2022 Erie Mercer Venango MA Kit

Pre-Enrollment Checklist Before making an enrollment decision, it is important that you fully understand our benefits and rules. If you have any questions, you can call and speak to a customer service representative at 1-877-381-3765* (TTY: 711*). Understanding the benefits  Review the full list of benefits found in the Evidence of Coverage (EOC), especially for those services for which you routinely see a doctor. Visit upmchealthplan.com/medicare or call 1-877-381-3765* (TTY: 711*) to view a copy of the EOC.  Review the provider directory (or ask your doctor) to make sure the doctors you see now are in the network. If they are not listed, it means you will likely have to select a new doctor.  Review the pharmacy directory to make sure the pharmacy you use for any prescription medicines is in the network. If the pharmacy is not listed, you will likely have to select a new pharmacy for your prescriptions. Understanding Important Rules  In addition to your monthly plan premium, you must continue to pay your Medicare Part B premium. This premium is normally taken out of your Social Security check each month.  Benefits, premiums, and/or copayments/coinsurance may change on Jan. 1, 2022.  Except in emergency or urgent situations, we do not cover services by out-of-network providers (doctors who are not listed in the provider directory). *Our hours change throughout the year. You can call us: • Oct. 1 – Dec. 7 seven days a week from 7 a.m. to 9 p.m. • Dec. 8 – Dec. 31 seven days a week from 8 a.m. to 8 p.m. • Jan. 1 – Sept. 30 Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 9 a.m. to 3 p.m. Y0069_221018_C Copyright 2021 UPMC Health Plan Inc.All rights reserved. 2022_PREENRLCHKHMO_21MCID1395 (MS) 8/3/21 Additional Information 89