2009 Medicare Benefits at a Glance

Refer to the 2009 NALC Health Benefit Plan brochure (RI 71-009) for complete details. 2008 Medicare Benefits at a Glance and Previous brochures are also available.

When Medicare is primary payer (Medicare Part B for prescriptions), all deductibles, coinsurances and copayments are waived, except for prescription drugs. See the chart below for a brief overview. Rely on your brochure for benefits when Medicare does not pay.

Benefit	You Pay
Hospitalization (no precertification required)
Inpatient Medical/Surgical and Mental Health	Nothing
Outpatient	Nothing
Physician Care
Inpatient and Outpatient Medical and Surgical Care	Nothing
Mental Health and Substance Abuse	Nothing - no limitations
Prescription Drugs *This is a mandatory generic program with a 30-day limit at local retail.
Retail: Note: You may purchase up to a 90-day supply (84-day minimum) of covered drugs and supplies at a CVS/Caremark Pharmacy through our Maintenance Choice Program. You will pay the applicable mail order copayment (see below) for each prescription purchased.	Network Retail — Non-network Retail —	15% of cost 50% of allowance
Mail Order:	60-day supply —	$7 generic $20 brand name
	90-day supply —	$10 generic $30 brand name
Catastrophic Limits	Nothing
When you have Medicare Part D We waive the following at retail when Medicare Part D is the primary payer: Refill limitations Day supply Calendar year drug deductible

This is a summary of some of the features of the NALC Health Benefit Plan. Detailed information on the benefits for the 2009 NALC Health Benefit Plan can be found in the official brochure. All benefits are subject to the definitions, limitations, and exclusions set forth in the official brochure.