Patient's Last name First name Middle initial Home address City, State, Zip code ________________________________ Email Address: __________________________________________________________________________________ What concerns do you have about your teeth? How do you feel about orthodontic treatment? Who suggested that you might need orthodontic treatment? Describe any previous orthodontic tr
Mvp health care medicare part d tier 5 select care $0 generic drugs and vaccines2014 MVP $0-COST GENERIC DRUGS To Control Blood Pressure
To Treat Heartburn / Ulcers
atenolol tabs benazepril/hydrochlorothiazide tabs To Treat Osteoporosis / Bone Health
bisoprolol fumarate/hydrochlorothiazide tabs bisoprolol fumarate tabs To Treat Mental Health Conditions
ﬂuoxetine caps, tabs, and oral solution enalapril maleate/hydrochlorothiazide tabs enalapril maleate tabs To Treat Glaucoma
^ Other forms of timolol solution (i.e. gel- forming) are in Tier 1 - Preferred Generic Drugs. $0-COST MVP SELECT
To Treat Pain
losartan potassium/hydrochlorothiazide tabs GENERIC DRUGS & VACCINES
propranolol/hydrochlorothiazide tabs propranolol tabs To Control High Cholesterol
When you choose a 2014 MVP Medicare Advantage plan with Part D, many triamterene/hydrochlorothiazide caps and tabs To Treat Thyroid Conditions
commonly used Part D prescription drugs and vaccines are available to you for To Treat Diabetes
free. You pay nothing — $0 — for our Tier 5 Select Care Drugs and select vaccines. Miscellaneous
What could you save? A lot.
Talk it over with your doctor. See if you both agree that one of MVP’s $0 cost drugs would be right for you. glyburide tabs metformin tabs metformin ER tabs (generic Glucophage XR only) Refer to the MVP Health Care Formulary a for the most up-to-date $0-cost generic drugs do not apply for the BasiCare PPO plan. list of Medicare Part D covered drugs and other helpful prescription information. This is not a complete list of drugs covered by our plan. For a complete listing, please call MVP’s Medicare Products Advisors Always talk with your doctor ﬁ rst!
Do not stop taking a prescribed medication before consulting with your doctor. Save even more.
Switch and save!
These common vaccines also are available from MVP at no cost to you when Here are just a few of the brand name drugs that you can switch you receive them at your local pharmacy or your doctor processes your for a $0 cost generic. Available at no cost all year long! Vaccines
If you’re taking this
Ask your doctor
You could save
brand name drug
about this $0 cost
this much per year
by switching to a
For tetanus and combination
$0 generic drug*
tetanus / diphtheria / pertussis
$420 - $1,080
To ensure that you pay $0 for your vaccine, always ask your doctor to process your Part D vaccine claims through a service called TransactRx. If your doctor does not process your claim using TransactRx, you will have to pay out-of-pocket for your vaccine and submit the claim to Express Scripts for reimbursement. MVP will reimburse vaccine claims up to MVP’s allowed amount. If your doctor chooses to charge more than the allowed amount, you will be responsible for paying the difference. Not all providers use the TransactRx service. Check with your doctor before getting your vaccine. Heartburn
$420 - $1,080
Less really is more. $0 drugs save you money.
Are you Medicare eligible? Looking to switch plans?
You can enroll from Oct. 15 – Dec. 7 during the annual Open Enrollment period. High blood
$420 - $1,080
Almost 65? Over 65 and getting ready to retire? Moving into or new to the area?
Our licensed MVP Medicare Products Advisors are ready to answer your questions and help you enroll Monday – Friday, 8 am – 5 pm Eastern Time at 1-888-280-6205
Already an MVP member? Call our Medicare Customer Care Center with your questions Monday – Friday, 8 am – 8 pm and Saturday, 8 am – 4 pm at 1-800-665-7924. From Oct. 1 – Feb. 14, call seven days a week, 8 am – 8 pm. High cholesterol
$420 - $1,080
Reference to any brand name products does not constitute an endorsement or recommendation. This information is not an attempt to replace professional medical advice. Please talk with your doctor or pharmacist if you have any questions about taking generic drugs. Osteoporosis
$420 - $1,080
MVP Health Plan, Inc. is a not-for-proﬁt HMO-POS/PPO organization with a Medicare contract. Enrollment in MVP Health Plan depends on contract renewal. The beneﬁt information provided is a brief summary, not a complete description of beneﬁts. For more information, contact the plan. Limitations, copayments, and restrictions apply. Beneﬁts, formulary, pharmacy network, provider network, premium ^ Other forms of timolol solution (i.e. gel-forming) are in Tier 1 - Preferred Generic Drugs. and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your *If your coverage is through your former employer, your savings may vary. Part B premium. Medicare evaluates plans based on a 5-Star Rating system. Star Ratings are calculated each year and may change from one year to the next.
The Twins By Lara Yokoshima Edition by Wingless Demon V. Something Rotten Interrupting his soft and harmonious breathing, the silver-haired youth slowly rolled his lazy body over the bed, changing from his right side to his left. He could feel the warm sun on his face, trying to attack his weak pupils through his half- opened eyelids. He stayed motionless for a few more minutes, unti