Medicare Matters. Amerihealth 65 for medicare Beneficiaries

AmeriHealth® Advantage

Benefit options

AmeriHealth Advantage provides Standard Medicare Part D prescription drug benefits: after the member’s yearly out-of-pocket costs reach $4,050, AmeriHealth Advantage members will pay the greater of five percent coinsurance or $2.25 generic and $5.60 brand copay thereafter.

AmeriHealth Advantage members who have limited incomes may qualify for extra help paying for prescription drugs. Members that qualify will have lower cost sharing and pay only a small amount for their prescription drugs.

Members who have limited incomes may qualify for one of the following two options:

  • $1.00 generic and $3.10 brand copays
  • $2.25 generic and $5.60 brand copays

Download the Download PDF 2008 AmeriHealth Advantage Summary of Benefits or Download PDF Evidence of Coverage for more information on:

  • applicable conditions and limitations;
  • premium information;
  • cost-sharing information;
  • information regarding conditions associated with receipt or use of benefits.

If you have limited income and resources, you may qualify for Download PDF Low-Income Subsidy. When you join AmeriHealth Advantage, Medicare will tell us how much extra help you are getting. Then we will let you know the amount you will pay. If you qualify, your drug costs will also be lower.

You can see if you qualify for a low-income subsidy by calling:

  • 1-800-MEDICARE (1-800-633-4227) (TTY/TDD 1-877-486-2048), 24 hours a day, seven days a week
  • Pennsylvania Office of Medical Assistance Programs (Medicaid) at 717-787-1870
  • The Social Security Administration at 1-800-772-1213 (TTY/TDD 1-800-325-0778), 7 a.m. to 7 p.m., Monday through Friday

Please note: in some cases, Medical Assistance copays will apply.

Benefits, formulary, pharmacy and provider networks, premiums, and/or copays may change on January 1, 2009. Please contact AmeriHealth Advantage for details.