FOR BREAKING NEWS VISIT WWW.QNS.COM NOVEMBER 22, 2018 • THE QUEENS COURIER 7
More Benefits for You!
You may be eligible for additional money-saving
benefits through our Dual Advantage plans, including:
• Monthly OTC Card up to $100
(to pay for items like OTC medications,
toothpaste, incontinence supplies, and more)
• Care Management support
• Top-quality doctors and hospitals
• Discounts for hearing devices*
• and many more!
MEDICARE HEALTH INSURANCE
JOHN L SMITH OR
Medicare Number/Número de Medicare
Coverage starts/Cobertura empieza
Entitled to/Con derecho a
HOSPITAL (PART A) MEDICAL (PART B)
Medicaid/Common Benefit Identification
Card (CBIC) NEW
For a complete listing of plans in your service area, contact the plan. The benefit information provided
is a brief summary, not a complete description of benefits. For more information, contact the plan.
Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium
and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay
your Medicare Part B premium. Out-of-network services may require more out-of-pocket expense than
in-network services. Benefit restrictions apply. Fidelis Legacy Plan is an HMO plan with a Medicare
contract. Enrollment in Fidelis Legacy Plan depends on contract renewal. *Fidelis Legacy Plan partners
with TruHearing for discounted purchases of hearing devices.
Call us today! 1-800-860-8707 TTY: 711
Monday–Sunday, 8:00 a.m.–8:00 p.m. from October 1–March 31
Monday–Friday, 8:00 a.m.–8:00 p.m. from April 1–September 30