Annual Notice of Changes 2024

Annual Notice of

Changes 2024

AARP® Medicare Rx Walgreens from UHC (PDP)

Toll-free 1-866-870-3470, TTY

711

8 a.m.-8 p.m.: 7 Days Oct-Mar; M-F Apr-Sept

myAARPMedicare.com

Do we have the right address for you?

If not, please let us know so we can keep you informed about your plan.

Y0066_ANOC_S5921_406_000_2024_M

Y0066_210610_INDOI_C

Find updates to your plan for next year

This notice provides information about updates to your plan, but it doesn't include all of the details.

Throughout this notice you will be directed to myAARPMedicare.com to review the details online.

All of the below documents will be available online by

October 15, 2023.

Pharmacy Directory

Review the 2024 Pharmacy Directory online to see which pharmacies are in our network

next year.

Drug List (Formulary)

You can look up which drugs will be covered by your plan next year and review any new

restrictions on our website.

Evidence of Coverage (EOC)

Review your 2024 EOC for details about plan costs and benefits. The EOC is the legal,

detailed description of your plan benefits. It explains your rights and the rules you need to

follow to get covered services and prescription drugs

Would you rather get paper copies?

If you want a paper copy of what is listed above, please contact our Customer Service at

1-866-870-3470 (TTY users should call 711). Hours are 8 a.m.-8 p.m.: 7 Days Oct-Mar; M-F

Apr-Sept

Reduce the clutter and get plan documents faster.

Visit myAARPMedicare.com to sign up for paperless delivery.

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 3

OMB Approval 0938-1051 (Expires: February 29, 2024)

AARP® Medicare Rx Walgreens from UHC (PDP) offered by UnitedHealthcare

Annual Notice of Changes for 2024

You are currently enrolled as a member of AARP® MedicareRx Walgreens (PDP).

Next year, there will be changes to the plan’s costs and benefits. Please see page 6

for a Summary of Important Costs, including Premium. This document tells about the

changes to your plan. To get more information about costs, benefits, or rules please

review the Evidence of Coverage, which is located on our website at

myAARPMedicare.com. You may also call Customer Service to ask us to mail you an

Evidence of Coverage.

You have from October 15 until December 7 to make changes to your Medicare

coverage for next year.

What to do now

1. Ask: Which changes apply to you

£ Check the changes to our benefits and costs to see if they affect you.

· Review the changes to our drug coverage, including authorization requirements and costs.

· Think about how much you will spend on premiums, deductibles, and cost sharing.

Check the changes in the 2024 Drug List to make sure the drugs you currently take are still

covered.

Think about whether you are happy with our plan.

2. Compare:

Learn about other plan choices

Check coverage and costs of plans in your area. Use the Medicare Plan Finder at

www.medicare.gov/plan-compare website or review the list in the back of your Medicare & You

2024 handbook.

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 4

OMB Approval 0938-1051 (Expires: February 29, 2024)

Once you narrow your choice to a preferred plan, confirm your costs and coverage on the

plan’s website.

3. Choose:

Decide whether you want to change your plan

If you don’t join another plan by December 7, 2023, you will be enrolled in AARP® Medicare Rx

Walgreens from UHC (PDP).

· To change to a different plan, you can switch plans between October 15 and December 7.

Your new coverage will start on January 1, 2024. This will end your enrollment with AARP®

MedicareRx Walgreens (PDP).

Additional Resources

UnitedHealthcare does not discriminate on the basis of race, color, national origin, sex, age, or

disability in health programs and activities.

· UnitedHealthcare provides free services to help you communicate with us such as documents

in other languages, braille, large print, audio, or you can ask for an interpreter. For more

information, please call us toll-free at the number on your member ID card or the front of your

plan booklet.

· UnitedHealthcare ofrece servicios gratuitos para ayudarle a que se comunique con nosotros.

Por ejemplo, documentos en otros idiomas, braille, en letra grande,

o en audio. O bien, usted

puede pedir un intérprete. Para obtener más información, llámenos al número gratuito que se

encuentra en su tarjeta de ID de miembro o en la portada de la guía de su plan.

About AARP® Medicare Rx Walgreens from UHC (PDP)

· Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated

companies, a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s

contract renewal with Medicare. UnitedHealthcare Insurance Company pays royalty fees to

AARP for the use of its intellectual property. These fees are used for the general purposes of

AARP. AARP and its affiliates are not insurers. You do not need to be an AARP member to

enroll. AARP encourages you to consider your needs when selecting products and does not

make specific product or pharmacy recommendations for individuals.

When this document says “we,” “us,” or “our,” it means UnitedHealthcare Insurance Company

or one of its affiliates. When it says “plan” or “our plan,” it means AARP® Medicare Rx

Walgreens from UHC (PDP).

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 5

Annual Notice of Changes for 2024

Table of Contents

Summary of important costs for 2024........................................................................................ 6

Section 1 We Are Changing the Plan’s Name.......................................................................8

Section 2 Changes to Benefits and Costs for Next Year...................................................... 8

Section 2.1: Changes to the Monthly Premium.............................................................8

Section 2.2: Changes to the Pharmacy Network.......................................................... 8

Section 2.3: Changes to Part D Prescription Drug Coverage...................................... 9

Section 3 Deciding Which Plan to Choose......................................................................... 12

Section 3.1: If You Want to Stay in AARP® Medicare Rx Walgreens from UHC (PDP)

....................................................................................................................12

Section 3.2: If You Want to Change Plans...................................................................12

Section 4 Deadline for Changing Plans..............................................................................13

Section 5 Programs That Offer Free Counseling about Medicare......................................14

Section 6 Programs That Help Pay for Prescription Drugs................................................ 14

Section 7 Questions?......................................................................................................... 15

Section 7.1: Getting Help from AARP® Medicare Rx Walgreens from UHC (PDP). 15

Section 7.2: Getting Help from Medicare.................................................................... 15

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 6

Questions?

Call Customer Service

1-866-870-3470

, TTY

711

, 8 a.m.-8 p.m.: 7 Days Oct-

Mar; M-F Apr-Sept

Summary of important costs for 2024

The table below compares the 2023 costs and 2024 costs for AARP® Medicare Rx Walgreens from

UHC (PDP) in several important areas. Please note this is only a summary of costs.

Cost 2023 (this year) 2024 (next year)

Monthly plan premium*

*Your premium may be higher or

lower than this amount. (See Section

2.1 for details.)

$28.30 $62.00

Part D prescription drug coverage

(See Section

2.3 for details.)

To find out which drugs are Covered

Insulin Drugs, review the most recent

Drug List we provided electronically. If

you have questions about the Drug

List, you can also call Customer

Service.

Deductible: $0 Tier 1

$350 Tier 2, Tier 3, Tier 4

and Tier 5, except for

covered insulin products

and most adult Part D

vaccines

Deductible: $0 Tier 1

$410 Tier 2, Tier 3, Tier 4

and Tier 5, except for

covered insulin products

and most adult Part D

vaccines

Copays/Coinsurance for

a one-month (30-day)

supply during the Initial

Coverage stage:

· Drug Tier 1: Preferred

retail cost-sharing (in-

network) $1

copayment

Copays/Coinsurance for

a one-month (30-day)

supply during the Initial

Coverage stage:

· Drug Tier 1: Preferred

retail cost-sharing (in-

network) $2

copayment

Drug Tier 2: Preferred

retail cost-sharing (in-

network) $10

copayment

Drug Tier 2: Preferred

retail cost-sharing (in-

network) $8

copayment

Drug Tier 3: Preferred

retail cost-sharing (in-

network) $40

copayment

Drug Tier 3: Preferred

retail cost-sharing (in-

network) $40

copayment

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 7

Questions?

Call Customer Service

1-866-870-3470

, TTY

711

, 8 a.m.-8 p.m.: 7 Days Oct-

Mar; M-F Apr-Sept

Cost 2023 (this year) 2024 (next year)

· Drug Tier 3 Covered

Insulin Drugs:

Preferred retail cost-

sharing (in-network)

$35 copayment

· Drug Tier 3 Covered

Insulin Drugs:

Preferred retail cost-

sharing (in-network)

$35 copayment

· Drug Tier 4: Preferred

retail cost-sharing (in-

network) 45% of the

total cost

· Drug Tier 4: Preferred

retail cost-sharing (in-

network) 50% of the

total cost

Drug Tier 5: Preferred

retail cost-sharing (in-

network) 27% of the

total cost

Catastrophic Coverage:

· During this payment

stage, the plan pays

most of the cost for

your covered drugs.

· For each prescription,

you pay the greater of:

- 5% coinsurance,

- $4.15 copay for

generic

(including brand

drugs treated as

generic) and a

$10.35 copay for

all other drugs.

Drug Tier 5: Preferred

retail cost-sharing (in-

network) 27% of the

total cost

Catastrophic Coverage:

· During this payment

stage, the plan pays

the full cost for your

covered Part D drugs.

· You may have cost

sharing for drugs that

are covered under our

enhanced benefit.

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 8

Section 1 We Are Changing the Plan’s Name

On January 1, 2024, our plan name will change from AARP® MedicareRx Walgreens (PDP) to

AARP® Medicare Rx Walgreens from UHC (PDP).

We will mail you a new UnitedHealthcare member ID card. If you have questions, or if your

UnitedHealthcare member ID card is damaged, lost, or stolen, call Customer Service at

1-866-870-3470 (TTY users should call 711) right away and we will send you a new card.

You will see the new plan name reflected on future communications where the plan name is

referenced.

Section 2 Changes to Benefits and Costs for Next Year

Section 2.1 Changes to the Monthly Premium

Cost 2023 (this year) 2024 (next year)

Monthly premium

(You must also continue to pay your

Medicare Part B premium unless it is

paid for you by Medicaid.)

$28.30 $62.00

· Your monthly plan premium will be more if you are required to pay a lifetime Part D late

enrollment penalty for going without other drug coverage that is at least as good as Medicare

drug coverage (also referred to as “creditable coverage”) for 63 days or more.

If you have a higher income, you may have to pay an additional amount each month directly to

the government for your Medicare prescription drug coverage.

Your monthly premium will be less if you are receiving “Extra Help” with your prescription drug

costs. Please see Section 6 regarding “Extra Help” from Medicare.

Section 2.2 Changes to the Pharmacy Network

An updated Pharmacy Directory is located on our website at

myAARPMedicare.com

. You may

also call Customer Service for updated pharmacy information or to ask us to mail you a Pharmacy

Directory.

There are changes to our network of pharmacies for next year.

Please review the 2024 Pharmacy

Directory to see which pharmacies are in our network.

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 9

It is important that you know that we may make changes to the pharmacies that are part of your

plan during the year. If a mid-year change in our pharmacies affects you, please contact Customer

Service so we may assist.

Section 2.3 Changes to Part D Prescription Drug Coverage

Changes to Our Drug List

Our list of covered drugs is called a Formulary or “Drug List.”

You can get the complete Drug List

by calling Customer Service

(see the back cover)

or visiting our website (

myAARPMedicare.com

We made changes to our Drug List, which could include removing or adding drugs, changing the

restrictions that apply to our coverage for certain drugs or moving them to a different cost-sharing

tier.

Review the Drug List to make sure your drugs will be covered next year and to see if there

will be any restrictions, or if your drug has been moved to a different cost-sharing tier.

Most of the changes in the Drug List are new for the beginning of each year. However, during the

year, we might make other changes that are allowed by Medicare rules. For instance, we can

immediately remove drugs considered unsafe by the FDA or withdrawn from the market by a

product manufacturer. We update our online Drug List to provide the most up to date list of drugs.

To find out which drugs are Covered Insulins, review the most recent Drug List we provided

electronically. If you have questions about the Drug List, you can also call Customer Service.

If you are affected by a change in drug coverage at the beginning of the year or during the year,

please review Chapter 7 of your Evidence of Coverage and talk to your doctor to find out your

options, such as asking for a temporary supply, applying for an exception and/or working to find a

new drug. You can also contact Customer Service for more information.

Changes to Prescription Drug Costs

Note:

If you are in a program that helps pay for your drugs (“Extra Help”),

the information about

costs for Part D prescription drugs may not apply to you.

We sent you a separate insert, called

the “Evidence of Coverage Rider for People Who Get Extra Help Paying for Prescription

Drugs” (also called the “Low Income Subsidy Rider” or the “LIS Rider”), which tells you about your

drug costs. If you receive “Extra Help” you will receive a “LIS Rider.” If you don’t receive it, please

call Customer Service and ask for the “LIS Rider” to be sent to you.

There are four “drug payment stages.”

The information below shows the changes for next year to the first two stages – the Yearly

Deductible Stage and the Initial Coverage Stage. (Most members do not reach the other two stages

– the Coverage Gap Stage or the Catastrophic Coverage Stage.)

Changes to the Deductible Stage

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 10

Stage 2023 (this year) 2024 (next year)

Stage 1: Yearly (Part D) Deductible

stage

During this stage,

you pay the full

cost

of your Tier 2, Tier 3, Tier 4 and

Tier 5 drugs until you have reached the

yearly deductible. The deductible does

not apply to covered insulin products

and most adult Part D vaccines,

including shingles, tetanus and travel

vaccines.

The deductible is $350.

During this stage, you pay

$16 for drugs on Tier 1

(in-network standard retail

30-day supply) and $1 on

Tier 1 (in-network

preferred retail 30-day

supply), and the full cost

of drugs on Tier 2, Tier 3,

Tier 4 and Tier 5 until you

have reached the yearly

deductible.

The deductible is $410.

During this stage, you pay

$17 for drugs on Tier 1

(in-network standard retail

30-day supply) and $2 on

Tier 1 (in-network

preferred retail 30-day

supply), and the full cost

of drugs on Tier 2, Tier 3,

Tier 4 and Tier 5 until you

have reached the yearly

deductible.

Changes to Your Cost-sharing in the Initial Coverage Stage

Stage 2023 (this year) 2024 (next year)

Stage 2: Initial Coverage stage

Once you pay the yearly deductible,

you move to the Initial Coverage stage.

During this stage, the plan pays its

share of the cost of your drugs and

you pay your share of the cost.

Most adult Part D vaccines are

covered at no cost to you.

The costs in this row are for a one-

month (30-day) supply when you fill

your prescription at a network

pharmacy.

For information about the costs for a

long-term supply or for mail-order

prescriptions, look in Chapter 4,

Section 5 of your

Evidence of

Coverage.

We changed the tier for some of the

drugs on our Drug List. To see if your

Your cost for a one-month

supply at a network

pharmacy:

Tier 1 - Preferred

Generic:

Standard cost-sharing:

You pay $16 per

prescription.

Preferred cost-sharing:

You pay $1 per

prescription.

Tier 2 - Generic:

Standard cost-sharing:

You pay

$20 per

prescription.

Your cost for a one-month

supply at a network

pharmacy:

Tier 1 - Preferred

Generic:

Standard cost-sharing:

You pay $17 per

prescription.

Preferred cost-sharing:

You pay

$2 per

prescription

Tier 2 - Generic:

Standard cost-sharing:

You pay

$20 per

prescription.

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 11

Stage 2023 (this year) 2024 (next year)

drugs will be in a different tier, look

them up on the Drug List.

Preferred cost-sharing:

You pay $10 per

prescription.

Tier 3 - Preferred Brand:

Standard cost-sharing:

You pay $45 per

prescription.

Preferred cost-sharing:

You pay $40 per

prescription

Tier 3 - Covered Insulin

Drugs:

Standard cost-sharing:

You pay $35 for covered

insulins.

Preferred cost-sharing:

You pay $35 for covered

insulins.

Tier 4 - Non-Preferred

Drug:

Standard cost-sharing:

You pay

50% of the total

cost.

Preferred cost-sharing:

You pay

45% of the total

cost.

Tier 5 - Specialty Tier:

Standard cost-sharing:

You pay

27% of the total

cost.

Preferred cost-sharing:

You pay $8 per

prescription.

Tier 3 - Preferred Brand:

Standard cost-sharing:

You pay $45 per

prescription.

Preferred cost-sharing:

You pay

$40 per

prescription.

Tier 3 - Covered Insulin

Drugs:

Standard cost-sharing:

You pay $35 for covered

insulins.

Preferred cost-sharing:

You pay $35 for covered

insulins.

Tier 4 - Non-Preferred

Drug:

Standard cost-sharing:

You pay 50% of the total

cost

Preferred cost-sharing:

You pay

50% of the total

cost.

Tier 5 - Specialty Tier:

Standard cost-sharing:

You pay

27% of the total

cost

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 12

Stage 2023 (this year) 2024 (next year)

Preferred cost-sharing:

You pay 27% of the total

cost.

Once your total drug

costs have reached

$4,660, you will move to

the next stage (the

Coverage Gap stage).

Preferred cost-sharing:

You pay 27% of the total

cost.

Once your total drug

costs have reached

$5,030, you will move to

the next stage (the

Coverage Gap stage).

Changes to the Coverage Gap and Catastrophic Coverage stages

The other two drug coverage stages – the Coverage Gap stage and the Catastrophic Coverage

stage – are for people with high drug costs. Most members do not reach the Coverage Gap

stage or the Catastrophic Coverage stage.

For the Coverage Gap Stage for drugs on Tier 1, your cost-sharing is changing from coinsurance to

a copayment.

Beginning in 2024, if you reach the Catastrophic Coverage stage, you pay nothing for covered Part

D drugs. You may have cost sharing for excluded drugs that are covered under our enhanced

benefit.

For specific information about your costs in these stages, look at Chapter 6, Sections 6 and 7, in

your Evidence of Coverage.

Section 3 Deciding Which Plan to Choose

Section 3.1 If You Want to Stay in AARP® Medicare Rx Walgreens from UHC

(PDP)

To stay in our plan, you don’t need to do anything

. If you do not sign up for a different plan by

December 7, you will automatically be enrolled in our AARP® Medicare Rx Walgreens from UHC

(PDP).

Section 3.2 If You Want to Change Plans

We hope to keep you as a member next year but if you want to change plans for 2024 follow these

steps:

Step 1: Learn about and compare your choices

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 13

You can join a different Medicare prescription drug plan,

· -- OR-- You can change to a Medicare health plan. Some Medicare health plans also include

Part D prescription drug coverage,

-- You can keep your current Medicare health coverage and drop your Medicare

prescription drug coverage.

To learn more about Original Medicare and the different types of Medicare plans, use the Medicare

Plan Finder (www.medicare.gov/plan-compare), read the Medicare & You 2024 handbook, call

your State Health Insurance Assistance Program (see Section 5), or call Medicare (see Section 7.2).

As a

reminder

, UnitedHealthcare Insurance Company or one of its affiliates offers other Medicare

health plans and Medicare prescription drug plans. These other plans may differ in coverage,

monthly premiums, and cost-sharing amounts.

Step 2: Change your coverage

· To change to a different Medicare prescription drug plan, enroll in the new plan. You will

automatically be disenrolled from AARP® Medicare Rx Walgreens from UHC (PDP).

· To change to a Medicare health plan, enroll in the new plan. Depending on which type of plan

you choose, you may automatically be disenrolled from AARP® Medicare Rx Walgreens from

UHC (PDP).

- You will automatically be disenrolled from AARP® Medicare Rx Walgreens from UHC (PDP) if

you enroll in any Medicare health plan that includes Part D prescription drug coverage. You

will also automatically be disenrolled if you join a Medicare HMO or Medicare PPO, even if

that plan does not include prescription drug coverage.

- If you choose a Private Fee-For-Service plan without Part D drug coverage, a Medicare

Medical Savings Account plan, or a Medicare Cost Plan, you can enroll in that new plan and

keep AARP® Medicare Rx Walgreens from UHC (PDP) for your drug coverage. Enrolling in

one of these plan types will not automatically disenroll you from AARP® Medicare Rx

Walgreens from UHC (PDP). If you are enrolling in this plan type and want to leave our plan,

you must ask to be disenrolled from AARP® Medicare Rx Walgreens from UHC (PDP). To

ask to be disenrolled, you must send us a written request or contact Medicare at 1-800-

MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week (TTY users should call

1-877-486-2048).

change to Original Medicare without a prescription drug plan

, you must either:

Send us a written request to disenroll or visit our website to disenroll online. Contact

Customer Service if you need more information on how to do so.

–

– Contact

Medicare

, at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a

week, and ask to be disenrolled. TTY users should call 1-877-486-2048.

Section 4

Deadline for Changing Plans

If you want to change to a different prescription drug plan or to a Medicare health plan for next

year, you can do it from

October 15 to December 7

. The change will take effect on January 1,

2024.

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 14

Are there other times of the year to make a change?

In certain situations, changes are also allowed at other times of the year. Examples include people

with Medicaid, those who get “Extra Help” paying for their drugs, those who have or are leaving

employer coverage, and those who move out of the service area.

If you recently moved into, currently live in, or just moved out of an institution (like a skilled nursing

facility or long-term care hospital), you can change your Medicare coverage at any time. You can

change to any other Medicare health plan (either with or without Medicare prescription drug

coverage) or switch to Original Medicare (either with or without a separate Medicare prescription

drug plan) at any time.

Section 5 Programs That Offer Free Counseling about Medicare

The State Health Insurance Assistance Program (SHIP) is an independent government program

with trained counselors in every state.

It is a state program that gets money from the federal government to give free local health

insurance counseling to people with Medicare. State Health Insurance Assistance Program

counselors can help you with your Medicare questions or problems. They can help you understand

your Medicare plan choices and answer questions about switching plans. You can find your SHIP

number and address in Chapter 2, Section 3 of the Evidence of Coverage.

Section 6 Programs That Help Pay for Prescription Drugs

You may qualify for help paying for prescription drugs. Below we list different kinds of help:

· “Extra Help” from Medicare.

People with limited incomes may qualify for “Extra Help” to pay

for their prescription drug costs. If you qualify, Medicare could pay up to 75% or more of your

drug costs including monthly prescription drug premiums, annual deductibles, and

coinsurance. Additionally, those who qualify will not have a coverage gap or late enrollment

penalty. To see if you qualify, call:

1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7

days a week;

The Social Security Office at 1-800-772-1213 between 8 a.m. and 7 p.m., Monday through

Friday for a representative. Automated messages are available 24 hours a day. TTY users

should call 1-800-325-0778; or

Your State Medicaid Office (applications).

· Help from your state’s pharmaceutical assistance program.

Montana has a program called

Montana Big Sky Rx that helps people pay for prescription drugs based on their financial need,

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 15

age, or medical condition. To learn more about the program, check with your State Health

Insurance Assistance Program.

· Prescription Cost-sharing Assistance for Persons with HIV/AIDS. The AIDS Drug Assistance

Program (ADAP) helps ensure that ADAP-eligible individuals living with HIV/AIDS have access

to life-saving HIV medications. Individuals must meet certain criteria, including proof of state

residence and HIV status, low income as defined by the state, and uninsured/under-insured

status. Medicare Part D prescription drugs that are also covered by ADAP qualify for

prescription cost-sharing assistance through the ADAP in your state. For information on

eligibility criteria, covered drugs, or how to enroll in the program, please contact the ADAP in

your state. You can find your state’s ADAP contact information in Chapter 2 of the Evidence of

Coverage.

Section 7 Questions?

Section 7.1 Getting Help from AARP® Medicare Rx Walgreens from UHC

(PDP)

Questions? We’re here to help. Please call Customer Service at 1-866-870-3470. (TTY only, call

711.) We are available for phone calls 8 a.m.-8 p.m.: 7 Days Oct-Mar; M-F Apr-Sept. Calls to these

numbers are free.

Read your 2024 Evidence of Coverage (it has details about next year's benefits and costs)

This Annual Notice of Changes gives you a summary of changes in your benefits and costs for

2024. For details, look in the 2024 Evidence of Coverage for AARP® Medicare Rx Walgreens from

UHC (PDP). The Evidence of Coverage is the legal, detailed description of your plan benefits. It

explains your rights and the rules you need to follow to get covered services and prescription

drugs. A copy of the Evidence of Coverage is located on our website at myAARPMedicare.com.

You may also call Customer Service to ask us to mail you an Evidence of Coverage.

Visit our Website

You can also visit our website at

myAARPMedicare.com

. As a reminder, our website has the most

up-to-date information about our pharmacy network (Pharmacy Directory) and our list of covered

drugs (Formulary).

Section 7.2 Getting Help from Medicare

To get information directly from Medicare:

Call 1-800-MEDICARE (1-800-633-4227)

You can call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should

call 1-877-486-2048.

2024 Annual Notice of Changes for AARP® Medicare Rx Walgreens from UHC (PDP) 16

Visit the Medicare Website

Visit the Medicare website (www.medicare.gov). It has information about cost, coverage,

and quality Star Ratings to help you compare Medicare prescription drug plansin your area. To

view the information about plans, go to www.medicare.gov/plan-compare.

Read Medicare & You 2024

Read the Medicare & You 2024 handbook. Every fall, this document is mailed to people with

Medicare. It has a summary of Medicare benefits, rights and protections, and answers to the most

frequently asked questions about Medicare. If you don’t have a copy of this document, you can get

it at the Medicare website (https://www.medicare.gov/Pubs/pdf/10050-medicare-and-you.pdf) or

by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call

1-877-486-2048.

葩Ԝ裊簯聂䍩粣䈁膞࣑ഘ豻繆ᛘሩ葩Ԝ蠿筶笵贍㦟肵䇑ࡂ蠿螙谩蝀䰞ಱ蔒菈

ራ韬螐聐粣䈁ઈഘ䈧艈虑ᛘ蠿Պઈ葌ԭ䇱芟蠿聂䍩⭥䈍ਧ⸱㚄篬葩Ԝಱ螐聐оᛘ䇢芴纩䈝蔀蠿蝸

竑蝋Ѫᛘ裊簯ᑞ裝ಱ䘉萙螐亩聂䍩膞࣑ಱ

葩肧裊簯聂舫蠿粣蔮膞肏ഘ竑赥繆ᛘ竑縑繘葩肧蠿筶笵贍蓌肵篯赸蠿螙谩

肪裘ಱ蔒菈粣蔮蚗ഘ誂脇謻ᛘ蠿赬蚗萴腳靈芟蠿聂膼舫衴贬贅翶缷绞葩肧ಱ赬茢ᛘ蠿蓳蔀蠿蝸竑

費裝ᛘಱ蠲萙聂舫膞肏ಱ

Chúng tôi có dịch vụ thông dịch viên miễn phí để trả lời các câu hỏi mà bạn có về chương

trình sức khoẻ hay thuốc của chúng tôi. Để gặp thông dịch viên, vui lòng gọi cho chúng tôi theo sốđiện

thoại miễn phí trên thẻ nhận dạng thành viên của bạn. Người nói cùng ngôn ngữ với bạn có thể giúp

bạn. Đây là dịch vụ miễn phí.

Ịṫ ⡦⓪ 㦮㟓䛞䝢⧲㠦 ὖ䞲㰞ⶎ㠦 ╋⼖䟊✲Ⰲ₆ 㥚䟊 ⶊ⬢ 䐋㡃㍲゚㓺⯒

㩲Ὃ䞿┞┺

䐋㡃㍲゚㓺⯒ 㧊㣿䞮⩺Ⳋ Ṗ㧛㧦䃊✲㠦㧞⓪ 㑮㔶㧦⿖╊ 㩚䢪⻞䢎⪲ 㩚䢪䟊

㭒㕃㔲㡺

䞲ῃ㠊⯒ ㌂㣿䞮⓪ 䐋㡃㌂Ṗ ☚㤖㦚 ✲Ⰺ 㑮㧞㔋┞┺ 㧊㍲゚㓺⓪ ⶊ⬢㧛┞┺

Если у Вас возникнут какие-либо вопросы о нашем плане медицинского страхования

или плане по приобретению препаратов, мы предоставим Вам бесплатные услуги устного

перевода. Для того чтобы воспользоваться услугами устного перевода, пожалуйста, свяжитесь с

нами по бесплатному номеру телефона, указанному на Вашей идентификационной карте

участника плана. Сотрудник, который говорит на Вашем

языке, сможет Вам помочь. Данная

услуга предоставляется бесплатно.

لوﺻﺣﻠﻟ .ﺎﻧﺑ ﺔﺻﺎﺧﻟا ﺔﯾودﻷا ﺔطﺧ وأ ﺔﯾﺣﺻﻟا ﺔطﺧﻟا لوﺣ كﯾدﻟ نوﻛﺗ دﻗ ﺔﻠﺋﺳأ يأ ﻰﻠﻋ درﻠﻟ ﺔﯾروﻓ ﺔﻣﺟرﺗ تﺎﻣدﺧ ﺎﻧﯾدﻟ

ﺔﻣدﺧ هذھ .كﺗﻐﻟ ثدﺣﺗﯾ ﺎﻣ صﺧﺷ كدﻋﺎﺳﯾﺳ .كﺗﯾوﺿﻋ فﯾرﻌﺗ ﺔﻗﺎطﺑ ﻰﻠﻋ ﻲﻧﺎﺟﻣﻟا فﺗﺎﮭﻟا مﻗر مادﺧﺗﺳﺎﺑ ﺎﻧﺑ لﺻﺗا ،مﺟرﺗﻣ ﻰﻠﻋ

.ﺔﯾﻧﺎﺟﻣ

हमारे ा या दवा ान के बारे म आपके िकसी भी  का उर देने के िलए हमारे पास मु

दुभािषया सेवाएं मौजूद ह। दुभािषया पाने के िलए

ए

कृ पया अपने सद पहचान प पर टोल-ी नंबर का उपयोग

करके हम कॉल कर। आपकी भाषा बोलने वाला कोई  आपकी मदद कर सकता है। यह एक िनःशु सेवा

है।

ᒰ␠ߩක≮߹ߚߪಣᣇ⮎ࡊ࡜ࡦߦ㑐ߔࠆ⾰໧ߦ߅╵߃ߔࠆߚ߼ߦޔήᢱߩㅢ⸶ࠨ࡯

ࡆࠬࠍߏ೑↪޿ߚߛߌ߹ߔޕㅢ⸶߇ᔅⷐߥ႐วߦߪޔળຬ+&ࠞ࡯࠼ߦ⸥タߐࠇߡ޿ࠆࡈ࡝࡯࠳

ࠗࡗ࡞⇟ภࠍ૶↪ߒߡޔᒰ␠߹ߢ߅໧޿วࠊߖߊߛߐ޿ޕ߅ቴ᭽ߩ⸒⺆ࠍ⹤ߔㅢ⸶⠪߇߅ᚻવ

޿޿ߚߒ߹ߔޕߎࠇߪήᢱߩࠨ࡯ࡆࠬߢߔޕ

For more information, please call customer service at:

AARP® Medicare Rx Walgreens from UHC (PDP) Customer

Service:

Call 1-866-870-3470

Calls to this number are free. 8 a.m.-8 p.m.: 7 Days Oct-Mar; M-F Apr-Sept. Customer

Service also has free language interpreter services available for non-English speakers.

TTY 711

Calls to this number are free.

8 a.m.-8 p.m.: 7 Days Oct-Mar; M-F Apr-Sept.

Write: P.O. Box 30770

Salt Lake City, UT 84130-0770

myAARPMedicare.com

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