CMS approved description of the Connecticut Pharmaceutical Assistance Contract to the Elderly (ConnPACE)

www.connpace.com

You May be Eligible for Extra Help in Paying the Cost of Your Prescription Drugs!

Health Net believes that everyone should have access to quality health care and affordable prescription drug coverage. Since the cost of drugs may increase as you grow older, you may consider getting help to pay for your plan premiums and prescription drug expenses. Financial assistance programs such as these can save you more money and limit your high out-of-pocket costs.

One such program is the Connecticut Pharmaceutical Assistance Contract to the Elderly (ConnPACE), a state-funded health insurance program that has been helping eligible senior citizens and disabled citizens afford the cost of most prescription medications since 1986. You do not need to have a Health Net plan to be enrolled with ConnPACE. If you qualify for ConnPACE and have a Health Net Ruby Option 1, Ruby Option 2, Ruby Option 3, or Navy Medicare Advantage plan, here’s how it works:

the State charges you a $30 annual enrollment fee
your Part D premium fee of $20.10 will be covered by ConnPACE, which can reduce your overall monthly plan premium costs
there is no yearly dollar limit on the amount of prescriptions covered
your only out-of-pocket expense is a copayment of $5 for each preferred generic1 prescription and no more than $16.25 for other drugs2 at Health Net participating pharmacies, until you reach your Part D Initial Coverage Limit
during the Medicare Part D “coverage gap,” you pay just $16.25 for both preferred generic and brand drugs2 (Ruby Option 1 members only pay $5 for generic drugs and $16.25 for brand drugs during the coverage gap1)

To get all the information you need about applying for ConnPACE, call 1-860-409-4555 or download their online brochure and application at www.connpace.com or by clicking here. If you have any questions about your Health Net membership, please call Health Net Member Services at 1-800-547-8734 (TTY/TDD 1-888-747-2424), 8:00 a.m. to 8:00 p.m., Monday through Friday.

In order to open the application, you will need to download Adobe Reader. Click here to get Adobe Reader free:

^{1 Please refer to your Health Net 2007 Comprehensive Formulary for more details.}
^{2 Some restrictions may apply. Please contact ConnPACE to learn more.}

^{H0755_2007_337 R1 CMS Approval: 4/07 CT36186 (5/07) 6012865}

Health Net of Connecticut, Inc. is an organization contracted with Medicare.