Annual Notice of Change/ Evidence of Coverage
The Evidence of Coverage booklet tells members how to get their Medicare medical care and prescription drugs (if applicable) through our plan, a Medicare Advantage Plan. The Evidence of Coverage booklet explains member’s rights and responsibilities, what is covered, and what you will pay as a member of the plan.
The benefits listed in the Evidence of Coverage are effective January 1st of the current year. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1, 2017.
Optional Supplemental Dental Benefit
SmartSaver Rx PDP
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. You must continue to pay your Medicare Part B Premium.
Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.
HealthNow New York Inc. is a Medicare Advantage and stand-alone PDP plan with a Medicare contract. Enrollment in HealthNow New York Inc. depends on contract renewal.
Content Last Updated January 19, 2016