some prescription drugs may require... Molina Medicare Choice Care and Molina Medicare Choice Care Select requires you or your physician to get a prior authorization for certain drugs. If you don t get approval prior to filling your prescriptions, Molina Medicare Choice Care or Molina Medicare Choice Care Select may not cover the drug. PA For certain drugs, the FDA limits the amount of the drug that Molina Medicare Choice Care and Molina Medicare Choice Care Select will cover. Any additional amount of medication requested, other than standard one-month or three-month supply, would need to be submitted to Molina Medicare Choice Care and Molina Medicare Choice Care Select for an exception review. QL In some cases, Molina Medicare Choice Care and Molina Medicare Choice Care Select requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, Molina Medicare Choice Care and Molina Medicare Choice Care Select may not cover Drug B unless you try Drug A. If Drug A does not work for you, Molina Medicare Choice Care and Molina Medicare Choice Care Select will then cover Drug B. ST You may be able to get a one-time full month supply of a drug that is not covered in the formulary to assist with a transition to a drug on the formulary.

Basic Prescription Benefits, Part D 2023 Medicare prescription drug plan basic coverage Phases of 2023 basic benefit Phase 1 Deductible Phase 4 Catastrophic coverage Phase 3 Coverage gap Phase 2 Initial coverage limit Dollar limits for each phase $0 - $505 $375 - $4,660 $4,660 - $7,400 Greater than $7,400 You Pay Beneficiary pays deductible first (if applicable) before plan starts to pay its share Copayment or coinsurance until total cost between plan and beneficiary s combined amounts (plus any deductible) reaches $4,660 25% of the total cost of brand-name drugs and 25% of the total cost of generic drugs. What beneficiary pays (and discount paid by drug company) count toward out-of-pocket spending to get out of the coverage gap $4.15 for generic and $10.35 for all other drugs; or 5% coinsurance, whichever is greater

Prescription Drug Coverage and Low-Income Subsidy Eligibility for LIS is determined by a beneficiary s state of residence. The federal government sets the eligibility criteria. But eligibility for LIS does not constitute Medicaid eligibility or eligibility for a D-SNP. Since dual eligible beneficiaries are low- income individuals, most also qualify for a Low- Income Subsidy (LIS) for their Part D coverage, often called Extra Help All Molina Medicare Plans integrate prescription drug coverage (Part D) Extra Help You may be able to get Extra Help to pay for your prescription premiums and cost. To see if you qualify for getting Extra Help, call: 1-800-Medicare (800-633-4227), 24 hours a day, 7 days a week. TTY users may call 1-877-486-2048. The Social Security office at 1-800-772-1213 between the hours of 7 a.m. and 7 p.m. Monday to Friday. TTY users may call 1-800-325-0778. Your State Medicaid office may also be able to help.

2023 Molina Healthcare Star Ratings Molina Healthcare received the following Overall Star Rating from Medicare: Texas Summary Star Rating: 3.5 Texas Health Plan Services: 3.5 Drug Plan Services: 3 Medicare evaluates plans based on a 5-Star rating system including quality of care of member services. Star Ratings are calculated each year and may change from one year to the next. For more information on Star Ratings go to www.Medicare.gov

Enroll Now

Next Steps What to Expect Next Thank you for considering Molina Healthcare! After your enrollment is processed you will receive: Acknowledgment of Enrollment Letter. Confirming that we received your Enrollment Form. Health Risk Assessment Survey. Completing this survey helps us understand your health history so we can make sure you get all the services you need. Your health is important to us, and we are here to help you feel your best. Confirmation of Enrollment Letter. Will be sent when Medicare approves your enrollment. Keep that letter for your records. You may use your Confirmation of Enrollment letter as proof of coverage until you receive your Member ID card. Annual Wellness Visit Appointment Call. One of our Care Connections team members will call you to set up an appointment for your Annual Wellness Visit. This can be done in the comfort of your home or on a telehealth video call. Our Nurse Practitioner will review your health history and partner with you to come up with a plan to access the care and services most helpful to you. We will also share this information with your doctor to ensure you receive the highest quality of care. You can also call us to set up your appointment at (844) 491-4763 TTY: 711. We look forward to meeting you! Member ID Card and Welcome Kit. Containing helpful member resources and information on how to access important plan documents like your: Evidence of Coverage (EOC) Formulary (Drug List) Provider/Pharmacy Directory Delta Dental. Use this card to access your plan covered supplemental dental services. Over-the-Counter (OTC) benefit information. You will be receiving your OTC product catalog with hundreds of products to choose from. It will include detailed instructions on how to place your order for approved OTC products.

Thank you

You can get this document for free in non-English language(s) or other formats, such as large print, braille, or audio. Call (866) 403-8293, (TTY: 711). The call is free. Molina Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, ethnicity, national origin, religion, gender, sex, age, mental or physical disability, health status, receipt of healthcare, claims experience, medical history, genetic information, evidence of insurability, geographic location. Please include the Multi-Languages that are located here. 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 (866) 403-8293, TTY: 711. Someone who speaks English can help you. This is a free service. Tenemos servicios de int rprete sin costo alguno para responder cualquier pregunta que pueda tener sobre nuestro plan de salud o medicamentos. Para hablar con un int rprete, por favor llame al (866) 403-8293, TTY: 711. Alguien que hable espa ol le podr ayudar. Este es un servicio gratuito. 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. Every year, Medicare evaluates plans based on a 5-star rating system. HMO: Molina Healthcare is an HMO Health Plan with a Medicare Contract. Enrollment depends on contract renewal. Other Pharmacies/Physicians/Providers are available in our network. SSBCI Disclaimer: The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify. Y0050_23_1288_LRSalesPres_M