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Retiree Health Benefits Program

This guide provides essential information on Medicare Part D and how it integrates with your state's retiree health benefits program. Learn about the enrollment periods, premium costs, drug formularies, and options available to you. Discover the value of lower premiums and flexibility under the enhanced Medicare Part D benefit and the steps you need to take for enrollment. Make informed decisions regarding your coverage, whether to stay in your current plan or switch to a medical-only option, all while ensuring you receive the best care and support.

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Retiree Health Benefits Program

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Presentation Transcript

  1. Retiree Health Benefits Program Medicare Part D and Your State Benefits Your Benefits Choices

  2. The good news! Basic Medicare Part D Your choices under the Retiree Health Benefits Program Actions you need to take and when We Will Look At…

  3. The Good News • State program’s new prescription drug option applies the value of Medicare Part D • Lower premiums and more flexibility

  4. Basic Medicare Part D • Passed Congress in 2003 and takes effect on Jan. 1, 2006 • Provided by Medicare-approved Prescription Drug Plans (PDPs) • Enrollment period is November 15, 2005 – May 15, 2006 • You enroll in a PDP, can switch each year

  5. Basic Medicare Part D • Coverage includes a formulary, or list of drugs covered by the plan • Some drug categories are not covered, for example • Drugs for symptomatic relief of cough and colds • Drugs used for cosmetic purposes • Drugs for weight loss or weight gain • Barbiturates

  6. Basic Medicare Part D National Average Estimated Monthly Premium = $32.20 Adjusted Each Year for Inflation

  7. The State Program and You This Means…. • Lower premiums and more flexibility!

  8. Retiree Health Benefits Program State Enhanced Medicare Part D Benefit • Incorporates Part D value into state program • Enhances Part D benefit

  9. Retiree Health Benefits Program State Enhanced Medicare Part D Benefit • Broad formulary includes generic, preferred brand and non-preferred brand drugs • Low copayments for generic and preferred brand drugs • Protection through the“donut hole” ($2,250 - $5,100) in Basic Part D

  10. Retiree Health Benefits Program State Enhanced Medicare Part D Benefit • Administered by Medco Health Solutions, Inc. • Medco national prescription drug network • No deductible for generic drugs • Drug tiers based on type and cost

  11. Retiree Health Benefits Program State Enhanced Medicare Part D Benefit

  12. Retiree Health Benefits Program • State Plans with Enhanced Medicare Part D BenefitStarting January 1 • Advantage 65 • Advantage 65 + Dental/Vision • Option I • Option II • Option II + Dental/Vision • Same medical coverage as today • New enhanced Part D coverage

  13. Retiree Health Benefits Program • New Medical-Only Plans Starting January 1 • Advantage 65 Medical-Only • Advantage 65 Medical-Only Plus Dental/Vision • Include same medical (and dental/vision) benefits as today • No prescription drug coverage

  14. Retiree Health Benefits Program Total Premiums *No new enrollees

  15. Retiree Health Benefits Program State Enhanced Medicare Part D Benefit Vs. Other Drug Plan Choices • Gather information • Compare costs • Check formularies • Convenience • Peace of Mind • Choose the plan that is best for you!

  16. Retiree Health Benefits Program What Do I Need to Do? • Review the notification materials carefully, then choose one: • Do nothing and remain in your current plan with the Enhanced Part D Drug Benefit • Select a state medical-only plan and re-enroll in a separate Part D plan (no return to state drug coverage in the future) • Cancel state program coverage • If you cancel state program coverage, you cannot return

  17. Retiree Health Benefits Program What Do I Need to Do? • Use the special enrollment form in your notification package to make a choice: • Enroll in a Medical-Only Plan • Cancel state program coverage • Switch from Option I, Option II to Advantage 65 plans • Take other permitted enrollment actions

  18. Retiree Health Benefits Program What Do I Need to Do? • Return form by November 30, 2005 • Provide Medicare Claim Number (if appropriate – see form) • If your form is not received by November 30, you default to your current plan with state Enhanced Medicare Part D

  19. Retiree Health Benefits Program Getting Assistance • State Medicare-coordinating prescription drug coverage • Medco: • 1-800-572-4098 • Medco Medicare Part D Plan quick link: www.dhrm.virginia.gov/hbenefits/retirees/medicareretiree.html

  20. Retiree Health Benefits Program Getting Assistance • Medicare Part D plans (not associated with the state program) • Medicare: • 1-800-Medicare • www.medicare.gov

  21. Medicare Part D and Your Benefits Thanks for listening! Now’s the time to ask questions Make the right choice for you!

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