Contract Termination

American Health Medicare is a Medicare Advantage organization with a Medicare contract. American Health Medicare is a coordinated care plan with a Medicare Advantage contract and a contract with the Puerto Rico Government Health Insurance Plan (Medicaid). To enroll, you must have Medicare Parts A and B, or have Medicare Parts A and B and Medicaid, have not been diagnosed with End Stage Renal Disease, and reside in one of the 78 municipalities of Puerto Rico. You must continue to pay your Medicare Part B premium. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. The benefits, formulary, pharmacy network, premium and/or copayment/coinsurance may change January 1st, 2013. Premiums,
copayments, coinsurance and deductibles may vary based on the level of help received. Limitations, copayment, and restrictions may apply. For more information contact the plan.
* Certain restrictions may apply.

H7554 _4006_12_05_E CMS Approved 01102012

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