Enrollment in New West Medicare is very easy. There's almost no paperwork. We take the complication out of Medicare and make it easy to understand.

With Medicare simplified, you can get all the comprehensive benefits of Medicare plus enhanced prescription drug coverage and a large network of physicians to choose from - you're even covered if you travel. Medicare Simplified eliminates the need for a Medicare supplement.

New West Medicare PPO Is a Preferred Provider Organization. You can obtain services from any Medicare participating provider; however, except for emergencies or urgent care, it may cost more to get care from out-of-network providers.

The benefit information provided below is a brief summary, not a comprehensive description of benefits. For more information see the Evidence of Coverage on the Plans & Forms tab or contact us at the numbers listed below.

New West Medicare PPO

Premiums
The New West Medicare PPO Plan has a premium of $15 in 2010. Additionally, you must still pay your Part B premium to Social Security.

You may decide to have your premium deducted from your Social Security Check or switch to premium withhold or direct bill at a later date; however, it could take up to three months for it take effect and you will ultimately be held responsible for those premiums.

Out of Pocket Maximum – NEW
In 2010 New West Medicare PPO will have an Out of Pocket maximum of $5,000. This is a combined in and out-of-network maximum that applies all plan benefits except Part D prescription drugs.

Deductible
There is no deductible.

Physical Exams
We cover one Physical Exam per year – You pay $0 co-payment for each in-network visit in 2010.

Office Visit
You pay a $20 co-payment for each in-network visit in 2010 and a $40 co-payment for each in-network specialist visit.

Prescription Drug Coverage
In 2010 this is a Medicare Part D plan with zero deductible and a $10 co-payment for generics.

Medicare Offers One-Time $250 Rebate

New HIV Screening Test Benefit Info

Emergency Care
You may go to any emergency room, worldwide. If you are admitted into the hospital within 3 days of an Emergency Room (ER) visit for the same condition, your ER co-payment will be waived.

Eligibility
You can join one of the New West Medicare plans if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area. However, individuals with End Stage Renal Disease (ESRD) are generally not eligible to enroll in New West Health Services’ Medicare plans unless they are members of our organization and have been since their dialysis began.

New West Medicare Enhanced PPO

Premiums
Premiums for the New West Medicare Enhanced Plan PPO are $65 per month in 2010. Additionally, you must still pay your Part B premium to Social Security.

You may decide to have your premium deducted from your Social Security Check or switch to premium withhold or direct bill at a later date; however, it could take up to three months for it take effect and you will ultimately be held responsible for those premiums.

Out of Pocket Maximum – NEW
In 2010 New West Medicare Enhanced PPO will have an Out of Pocket maximum of $3,400. This is a combined in and out-of-network maximum that applies all plan benefits except Part D prescription drugs.

Deductible
There is no deductible.

Office Visit
You pay a $10 co-payment for each in-network visit in 2010 and a $20 co-payment for each in-network specialist visit.

Physical Exams
We cover one Physical Exam per year – You pay a $0 co-payment for each in-network visit in 2010.

Dental & Vision Benefits
2010 benefits include a $200 allowance for preventive dental care per year and $100 allowance towards eyewear per year – In network or out of network.

Prescription Drug Coverage
In 2010 this is a Medicare Part D plan with zero deductible and $10 co-payment for generics. Additionally, we cover all generics through the gap on this plan.

Medicare Offers One-Time $250 Rebate

New HIV Screening Test Benefit Info

Emergency Care
You may go to any emergency room, worldwide. If you are admitted into the hospital within 3 days of an Emergency Room (ER) visit for the same condition, your ER co-payment will be waived.

Eligibility
You can join one of the New West Medicare plans if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area. However, individuals with End Stage Renal Disease (ESRD) are generally not eligible to enroll in New West Health Services’ Medicare plans unless they are members of our organization and have been since their dialysis began.

Disclaimers
New West Health Services is a Montana company. New West Medicare Advantage PPO is offered by New West Health Services, a Medicare Advantage organization contracting with the federal government. New West's Medicare contract with CMS is renewed annually, availability of coverage beyond the end of the current contract year is not guaranteed. Anyone living in the services area who is entitled to Medicare Part A and enrolled in Medicare Part B may apply. Enrollees must continue to pay their Medicare Part B monthly premium (& Part A premium if applicable). Cost sharing and the monthly plan premium apply.

If you have special needs, this document may be available in other formats. Please contact our Customer Services Department for more information.

Physical Address:
New West Health Services
130 Neill Ave
Helena, MT 59601

New West Health Services
2132 Broadwater Ave., Unit A-1
Billings, MT 59102

New West Health Services
1203 Hwy 2 West, Suite #45
Kalispell, MT 59901-6071

Note: (H2701_NW#135-09-09) CMS Approval Date: 10-13-2009
Last updated on 06-27-2010