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Premium Information - 2009


Extra Help in paying for prescriptions
If you have limited income and resources, you may qualify for Extra Help.
Medicare will help you pay some of your prescription costs. To receive this extra help, you must apply with the Social Security Administration. If you qualify for
Extra Help from Medicare, your out-of-pocket drug costs may be different than
those described in your Evidence of Coverage. With Healthfirst Medicare
prescription drug coverage and Medicare Extra Help most of your drug costs will
be covered and you will only have to pay a small co-payment or co-insurance
when you fill your prescriptions.

If you have not already applied for Extra Help, you should contact the Social
Security Administration at www.socialsecurity.gov, or by phone at:
1-800-772-1213 or TTY 1-800-325-0778
Monday – Friday between 7:00 am and 7:00 pm.


This table shows you what your monthly plan premium will be if you
get extra help

Level of extra help for 2009
Your level of extra help Monthly Premium:
Healthfirst NJ Increased Benefits Plan
Healthfirst NJ Life Improvement Plan
100% $0
75% $7.73
50% $15.45
25% $23.18
0% $30.90


Level of extra help for 2009
Your level of extra help Monthly Premium:
Healthfirst NJ Medicare Plus Plan
100% $17.50
75% $23.63
50% $29.75
25% $35.88


The premium information listed above does not include any Part B Premium you may have to pay. The premiums listed above include both medical and prescription drug benefits.

H7015 MK08_90v2 MM/2008 Pending CMS Approval

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Neither Healthfirst, Inc. and its subsidiaries in New York or Healthfirst Health Plan of New Jersey, Inc. in New Jersey have any association with the Greenville Hospital System, Healthfirst, Inc. of South Carolina, or any other organization operating elsewhere in the country under the name Healthfirst.

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