PUP (HMO) Medicare Advantage plans are offered by Physicians United Plan (HMO). Physicians United Plan, Inc. (PUP) is a health plan with a Medicare contract. You must have
both Medicare Part A and B, and must reside in the service area of the plan. Individuals with End-Stage Renal Disease are generally not eligible to enroll in Physicians United
Plan (HMO). To join PUP Extra (HMO), a Special Needs Plan, you must also receive assistance from the state. Please speak with a benefit consultant or call PUP to see if you are
eligible to join. The plan’s contract with the Centers for Medicare & Medicaid Services is renewed annually. Availability of coverage beyond the end of the current contract year
is not guaranteed.
You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Your ability to enroll may be limited to certain
times of the year. For more information contact Member Services at 1-866-571-0693, 7 days a week, between 8:00 a.m. and 8:00 p.m. local time. TTY 800-955-8771. You must use
network providers to receive plan benefits except under emergency or urgent care situations or for out-of-area renal dialysis.
You must use network pharmacies to access prescription drug benefits, except under non-routine circumstances when you cannot reasonably use network pharmacies. The pharmacy
network includes over 60,000 retail, mail order, long-term care, home infusion and I/T/U (Indian Health Service, Tribes or Urban Indian) pharmacies. For information about mail
order, names and addresses of network pharmacies or for more information call 1-866-571-0693 or TTY 1-800-955-8771, Monday through Sunday, 8:00 a.m. to 8:00 p.m. local time.
Or write us at Physicians United Plan, Inc., 9201 Southpark Center Loop, Ste. 200, Orlando, FL 32819, or go to www.pupcorp.com.
You may be able to get extra help to pay for your prescription drug premium and costs. People with limited incomes may qualify for Extra Help to pay for their prescription
drug costs. If eligible, Medicare could pay for seventy-five percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance.
Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. To see
if you qualify for getting extra help, call: 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security
Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call-1-800-325-0778; or your State Medicaid Office.
Medicare beneficiaries may enroll in PUP through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.medicare.gov/pdp-enrollment.asp. For
more information contact PUP at 1-866-571-0693, TTY/TDD 1-800-955-8771.
The document is available in alternate formats or languages. For more information contact PUP at 1-888-827-5787, TTY/TDD 1-800-955-8771.