North Shore Towers Courier n November 2016 61 Medicare Advantage Prescription Drug Plans or low cost Plan premiums Doctor visits Generic drugs • Dental, vision and hearing • Transportation • Over-the-counter pre-paid cards • Fitness center membership $0 Contact us for eligibility and enrollment [email protected] | agewellnewyork.com We’re here for your call. Toll Free 1.866.586.8044 | TTY/TDD 1.800.662.1220 AgeWell New York, LLC is a HMO plan with a Medicare contract and a Coordination of Benefits Agreement with New York State Department of Health. Enrollment in AgeWell New York, LLC depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is available for free in other languages. Please call customer service at 1-866-586-8044 or TTY 1-800-662-1220 seven days a week from 8:00 am to 8:00 pm Eastern Time or visit www.agewellnewyork.com. AgeWell New York complies with applicable Federal civil rights laws and does not discriminate on the basis of races, color, national origin, age, disability, or sex. AgeWell New York cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. AgeWell New York 遵守適用的聯邦民權法律規定，不因種族、膚色、民族血統、年齡、殘障或 別而歧視任何 人。 ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Call 1-866-586-8044 (TTY: 1-800-662-1220). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-586-8044 (TTY: 1-800-662-1220). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-866-586-8044 (TTY: 1-800-662-1220). H4922_MA_4002 Accepted 09102016
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