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Retiree Health Benefits Program. Medicare Part D and Your State Benefits Your Benefits Choices. 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…. The Good News.
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Retiree Health Benefits Program Medicare Part D and Your State Benefits Your Benefits Choices
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…
The Good News • State program’s new prescription drug option applies the value of Medicare Part D • Lower premiums and more flexibility
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
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
Basic Medicare Part D National Average Estimated Monthly Premium = $32.20 Adjusted Each Year for Inflation
The State Program and You This Means…. • Lower premiums and more flexibility!
Retiree Health Benefits Program State Enhanced Medicare Part D Benefit • Incorporates Part D value into state program • Enhances Part D benefit
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
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
Retiree Health Benefits Program State Enhanced Medicare Part D Benefit
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
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
Retiree Health Benefits Program Total Premiums *No new enrollees
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!
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
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
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
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
Retiree Health Benefits Program Getting Assistance • Medicare Part D plans (not associated with the state program) • Medicare: • 1-800-Medicare • www.medicare.gov
Medicare Part D and Your Benefits Thanks for listening! Now’s the time to ask questions Make the right choice for you!