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2011 Summary of Benefits
2011 Evidence of Coverage

How to Contact Us:

Telephone: 800.475.8466

TTY: 800.659.2656

Fax: 719.589.4901

Address:
700 Main Street, Suite 100
Alamosa, CO 81101

Hours: 8:00 am-8:00 pm
7 days a week

2010 PLAN INFORMATION - COLORADO CHOICE MEDICARE (COST)

Plans & Premiums to Choose From:
Click on the Evidence of Coverage below to view the detailed benefit information for contract year 2010. This information provides comprehensive benefit information and explains covered & non-covered benefits, what to do if you are unhappy with our services and other detailed plan information.

Plan Premium*
Colorado Choice Silver Plan (Cost)
2010 Evidence of Coverage
$0/Month
Colorado Choice Gold Plan (Cost)
2010 Evidence of Coverage
$45/Month
Colorado Choice Platinum Plan (Cost)
2010 Evidence of Coverage
$55/Month

Click on the Summary of Benefits document below for an overview and comparison of our plans and benefits.

2010 Summary of Benefits

*You must continue to pay your Medicare Part B premium.


How to Enroll
Call us at 1-800-475-8466 toll free or 719-589-3696, 8:00 a.m. to 8:00 p.m., 7 days a week.


A Health Plan with a Medicare contract.

DISCLAIMER
We renew our contract with Medicare annually. The availability of coverage beyond the end of the current year is not guaranteed.

Benefits, premium and/or copayments/coinsurance may change each year on January 1. Benefits may be subject to copayments, limitations and/or restrictions. See the Evidence of Coverage or contact Customer Service for details.

The benefit information contained herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.

You are eligible to enroll if you are entitled to Medicare Part A and enrolled in Medicare Part B and you live in the service area. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Eligible beneficiaries can enroll in Colorado Choice at any time.

You can use any doctor who is part of Colorado Choice's network. You may also go to doctors outside of our network. We may not pay for services you receive outside of our network, but Medicare will pay for its share of charges it approves. You will be responsible for paying the Medicare deductible and coinsurance for those services, unless they were authorized in advance by Colorado Choice.

Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment and any applicable conditions associated with using the plan benefits.

Information is available in alternative formats or languages. Please call 1-800-475-8466 for details. Se puede presentar la información acerca del plan en un formato o idioma distinto. Para solicitar un documento en español, favor de llamar a Atención al Cliente, al número telefónico indicado debajo.

For more information, contact Customer Service at 1-800-475-8466 toll free or 719-589-3696, 8:00 a.m. to 8:00 p.m., 7 days a week. If you are hearing impaired and use TTY equipment, call 1-800-659-2656 (Para asistencia en español llame al 1-800-475-8466.


Information is current as of 11/10/10.  Please contact our Customer Services department to verify that you have the most up to date information.

H0657_MCWeb CMS Approval 11/24/2010
 

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