Legal Disclosures

Not connected with or endorsed by the U.S. Government or the federal Medicare program.

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent or insurance company.

Please check with your doctor before you start a physical activity program. The SilverSneakers^® Fitness Program is provided by an independent company. SilverSneakers is a value-added program. It is not insurance and not part of the Medicare Supplement insurance plans. It can be changed or withdrawn at any time. The SilverSneakers fitness program is provided by Tivity Health, an independent company. Tivity Health and SilverSneakers are registered trademarks or trademarks of Tivity Health, Inc., and/or its subsidiaries and/or affiliates in the USA and/or other countries. ©2021 Tivity Health, Inc. All rights reserved.

This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, please contact your agent or the health plan.

The Wellpoint plans are Medicare plans with a Medicare contract and for SNP plans a contract with the state Medicaid plans. Enrollment in Wellpoint depends on contract renewal.

In Arizona: services are provided by Wellpoint Texas, Inc., Wellpoint Ohio, Inc., or Wellpoint Insurance Company. In Iowa: services are provided by Wellpoint Iowa, Inc. In New Jersey: services are provided by Wellpoint New Jersey, Inc. or Wellpoint Insurance Company. In New Mexico: services are provided by Wellpoint Community Care of New Mexico, Inc., In Tennessee: services are provided by Wellpoint Texas, Inc. or Wellpoint Tennessee, Inc. In Texas: services are provided by Wellpoint Texas, Inc. or Wellpoint Insurance Company. In Washington: services provided by Wellpoint Washington, Inc. Part D coverage is provided by Wellpoint Life & Health Insurance Company.

Wellpoint is a Medicare Advantage plan with Medicare contracts. Wellpoint is an SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Wellpoint depends on contract renewal.

This information is not a complete description of benefits. Call Customer Service, (TTY: 711) for more information.

Disclosures And Important Information

Non-Discrimination Notice: The plan documents may be available in other languages. Or, if you have special needs, the documents may be available in other formats. Please review the Notice of Non-Discrimination in Health Programs and Activities and call Customer Service for details.

For Arizona:

Coverage is provided by Wellpoint Insurance Company. Once enrolled into your Medicare Supplement insurance plan, your coverage is guaranteed for the life of the plan with only two exceptions/restrictions: nonpayment of premiums or material misrepresentation.

For Iowa:

Wellpoint Iowa, Inc. is an HMO D-SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Wellpoint Iowa, Inc. depends on contract renewal.

For New Jersey:

For Plans H3240_013 and H3240_016: Wellpoint Dual Coordination (HMO D-SNP) is a D-SNP plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellpoint Dual Coordination (HMO D-SNP) depends on contract renewal.

For Plan H3240_024: Wellpoint Dual Secure (HMO POS D-SNP) is a D-SNP plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellpoint Dual Secure (HMO POS D-SNP) depends on contract renewal.

For Tennessee:

Wellpoint is an HMO D-SNP plan with a Medicare contract and a contract with the State Medicaid program. Enrollment in Wellpoint depends on contract renewal.