Molina Medicare Options HMO is a Medicare Advantage Prescription Drug plan (MAPD). Molina Medicare Options Plus and Healthy Advantage HMO SNP are Medicare Advantage Prescription Drug Special Needs plan(s) (MAPD-SNP). Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2013. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information, contact the plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party. Limitations, copayments, and restrictions may apply.

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;
• 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
• Your State Medicaid Office.

MAPD Members may enroll in the plan only during specific times of the year, while MAPD SNP Members may enroll in the plan any time of the year. Contact the plan for more information. Individuals must have both Medicare Part A and Part B to enroll in the plan. Members must reside in the Molina service area. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help that you may receive. Contact the plan for further details. You must use plan providers except in an emergency or urgent care situations or for out of area renal dialysis. If you obtain routine care from out-of-network providers, neither Medicare nor Molina Medicare and Healthy Advantage HMO SNP will be responsible for the costs. Medicare beneficiaries may enroll in Molina Medicare Options HMO, Molina Medicare Options Plus HMO SNP or Healthy Advantage HMO SNP through the CMS Medicare Online Enrollment Center located at www.medicare.gov. The Medicare program rates how well plans perform in different categories (for example, detecting and preventing illness, ratings from patients, patient safety and customer service and other measures). If you have access to the web, you may use the web tools on www.medicare.gov and select "Compare Medicare Prescription Drug Plans" or "Compare Health Plans and Medigap Policies in Your Area" to compare the plan ratings for Medicare plans in your area. You can also call us directly to obtain a copy of the plan ratings for this plan. You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances, and quantity limitations and restrictions may apply. People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75 percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't even know it. For more information about this extra help contact your local Social Security Office or call 1-800-MEDICARE (1-800-633-4227) 24 hours per day, 7 days a week. TTY users should call 1-877-486-2048. This information is available for free in other languages. Please contact our customer service number at 1-800-665-3086 for additional information. Esta información está disponible gratuitamente en otros idiomas. Para información adicional, favor de llamar a nuestro departamento de Servicios para Miembros al: 1-800-665-3086. Other Providers are Available in Our Network. Other plans may be available in the service area. A Health Plan with a Medicare Contract. A Coordinated Care plan with a Medicare Advantage Contract and a contract with the state Medicaid program.