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What does Passport Advantage (HMO) Cover? - 2010

Passport Advantage covers all of the following through one plan:

Hospital Stays (Medicare Part A)
Doctor Visits (Medicare Part B)
Prescription Drugs (Medicare Part D)

Extra Coverage as a Passport Health Plan member

As a Passport Advantage member, you continue to get Medicaid benefits from Passport Health Plan! This includes:

Vision,
Dental, and
Some prescription drugs not covered by Medicare.

To see how Passport Advantage and Passport Health Plan work together, see our Benefits Chart.

These important papers tell you about the benefits and rules of Passport Advantage:

2010 Summary of Benefits (PDF)
Download a booklet that tells you about 2010 Passport Advantage benefits

2010 Evidence of Coverage (PDF)
Download a book that explains all of Passport Advantage's rules and benefits for 2010
- 2010 Evidence of Coverage in Russian (PDF)

Benefits, formulary, pharmacy, network, premium, and/or co-payments/co-insurance may change on January 1, 2011. Please contact Passport Advantage for details. Premiums, co-pays, coinsurance, and deductibles may vary based on the level of help you receive. Please contact Passport Advantage for further details. The monthly plan premium is $0 for Passport Advantage members, for both medical and prescription drug benefits. If you are a Passport Advantage member, that means you are receiving full Medicaid benefits and Kentucky Medicaid is paying your monthly Medicare Part A and Part B premium. If you lose your eligibility for full Medicaid benefits, you may have to pay for these premiums. Kentucky Medicaid pays the Part B premium for Passport Advantage members. For full information on Passport Advantage benefits, call our Members Services at 1-800-578-0603, then press 1, (TTY: 1-800-648-6056) 7 days of the week from 8 a.m. to 8 p.m.

Passport Advantage is a health plan with a Medicare contract. This Plan is available to all active Passport Health Plan members with Medicare Parts A and B. For full information on Passport Advantage benefits call Member Services. The content on this website is available in alternate formats, such as Braille, large type, or another language. Please call us at 1-800-578-0603, then press 1 (TTY: 1-800-648-6056), 7 days a week from 8 a.m. to 8 p.m. to request another format.
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