Unicare's SecurityChoice^SM plan, a Private Fee For Service Plan, offers Medicare Beneficiaries an affordable way to avoid the "gaps" in their Medicare coverage.

With SecurityChoice, you pay just a $9 monthly plan premium* along with a low copayment for most office visits and other medical services you receive.

UNICARE's SecurityChoice Plan provides benefits for:

• Doctor Office Visits
• Inpatient Hospital Services
• Emergency Care Services
• Ambulance Services
• Durable Medical Equipment
• Diagnostic Tests, including X-rays and Laboratory Services
• Routine Physical Exams
• Vision Services
• Hearing Services

With SecurityChoice, as long as your health care practitioner is willing to accept the terms and conditions of the plan, you may receive services from any medical provider you choose who would otherwise be paid by Medicare**. You simply need to advise the provider, prior to receiving goods or services, that you are covered by the SecurityChoice Plan. You must show them your member identification card and give them a copy of the Provider Disclosure at the time of each visit. By doing this, the provider is agreeing to accept your plan coverage and they will be made aware of how to submit their billing and how they will receive reimbursement.

As long as you meet the following criteria, you are eligible to apply for the SecurityChoice plan:

• You must be entitled to Medicare Part A benefits and you continue to pay your Medicare Part B monthly premium
• Your permanent residence is within SecurityChoice's geographic service area
• You do not have kidney failure requiring dialysis or kidney transplantation (End-Stage Renal Disease)

* In addition to the monthly Medicare Part B premium.
** You may be responsible for excess charges (charges beyond the Medicare-approved amount) up to the amount allowed by law in your state, if you choose to receive care from a provider who does not accept Medicare Assignment. When choosing to receive services from a Rural Health Clinic, Community Health Clinic or Federally Qualified Health Clinic, you will be responsible for 20% coinsurance in lieu of the specified Plan copayment or coinsurance amount.

SecurityChoice is a Medicare Advantage Fee For Service Plan with a Medicare Contract. Unicare's contract with The Centers For Medicare and Medicaid Services is renewed annually and availability of coverage beyond the end of the contract year is not guaranteed. The benefits, premiums, copayments and service areas for SecurityChoice are subject to change annually upon contract renewal with the Medicare Program.

UNICARE is not connected with or endorsed by the U.S. Government or the federal Medicare program.  Medical coverage is provided by UNICARE Life & Health Insurance Company, a separately incorporated and capitalized subsidiary of WellPoint Health Networks Inc.

® registered mark and SM service mark of WellPoint Health Networks
2004 WellPoint Health Networks Inc.