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Frequently Asked Questions about Advantra Savings

• What is a Medicare Advantage Medical Savings Account (MSA) plan?
• What is Advantra Savings?
• How does the High-Deductible Medicare Advantage Plan work?
• How does the Medical Savings Account work?
• Who is HealthEquity? Am I allowed to select another MSA Administrator?
• How can I get access to the money in my account?
• How can I use the money in my account?
• How can I keep track of my expenses?
• Who owns the MSA account?
• Is my account taxed?
• What are Qualified Medical Expenses?
• How much will I have to pay for health care?
• Can I have or buy other insurance?
• Can I keep my Medigap (Medicare Supplement Insurance) Policy?
• Who can join Medicare Advantage Medical Savings Account (MSA) plans?
• When may I Join or Disenroll from a Medicare Advantage MSA plan?
• Will my spouse be able to use money in the account if I die?
• What if my beneficiary isn't my spouse?
• Can my Medicare MSA Plan cancel my coverage?
• What happens to the money in my account if I leave the plan?
• Can I Use the Same Doctors and Hospitals That I Use Now, or
            Do I Need to Use a Network of Physicians?
• What if my provider won't accept my Medical Savings Account plan?
• Do I Have to Go Through a Primary Care Doctor like an HMO?

What is a Medicare Advantage Medical Savings Account (MSA) plan?

Medicare Advantage MSA plans are offered through private insurance companies. They include two components:

• a high deductible health plan that covers Medicare A and B services and
• a MSA account that you can use to pay for qualified medical services.

It is not the same as the Original Medicare plan that is offered by the Federal Government.

It is not a Medicare supplement, Medigap, Medicare Select, or Prescription Drug Plan.

You still have Medicare; however your claims will be processed through the MSA plan not Original Medicare.

Medicare MSA Plans don't cover Medicare Part D prescription drugs. However, if you join a Medicare MSA Plan, you can also join a stand-alone Medicare Prescription Drug Plan (PDP) to add this coverage.

Look at your "Medicare & You" handbook, call 1-800-MEDICARE (1-800-633-4227), or visit www.medicare.gov on the web for more information about Medicare Prescription Drug Plans (PDP) available in your area.

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What is Advantra Savings?

Advantra Savings is the name of the Medicare Advantage MSA plan offered through First Health Life & Health Insurance Company, the Coventry subsidiary that contracts with the Centers for Medicare & Medicaid Services, the federal agency that administers Medicare.

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How does the High-Deductible Medicare Advantage Plan work?

Medicare Advantage Plans provide your Part A and Part B coverage. If you decide to join a Medicare MSA Plan, you will get your Medicare-covered health care through a high-deductible Medicare Advantage Plan. You will not have to pay a monthly premium for this plan other than the Medicare Part B premium. Medicare pays the Medicare Advantage Plan premium for you.

You will pay for Medicare Part A and B services until you meet your yearly deductible (the amount you must spend in Medicare-covered health care costs before your Advantra Savings coverage begins). However all claims should be submitted to Coventry (Advantra Savings) to make sure that you do not pay more than Medicare allowed amounts and to ensure covered expenses are applied to the deductible.

After you meet your deductible, Advantra Savings pays 100% for Medicare Part A and B services ($0 copayment).

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How does the Medical Savings Account work?

Advantra Savings plan will deposit a fixed sum of money from Medicare into your interest bearing medical savings account at the beginning of each calendar year. Only Advantra Savings can deposit money into this account - you can not deposit your own money.

Any money left in your account at the end of the year will remain in your account. If you stay with the Medicare MSA Plan the following year, the new deposit will be added to any leftover amount.

You can use the money in your account to pay for your medical or non-medical expenses, but only Medicare-covered Part A and Part B services are credited toward your deductible. Also, you must pay taxes on any non-medical expenses.

If you use all of the money in your account and haven't met your deductible, you must pay out-of-pocket until you reach your deductible. After you reach your deductible, your plan will cover your Medicare-covered services. (Look at the Advantra Savings Summary of Benefits, your "Medicare & You" handbook or visit www.medicare.gov on the web to find out what Medicare covers.)

Note: You will be responsible for handling the money in your account. This includes deciding whether to pay for health care services using your account funds or your own money.

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Who is HealthEquity? Am I allowed to select another MSA Administrator?

When you join Advantra Savings, we will automatically set-up a medical savings account (MSA) for you through HealthEquity. HealthEquity specializes in administering consumer driven health care accounts. Coventry will pay fees associated with this account while you are an Advantra Savings member.

All HealthEquity MSA accounts are insured for $100,000 and earn interest at competitive rates. In addition, HealthEquity provides members with information, guidance and assistance to help you manage your medical savings account. Once you become a member of Advantra Savings, you have 24/7 access to HealthEquity Customer Service. Services include:

• Telephonic and on-line access to account balances and claims payment status.
• Guidance on when to use your MSA account and how to make consumer-driven health care work for you.
• Information on the tax ramifications of having a tax-free health care account.
• Easy options for paying medical bills: either online or by phone.
• Debit card services.
• Record keeping and tax reporting.
• Lifetime claims, spending record, permanent claims & financial records to enable future tax benefits.

HealthEquity, Inc. is an independent financial institution that Coventry Health Care, Inc. has contracted with to administer the savings accounts for Advantra® Savings. HealthEquity, Inc. is not an affiliate of Coventry Health Care, Inc.

HealthEquity does not have to administer your MSA account. You may select another financial institution; however you will be responsible for:

• ensuring that institution qualified to administer MSA accounts
• paying any account administrative fees
• all reporting required for tax purposes

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How can I get access to the money in my account?

For Medicare covered visits such as hospital services or doctor's office visits, you or your provider should submit claims to Advantra Savings even before you have met your deductible. This is to ensure that you do not pay more than the Medicare allowed amount and that expenses are credited against your deductible. Advantra Savings will electronically transmit claims to HealthEquity and you can make the decision whether to use your MSA account to pay these funds or send a check to the provider directly.

HealthEquity will also send you a special debit card to use with your account. We strongly encourage you to use this card to pay for only those qualified medical services that are not covered by traditional Medicare, e-g., hearing aids; prescription drug copayments or over the counter (OTC) drugs to ensure that you do not pay more than the Medicare allowed amount for services. Amounts over and above the Medicare allowed amount will not be applied to you deductible.

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How can I use the money in my account?

You can use the money in your account for medical or non-medical expenses, but only Medicare-covered Part A and Part B services are credited toward your deductible. Non-qualified medical expenses are subject to income tax.

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How can I keep track of my expenses?

HealthEquity will send you a monthly statement that will list your account activity. You can also get information on whether your expenses count toward your deductible by contacting Advantra Savings Customer Services. You may also review account activity through My Online Services on the Internet.

You are responsible for tracking your own expenses if you move your deposit to an alternative bank or financial institution.

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Who owns the MSA account?

• You own the MSA account and accrued interest subject to CMS rules for disenrollment or death during the contract year;
• Any funds remaining in the account from prior contract years remain your property /property of your estate;
• If you disenroll mid-year (e.g. qualify for a special election period (SEP) or die), you must refund the unearned portion of the MSA account to CMS through Advantra Savings.

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Is my account taxed?

If you use the money in your account for non-medical expenses, it will be taxed as part of your income and will also be subject to an additional tax penalty. The money in your account and any interest you receive isn't taxed if you spend it on Qualified Medical Expenses.

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What are Qualified Medical Expenses?

Qualified Medical Expenses are the same types of services and products that otherwise could be deducted as medical expenses on your yearly income tax return. Some Qualified Medical Expenses, like doctors' visits, lab tests, and hospital stays, are also Medicare-covered services. Other Qualified Medical Expenses, like dental and vision care aren't covered by Medicare Part A and Part B. Qualified Medical Expenses count toward your Medicare MSA Plan deductible only if the expenses are for Medicare-covered Part A and Part B services.

For a complete list of the services and products that count as Qualified Medical Expenses and for other tax information, call the Internal Revenue Service at 1-800-TAX-FORM (1-800-829-3676). Ask for a free copy of the IRS publication #502, "Medical and Dental Expenses" and IRS publication #969 "Health Savings Accounts and Other Tax-Favored Health Plans". Or, visit www.irs.gov on the web and select "Forms and Publications" to view or print a copy of the publication.

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How much will I have to pay for health care?

• You will not have a monthly plan premium. Medicare pays the monthly premium for the Medicare MSA Plan.
• You (or someone on your behalf) must continue to pay your monthly Medicare Part B premium ($96.40 in 2008).
• If you use all of the money in your account and haven't yet met your deductible, you must pay out-of-pocket until you reach your deductible. Only Medicare-covered Part A and Part B expenses count towards the deductible.
• Providers may not generally charge more than Original Medicare amounts. In some cases, however, you may have to pay the difference between what your provider charges and the Medicare-approved amount if your provider doesn't accept assignment (A payment agreement between Medicare and a doctor or supplier.)

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Can I have or buy other insurance?

In general, if you join a Medicare MSA Plan, you can't have other health insurance that covers the costs that would count toward your Medicare MSA Plan's yearly deductible.

Since Medicare MSA Plans don't offer Medicare Part D prescription drug coverage, you can join a stand-alone Medicare Prescription Drug Plan to get help with your drug costs. Visit www.medicare.gov on the web or call 1-800-MEDICARE (1-800-633-4227) to find out what plans are available in your area.

You can also buy some limited benefit policies in addition to your Medicare MSA Plan coverage, such as dental, vision, or long-term care policies. Call the State Health Insurance Assistance Program (SHIP) in your area for more information about these types of insurance policies. To get the telephone number for the SHIP in your area, visit www.medicare.gov on the web or call 1-800-MEDICARE (1-800-633-4227).

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Can I keep my Medigap (Medicare Supplement Insurance) Policy?

If you already have a Medigap policy, you can keep your policy. However, you will have to keep paying your premiums and you may get little or no benefit from it while you are in a Medicare MSA Plan. If you drop your Medigap policy, you may not be able to get it back, except in certain situations.

Note: If you are in a Medicare MSA Plan, it's illegal for anyone to sell you a Medigap policy. For more information about Medigap, visit www.medicare.gov on the web and select, "Find A Medicare Publication" to view a copy of the booklet "Choosing a Medigap Policy."

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Who can join Medicare Advantage Medical Savings Account (MSA) plans?

• Medicare Beneficiaries who are enrolled in traditional Medicare Part A and Part B. (You must continue to pay your Part B premium while you are enrolled in a Medicare Advantage MSA plan;
• Must live in the approved service area and intend to reside in the US for at least 183 days during the year;
• May not have End Stage Renal Disease (ESRD) (unless you no longer requires dialysis or have had a successful transplant);
• May not be eligible for Medicaid - dual eligibles are not permitted to enroll in this product;
• May not be eligible for or covered under other health benefits programs including Federal Employee Health Benefits (FEHBP), Department of Veteran Affairs (VA) or Department of Defense (DOD);
• May not have other insurance that covers all or part of the annual MSA plan deductible;
• May not be in a hospice setting;
• May not be actively employed e.g. working aged

If it is subsequently found out that you were not eligible at the time of enrollment, you will be automatically disenrolled back to the original effective date and must refund the entire MSA deposit amount.

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When may I join or disenroll from a Medicare Advantage MSA plan?

Individuals may enroll in MSA plans

• during the Annual Election Period (AEP) (November 15-December 31)
• during their Initial Election Period (IEP) when they first become eligible for Medicare
• CMS prorates the MSA account deposit if a member enrolls mid-year e.g. July 1, they will receive only 1/2 of the MSA deposit

Individuals may disenroll only during the AEP or if a special election period (SEP) applies.

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Will my spouse be able to use money in the account if I die?

Any funds in your account that were deposited before the current calendar year are part of your estate. If your spouse is your beneficiary, he or she can keep part of the deposit made in the current calendar year to your account. No more funds will be added. Part of the most recent deposit (based on the number of months left in the current calendar year) may have to be refunded to Medicare. The rest of the money in the account at the time of your death can be used for your spouse's medical expenses.

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What if my beneficiary isn't my spouse?

If you name a beneficiary for your account who isn't your spouse, the money in it after your death is counted toward that person's gross income when he or she files that year's income tax return. If your estate receives the money in your account, it's counted as gross income on your final tax return.

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Can my Medicare MSA Plan cancel my coverage?

Your plan must cancel your coverage if you

• get Medicaid.
• enroll in a Federal Employee Health Benefits Program plan.
• get health care benefits from the Department of Defense (TRICARE) or the Department of Veterans Affairs.
• get benefits that cover all or part of the yearly MSA deductible permanently.
• move outside of the service area of the plan or are temporarily out of the service area for longer than six months.

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What happens to the money in my account if I leave the plan?

If you leave your Medicare MSA Plan, no more money will be added to your account. Part of the most recent deposit (based on the number of months left in the current calendar year) may have to be refunded to Medicare.

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Can I Use the Same Doctors and Hospitals That I Use Now, or Do I Need to Use a Network of Physicians?

With Medical Savings Account, you can see any licensed provider who is willing to accept Medicare's terms and conditions (Medicare assignment) and payment through Advantra Savings. You are not locked into a network of providers and you do not need a referral for Medicare's covered services.

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What if my provider won't accept my Medical Savings Account plan?

Providers are not required to provide services to enrollees in a Medical Savings Account plan. If your provider currently bills Medicare, he or she will receive the same reimbursement from Advantra Savings as Original Medicare. If your providers do not want to accept Medicare assignment, you should seek care from another provider who is willing to provide services to Medical Savings Account members.

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Do I Have to Go Through a Primary Care Doctor like an HMO?

No. Under Medical Savings Account, you can obtain care directly from any licensed providers who are willing to accept the Medicare assignment.

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