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Optional Dental
Part "D" Subsidy

Each Alliance Medicare PPO Option provides different benefits. Option 1 and Option 2 include both medical and prescription drug benefits to ensure you have coverage for today's needs as well as protection for unexpected expenses tomorrow.

All drug prices are based on the Alliance-negotiated price. You pay the lower of your copay or the actual cost of a covered drug.

*A 90-day supply is available on most prescriptions filled through mail-order or select pharmacies at 2-1/2 times the applicable 30-day copay.

** Excludes monthly premiums and costs of non-covered drugs, including costs of drugs purchased outside the U.S.

*** In 2012, for Generic drugs purchased in the Coverage Gap:

• With Option 1 - you pay 86% of our negotiated price
• With Option 2 - you pay whichever is lower: the fixed copay or 86% of our negotiated price

For all Brand-Name drugs purchased in the Coverage Gap:

With either Option - you pay 50% (half) of our negotiated price, plus the applicable pharmacy dispensing fee. Even though you pay only part of the costs, the full cost of Brand-Name drugs counts toward your annual total out-of-pocket cost for prescription drugs. This means you may exit the Coverage Gap and enter the Catastrophic Coverage period with its enhanced benefits more quickly

Convenient pharmacies

Alliance Medicare PPO covers both Brand-Name and Generic prescription drugs at any of more than 2,000 pharmacies in our network, which includes:

• Retail (some provide free home delivery)
• Mail-order
• Medical center
• Long-term care
• Indian Health, Tribal, and Urban pharmacies

If you travel, you can get your prescription drugs at any network pharmacy with nationwide locations (like CVS or Kmart). Plus, you are always covered throughout the U.S. for emergency prescriptions.

Generally, you must get your prescription drugs at a pharmacy in our network, except in emergency or urgent care situations.

PDF Pharmacy Directory (need link)
View our affiliated pharmacy directory online.

Getting Extra Help for prescription drug coverage

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 (800-663-4227), TTY users should call (877) 486-2048, 24 hours a day, seven days a week;

• The Social Security Administration at (800) 772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call (800) 325-0778; or Your state
Medicaid office

Learn more about getting Extra Help

Your HAP representative can help you with:

• Your options
• Our formulary
• Our pharmacy network

For more information about our prescription drug benefits, call us toll-free at:

(800) 868-3153 or
TTY/TDD (800) 649-3777

For pharmacy and mail-order pharmacy information, call toll-free:

Alliance Medicare PPO
(888) 658-2536 or
TTY/TDD (800) 649-3777

Office hours:
Monday through Friday, 8 a.m. to 8 p.m.
Saturday, 8 a.m. to noon.
At all other times, you may access our Interactive Voice Recording system at the same number and leave your name and phone number. A HAP Medicare Customer Service Representative will return your phone call the next business day.

Extended hours from October 15 through February 14:
7 days a week, 8 a.m. to 8 p.m.

You can also write to us at:
HAP Client Services
Attn: Medicare
2850 W. Grand Boulevard
Detroit, Michigan 48202

Important information

Alliance Medicare PPO is a health plan with a Medicare contract. Generally, your Alliance Medicare PPO prescription drug benefits are only available at contracted network pharmacies, except in emergency or urgent care situations. Alliance Medicare PPO members must receive prescription drug coverage through their plan. If you enroll in a stand-alone prescription drug plan, you will lose your Alliance Medicare PPO benefits.
The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.

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