ends december 7, 2017 - iowa · medicare supplement a, b, c, f, k or l plans guaranteed issue...
TRANSCRIPT
Stateof
IowaRe
tirees
2018
Enrollm
enta
ndCh
ange
JimPierson
Employee
&Re
tiree
BenefitsS
pecialist
Departmen
tofA
dministrativeServices,H
uman
Resources
2018
Enrollm
ent&
Chan
gePe
riod 2
Opp
ortunityto
electo
rchangeyour
health
insuranceop
tions
oraddeligiblefamily
mem
bersto
your
dentalplan
End
s D
ecem
ber 7
, 201
7
Changese
ffectiveJan1,20
18
2018
Enrollm
ent&
Chan
gePe
riod 2
SusanPiel
Retiree
BenefitsS
pecialist
86689
524
Wha
twediscusstod
ay
•Overviewof
thene
whe
alth
plan
•Networks
•Plan
desig
n
•He
alth
prem
iumsb
eforeMed
icare
•He
alth
plansfor
Med
icareeligibleretirees
•He
alth
insuranceen
rollm
ent
•De
ntalinsurance
•Que
stions
andansw
ers
4
Overviewof
thene
wplan
In20
18,the
Statewillofferthe
retireesthe
followinghe
alth
plans.
5
RetireesN
OTeligibleforM
edicare
Retireese
ligibleforM
edicare
IowaCh
oice
IowaCh
oice
NationalCho
ice
NationalCho
ice
Grou
pProgram
FGrou
pProgram
N
Noprovisionfor
rejoiningtheState’s
health
orde
ntalplan
sif
youdrop
coverage
asa
retiree!
Exception:
Ifyoucontinue
coverage
onyour
spou
se’sStateof
Iowa
health
and/or
dentalcoverage,you
canrejoinretiree
coverage
whenspou
seterm
inates
employment.
6
Overviewof
thene
wplan
For2
018,theStateof
Iowaisofferin
gon
ehe
alth
plan
•One
health
plan
with
twoop
tions
•IowaCh
oice
•NationalCho
ice
•Plan
design
isiden
tical
•Theon
lydiffe
rencebe
tweenthetw
oop
tions
arethene
tworks
•He
alth
care
services
coveredtoda
ywillcontinue
tobe
coveredne
xtyear
•Thecostshaream
ountsfor
services
may
diffe
r
7
Networks
IowaCh
oice
uses
Wellm
ark’sB
lueAc
cess
netw
ork
•Co
verscare
inIowaandincoun
tiessharin
gabo
rder
with
Iowa
•10
0pe
rcento
fIow
aho
spita
lsand96
percento
fIow
ado
ctors
•Limite
dprovidersinthesurrou
ndingcoun
ties
•Out
ofne
tworkcoverage
isno
tavailableexcept
inthecaseso
f•
Emergencies
•Accide
ntalinjurie
s•
Ifservices
areno
tavailablein
netw
orkandan
outof
netw
ork
referralhasb
eensubm
itted
andapproved
byWellm
arkin
advanceof
theservice
8
Networks
Nationa
lCho
iceuses
Wellm
ark’sA
llian
ceSelectne
twork
•Givesy
outhefreedo
mto
geth
ealth
care
from
anyprovider
locatedin
theUnitedStates
•InIowa,in
netw
orkcare
canbe
received
at10
0pe
rcento
fhospitalsand
with
99pe
rcento
fdoctors
•Outsid
ethestate,accessto
96pe
rcento
fhospitalsand93
percento
fdo
ctors
•See
anyprovider
youchoo
se•S
eeaprovider
who
participates
inWellm
ark’sA
lliance
Selectne
twork,
youwillhave
lower
outof
expe
nses
9
Networks
IowaCh
oice
andNationa
lCho
icene
tworks
arediffe
rent
•Search
forp
rovide
rsusingtheFind
ADo
ctor
linkat
www.wellm
ark.com
•Ch
oose
Blue
Accessto
findaprovider
orfacilityintheIowa
Choice
netw
ork
•Ch
oose
Allia
nceSelectto
findaprovider
orfacilityinthe
Nationa
lCho
icene
twork
10
Networks
Which
optio
nwillletm
ego
toMayoun
derthe
newplan
?•Nationa
lCho
icecoversmanyof
theprovidersa
ndclinicsthata
repartof
MayoClinicHe
alth
System
•IowaCh
oice
does
nota
llowforo
utof
statebe
nefitse
xcep
tin
emergencysituatio
nsor
with
anapproved
outof
netw
orkreferral 11
Networks
IowaCh
oice
andGu
estM
embe
rship
•Out
ofne
tworkcoverage
isno
tavailableexcept
inthecaseso
f–Em
ergencies
–Accide
ntalinjurie
s–Wellm
arkapproved
outof
netw
orkservice
•Youcangeta
GuestM
embe
rshipthroughWellm
ark
12
Networks
GuestM
embe
rship
•Ifyouaregoingto
beou
tofthe
servicearea
fora
tleast90
consecutivedays
•Gu
estM
embe
rshipallowsy
ouaccessforcovered
services
atBlue
Crossa
ndBlue
Shieldhe
alth
care
providersthrou
ghou
tthe
U.S.
•OnlyavailableintheU.S.
•Be
nefitso
nlyforthe
statewhe
reyouresid
es
•Prem
iumsrem
ainthesame
•Co
stsharingremains
thesame
•Fora
guestm
embe
rship
contactW
ellm
arkcustom
erservice80
062
200
43
13
Wha
twediscusstod
ay
•Overviewof
thene
whe
alth
plan
•Networks
•Plan
desig
n
•He
alth
prem
iumsb
eforeMed
icare
•He
alth
plansfor
Med
icareeligibleretirees
•He
alth
insuranceen
rollm
ent
•De
ntalinsurance
•Que
stions
andansw
ers
14
Plan
Design
•Thebe
nefit
desig
nof
both
netw
orkop
tions
isidentical
•Allofthe
health
care
services
coveredtodaywillcontinue
tobe
coverednextyear
•Co
stshaream
ountsy
oupayforservicesm
aydiffe
r
15
Health
Insurance 16
Prim
aryCa
reProviders(PC
P)$1
5copay
•Family
practitione
r•
Gene
ralpractition
er•
Internalmed
icinepractitione
r•
Obstetrician/Gy
necologist
•Pediatrician
•Ad
vanced
registered
nursepractitione
r(AR
NP)
•Ph
ysicianassistant
(PA)
Specialists$3
0copay
•Allother
providersa
reconsidered
nonprim
arycare
providerso
rspe
cialists.
Exam
ples
oftheseinclud
ecardiologists,de
rmatologists,andorthop
edists.
Other
Providers$
15copay
•Ch
iropractor
•Ph
ysicalTherapist
•Occup
ationalThe
rapist
•Speech
Therapist
Office
Visit
IowaCh
oice/N
ationa
lCho
ice
Health
Insurance 17
IowaCh
oice/N
ationa
lCho
ice
Dedu
ctible
•Single
•Family
$250
$500
4thQDe
ductibleCa
rryOver
Dedu
ctiblefrom
theprevious
4th
quarterw
illcarryover
tothenext
bene
fitpe
riodde
ductible
Services
with
copays
areNOT
subjecttothede
ductible
Plan
Design
18
IowaCh
oice/N
ationa
lCho
ice
Coinsurance
IowaCh
oice
10%
NationalCho
ice
10%
20%
(Out
ofne
twork)
Out
ofPo
cket
Maxim
um•
Single
•Family
(Sep
arateou
tof
forp
rescrip
tiondrugs)
$1,000
$2,000
Lifetim
eMaxim
umNolifetim
emaxim
umexcept
$25,000forinfertility
HospiceRe
spite
15Da
ysInpatie
nt15
Days
Outpatie
nt
Plan
Design
19
NEW
Health
Bene
fit:Telem
ed(Doctorson
Deman
d)•Be
ginn
ingJanu
ary1,20
18,virtualvisitsthrough
Doctor
OnDe
mand
•Visit
ado
ctor
onasm
artpho
neor
tablet
from
almost
anyw
here
•Re
ceivetreatm
entfor
themostcom
mon
med
ical
cond
ition
sand
prescribed
med
ications,ifn
eede
d•$1
0copaype
rvisit
Plan
Design
IowaCh
oice
Nationa
lCho
ice
BehavioralHe
alth
Office
Visit
$15copay
EyeExam
(One
routineeyeexam
percalen
daryear)
$30copay
HearingExam
(One
routinehe
aringexam
percalen
daryear)
$30copay
20
Plan
Design
21
IowaCh
oice/N
ationa
lCho
ice
UrgentC
areCe
nter
$15copay
EmergencyRo
om$1
00Co
pay(W
aivedifadmitted
)
Inpatie
ntHo
spita
lServices
IowaCh
oice
10%after
dedu
ctible
NationalCho
ice
Network10
%after
dedu
ctible
Non
netw
ork20
%afterd
eductib
le
Outpatie
ntTherapy
Services
(Che
mothe
rapy
PhysicalTherapy
Occup
ationalThe
rapy
Respira
tory
Therapy
Speech
Therapy)
IowaCh
oice
10%after
dedu
ctible
NationalCho
ice:
Network10
%after
dedu
ctible
Non
netw
ork20
%afterd
eductib
le
Plan
Design
22
Pharmacy
IowaCh
oice/N
ationa
lCho
ice
Retail
•Ge
neric
•PreferredBrand
•Non
PreferredBrand
•Specialty
30Da
ySupp
ly$1
0copay
$25copay
$50copay
$100
copay
MailO
rder
•Ge
neric
•PreferredBrand
•Non
PreferredBrand
90Da
ySupp
ly$2
0copay
$50copay
$100
copay
Out
ofPo
cket
Maxim
um•Single
•Family
$5,850
$11,700
Specialty
Drugs
•Specialty
drugsa
represcriptio
nmed
ications
that
requ
irespecialhandling,administratio
nor
mon
itorin
g•
Thesedrugsa
reused
totreatcom
plex,chron
icandoftencostly
cond
ition
s,such
asmultip
lesclerosis,rhe
umatoidarthritis,
hepatitisCandhe
mop
hilia
•Unsurewhe
ther
aprescriptio
nfalls
into
the“spe
cialtydrug
”category
1.Go
toWellm
ark.com.
2.Clickon
theIndividu
als&Families
tab.
3.SelectMyEm
ployer
Provides
MyInsurance.
4.SelectPrescriptio
nDrug
Inform
ationandthen
Wellm
arkDrug
List.
5.SelectBlue
RXCo
mplete.
6.Search
thedrug
byname.
23
Additio
nalresou
rces 24
•Re
view
2018
Retiree
Enrollm
enta
ndCh
ange
web
page
https://das.iowa.gov/hu
man
resources/em
ployee
and
retiree
bene
fits/20
18retiree
enrollm
entandchange
perio
d
•CallWellm
arkCu
stom
erServiceat
800.622.0043
or888.781.4262
(TTY)
•Send
anem
ailtostateretire
Wha
twediscusstod
ay
•Overviewof
thene
whe
alth
plan
•Networks
•Plan
desig
n
•He
alth
prem
iumsb
eforeMed
icare
•He
alth
plansfor
Med
icareeligibleretirees
•He
alth
insuranceen
rollm
ent
•De
ntalinsurance
•Que
stions
andansw
ers
25
2018
mon
thlyprem
iums 26
Single
Family
IowaCh
oice
$712
.00
$1,668
.00
NationalCho
ice
$765
.00
$1,791
.00
Health
prem
iumsfor
nonMed
icareeligibleretirees
Total
Prem
ium
SLIP
Contrib
ution
Retiree
Contrib
ution
IowaCh
oice
Single
$712
.00
$672
.00
$40.00
Family
$1,668
.00
$1,518
.00
$150
.00
NationalCho
ice
Single
$765
.00
$672
.00
$93.00
Family
$1,791
.00
$1,518
.00
$273
.00
Health
prem
iumsS
LIPretirees
2018
mon
thlyprem
iums
SLIP
Retireesfrom
anexecutivebran
chno
ncontract
positio
n
•TheHe
althyOpp
ortunitie
sWellnessP
rogram
andwith
itsassociated
financialprem
ium
incentives
willNOT
continue
in20
18
27
Wha
twediscusstod
ay
•Overviewof
thene
whe
alth
plan
•Networks
•Plan
desig
n
•He
alth
prem
iumsb
eforeMed
icare
•He
alth
plansfor
Med
icareeligibleretirees
•He
alth
insuranceen
rollm
ent
•De
ntalinsurance
•Que
stions
andansw
ers
28
Guaran
teed
issueMed
icareSupp
lemen
t 29
Stateretirees
•EnrolledinMed
icareand
–Blue
Access
–Blue
Advantage
–IowaSelect
–Program
3Plus
–De
ductible3Plus
•Qualifyfora
guaranteed
issue
right
topu
rchase
anindividu
alany
Med
icareSupp
lemen
tA,B,C,F,K
orLplans
Guaran
teed
issueMed
icareSupp
lemen
t 30
Stateretirees
Guaranteed
Issuerig
htmeans
that
theinsurancecompany:
•Mustsellyou
apo
licy
•Mustcover
preexistingcond
ition
s•
Cann
otcharge
youmorebe
causeof
pastor
presenth
ealth
prob
lems
Youhave
63days
from
thedayyour
coverage
ends
toapplyfora
Med
icareSupp
lemen
tpolicy
Toreceivethisguaranteed
issue
right
youmusta
pplyfora
policyby
March
4,20
18
Med
icareRe
source
Senior
Health
InsuranceInform
ationProgram
(SHIIP)
•SH
IIPisafree,con
fidentia
land
unbiased
serviceof
theState
ofIowathat
helpsIow
ansm
akeinform
edde
cisio
nsabou
tMed
icareandothe
rhealth
coverage
•SH
IIPhasc
ounselorsa
crossthe
statethat
areavailableto
meetw
ithyouon
eto
oneto
discuss
•Orig
inalMed
icare(PartsA&B)
•Med
icareSupp
lementP
lans
•Med
icareAd
vantage(M
edicarePartC)
•Med
icarePartD
•Co
ntact SHIIPat:
180
035146
64or
http://the
rightcalliow
a.gov
31
RETIRE
EMED
ICAR
ESO
LUTIONS
JUDY
DET
RICK
Team
Lead
er –
Sale
s/Se
rvice
S574
3_03
0717_
GB02
_IA_S
D In
tern
al Ap
prov
al 03
/07/
2017
Con
fiden
tial a
nd P
ropr
ieta
ry –
Wel
lmar
k B
lue
Cro
ss a
nd B
lue
Shie
ld33
LET’S
TALK
ABO
UT
MED
ICAR
ELE
T’S TA
LK A
BOUT
MED
ICAR
E
FILL
ING
THE
GAP
ADDI
TION
AL B
ENEF
ITS
AND
COVE
RAGE
WHA
T’S N
EXT?
Orig
inalMed
icare
Confiden
tialand
Prop
rietary
–Wellm
arkBlue
Crossa
ndBlue
Shield
34
PPart
A —
hosp
ital
cove
rage
•In
patie
nt h
ospi
tal
care
•Sk
illed
nur
sing
faci
lity
care
•H
ospi
cePa
rt B
—m
edic
al
cove
rage
•O
utpa
tient
car
e an
d se
rvic
e•
Dur
able
med
ical
eq
uipm
ent
•Pr
even
tive
care
Not
cov
ered
:•
Ded
uctib
les,
coin
sura
nce,
and
cop
ays
•M
ost o
utpa
tient
pr
escr
iptio
n dr
ugs
•Ca
re b
eyon
d M
edic
are’
s lim
its•
Mos
t car
e re
ceiv
ed
outs
ide
the
U.S
.•
Char
ges
exce
edin
g M
edic
are
appr
oved
am
ount
sTh
ere’
s a
gap.
Con
fiden
tial a
nd P
ropr
ieta
ry –
Wel
lmar
k B
lue
Cro
ss a
nd B
lue
Shie
ld35
FILL
ING
THE
GAP
LET’S
TALK
ABO
UT M
EDIC
ARE
FILL
ING
THE
GAP
ADDI
TION
AL B
ENEF
ITS
AND
COVE
RAGE
WHA
T’S N
EXT?
Med
icaresupp
lemen
t
•Individu
alplans
•Med
icaresupp
lemen
tplans
may
also
becalledMed
igap
plans
•Mustb
een
rolledinMed
icarePartAandPartB
•Offe
redby
privateinsurancecompanies,not
thegovernmen
t
Confiden
tialand
Prop
rietary
–Wellm
arkBlue
Crossa
ndBlue
Shield
36
Wellm
ark’sM
edicareSupp
lemen
tPlans
Confiden
tialand
Prop
rietary
–Wellm
arkBlue
Crossa
ndBlue
Shield
37
Plan
APl
an D
Plan
FPl
an F
-H
DPl
an G
Plan
N
Basi
c be
nefit
s
Skill
ed n
ursi
ng fa
cilit
y co
insu
ranc
e
Part
A d
educ
tible
Part
B d
educ
tible
Part
B e
xces
s
Fore
ign
trav
el
Wellm
ark’sM
edicareSupp
lemen
tPlanPR
emiums
Confiden
tialand
Prop
rietary
–Wellm
arkBlue
Crossa
ndBlue
Shield
38
Plan
FPreferredNon
toba
ccoRa
tes
Age
Male
Female
Age
Malewith
Standard
PartD
Femalewith
Standard
PartD
Age
Malewith
Prem
ier
PartD
Femalewith
Prem
ier
PartD
<65
$255.50
$225.90
<65
$292.90
$263.30
<65
$356.10
$326.50
65$142.10
$125.70
65$179.50
$163.10
65$242.70
$226.30
66$146.70
$129.60
66$184.10
$167.00
66$247.30
$230.20
67$151.30
$133.80
67$188.70
$171.20
67$251.90
$234.40
68$155.90
$137.80
68$193.30
$175.20
68$256.50
$238.40
69$160.80
$142.20
69$198.20
$179.60
69$261.40
$242.80
70$165.30
$146.10
70$202.70
$183.50
70$265.90
$246.70
71$179.40
$158.60
71$216.80
$196.00
71$280.00
$259.20
72$184.80
$163.30
72$222.20
$200.70
72$285.40
$263.90
73$190.20
$168.10
73$227.60
$205.50
73$290.80
$268.70
74$196.00
$173.30
74$233.40
$210.70
74$296.60
$273.90
75$201.80
$178.50
75$239.20
$215.90
75$302.40
$279.10
76$211.50
$187.10
76$248.90
$224.50
76$312.10
$287.70
77$222.10
$196.40
77$259.50
$233.80
77$322.70
$297.00
78$233.90
$206.80
78$271.30
$244.20
78$334.50
$307.40
79$245.30
$216.90
79$282.70
$254.30
79$345.90
$317.50
80$257.70
$227.90
80$295.10
$265.30
80$358.30
$328.50
81+
$284.70
$251.70
81+
$322.10
$289.10
81+
$385.30
$352.30
Wellm
ark’sM
edicareSupp
lemen
tPlanPR
emiums
Confiden
tialand
Prop
rietary
–Wellm
arkBlue
Crossa
ndBlue
Shield
39
Plan
GPreferredNon
tobaccoRa
tes
Age
Male
Female
AgeMalewith
Standard
PartD
Femalewith
Standard
PartD
Age
Malewith
Prem
ier
PartD
Femalewith
Prem
ier
PartD
<65
$223.70
$197.80
<65
$261.10
$235.20
<65
$324.30
$298.40
65$124.50
$110.10
65$161.90
$147.50
65$225.10
$210.70
66$128.40
$113.50
66$165.80
$150.90
66$229.00
$214.10
67$132.50
$117.20
67$169.90
$154.60
67$233.10
$217.80
68$136.60
$120.70
68$174.00
$158.10
68$237.20
$221.30
69$140.80
$124.60
69$178.20
$162.00
69$241.40
$225.20
70$144.80
$128.00
70$182.20
$165.40
70$245.40
$228.60
71$157.10
$138.90
71$194.50
$176.30
71$257.70
$239.50
72$161.80
$143.00
72$199.20
$180.40
72$262.40
$243.60
73$166.50
$147.30
73$203.90
$184.70
73$267.10
$247.90
74$171.60
$151.80
74$209.00
$189.20
74$272.20
$252.40
75$176.70
$156.30
75$214.10
$193.70
75$277.30
$256.90
76$185.20
$163.90
76$222.60
$201.30
76$285.80
$264.50
77$194.50
$172.00
77$231.90
$209.40
77$295.10
$272.60
78$204.80
$181.10
78$242.20
$218.50
78$305.40
$281.70
79$214.80
$190.00
79$252.20
$227.40
79$315.40
$290.60
80$225.70
$199.60
80$263.10
$237.00
80$326.30
$300.20
81+
$249.30
$220.40
81+
$286.70
$257.80
81+
$349.90
$321.00
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ark’sM
edicareSupp
lemen
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Confiden
tialand
Prop
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Crossa
ndBlue
Shield
40
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NPreferredNon
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Female
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$82.60
65$130.70
$120.00
65$193.90
$183.20
66$96.30
$85.20
66$133.70
$122.60
66$196.90
$185.80
67$99.30
$87.80
67$136.70
$125.20
67$199.90
$188.40
68$102.30
$90.50
68$139.70
$127.90
68$202.90
$191.10
69$105.60
$93.40
69$143.00
$130.80
69$206.20
$194.00
70$108.50
$95.90
70$145.90
$133.30
70$209.10
$196.50
71$117.80
$104.10
71$155.20
$141.50
71$218.40
$204.70
72$121.30
$107.20
72$158.70
$144.60
72$221.90
$207.80
73$124.90
$110.40
73$162.30
$147.80
73$225.50
$211.00
74$128.70
$113.80
74$166.10
$151.20
74$229.30
$214.40
75$132.60
$117.20
75$170.00
$154.60
75$233.20
$217.80
76$139.00
$122.80
76$176.40
$160.20
76$239.60
$223.40
77$145.80
$129.00
77$183.20
$166.40
77$246.40
$229.60
78$153.50
$135.80
78$190.90
$173.20
78$254.10
$236.40
79$161.20
$142.40
79$198.60
$179.80
79$261.80
$243.00
80$169.20
$149.70
80$206.60
$187.10
80$269.80
$250.30
81+
$187.00
$165.30
81+
$224.40
$202.70
81+
$287.60
$265.90
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icareSupp
lemen
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tMore
Confiden
tialand
Prop
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Crossa
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Shield
41
Disc
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s on h
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visio
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Optio
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nDrug
Coverage
Confiden
tialand
Prop
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–Wellm
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Crossa
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Shield
42
•M
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Shield
43
•Aw
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LevelCom
parison
Confiden
tialand
Prop
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Crossa
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Shield
44
Med
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det
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Med
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and-
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alap
proval
47
Plan
details
Inne
tworkmem
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Blue
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Mon
thlyprem
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$20.97
$32.52
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Maxim
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$1,000
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$150
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$200
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/Hearin
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Confiden
tialand
Prop
rietary
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arkBlue
Crossa
ndBlue
Shield
–Pe
ndingfin
alap
proval
48
Plan
details
Silver
Vision
&He
aring100
Silver
Vision
&He
aring130
Mon
thlyprem
ium
$9.78
$15.90
Diagno
stic
services:$
10copay
Eyeexam
Coveredinfullafter$
10copay,
every12
mon
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Coveredinfullafter$
10copay,
every12
mon
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Eyew
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prod
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Fram
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mon
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after$
25materialscopay;$100
retailallowance.
Coveredon
ceevery24
mon
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after$
10materialscopay;$130
retailallowance.
Standard
plastic
lenses
One
paircoveredinfullafter
$25materialscopay,every12
mon
ths.
One
paircoveredinfullafter
$10materialscopay,every12
mon
ths.
Contactlen
ses
Coveredup
to$110
retail
allowance,every
12mon
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lieuof
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Coveredup
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Lens
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20%offp
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tandUVprotectivecoating.
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Compreh
ensiv
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mon
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Hearingde
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s,mainten
ance
plan
•One
year
offollow
upcare
•Tw
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ffreebatteries
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warranty
•Lossanddamageprotectio
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pere
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discou
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•One
year
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•Tw
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(160
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warranty
•Lossanddamageprotectio
n
Con
fiden
tial a
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ropr
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Wel
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EXT?
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Confiden
tialand
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rietary
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Crossa
ndBlue
Shield
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Disclaim
erInform
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Wellm
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Blue
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Confiden
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Shield
51
Wellm
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and B
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hield
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priet
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Wellm
arkB
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and B
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THAN
K YO
U
Health
InsuranceafterM
edicare 53
2018
Med
icareeligibleretiree
health
plans
•Iow
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Health
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Med
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Health
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Single
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Fan
dN
Advantages
oftheGrou
pProgram
FandNvs.
Individu
alMed
icareSupp
lementP
lan
•Ab
ilityto
moveback
totheregularS
tate
ofIowaplansthata
reoffereddu
ringthenexten
rollm
enta
ndchange
perio
d
•NoAg
eor
Gend
erRe
latedPrem
iums
•NoHe
alth
Que
stions
61
Grou
pProgram
Fan
dN
Bene
fits
FPays
NPays
Med
icarePartAcoinsuranceandho
spita
lcosts
100%
100%
PartBde
ductible
100%
0%Med
icarePartBcoinsuranceor
copaym
ent
100%
100%
*Foreigntravelem
ergency(upto
plan
limits)
80%
80%
Comparison
ofStateof
IowaGrou
pProgramsF
andN
*Group
Program
Npays
100pe
rcen
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ento
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eofficevisitsandup
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tresultin
ginan
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ntadmission
62
Grou
pFan
dNPlan
•Grou
pProgramsF
andNareon
lyavailableas
asin
glecontract
•Youandyour
Med
icareeligiblespou
seeach
have
asin
gleGrou
pPlan
contract
Youmay
findthesamesupp
lementalcoverag
eprovided
atamoreaffordab
lerate
Mon
thlyPrem
ium
SingleCo
ntract
Grou
pProgram
FSingleCo
ntract
$260.10
Grou
pProgram
NSingleCo
ntract
$171.40
63
Grou
pMed
icareBlue
Rx(PDP
)
•TwoGrou
pMed
icareB
lueRx
planstochoo
sethat
coordinate
with
your
Grou
pNPlan
•Grou
pMed
icareB
lueRx
(Basic)
•Grou
pMed
icareB
lueRx
(Plus)
•Group
Med
icareB
lueRx
isrequ
iredwith
theGrou
pProgram
FandNPlan
•Group
Med
icareB
lueRx
isno
tavailableby
itself
64
Grou
pMed
icareBlue
Rx(PDP
)Ba
sic
Plus
Tier
1:Co
veredGe
neric
Drugs
$10copay
$10copay
Tier
2:Co
veredPreferredBrandDrugs
$30copay
$25copay
Tier
3:Co
veredNon
PreferredBrandDrugs
$50copay
$40copay
CoveredSpecialty
Tier
Drugs
$50copay
25%coinsurance
Mon
thlyPrem
ium
$100
.20
$148
.60
HowaretheBa
sicandPlus
plansd
ifferent?
•Theam
ount
ofcoverage
whileinthecoverage
gap
65
•Mailorder
isalso
available
Grou
pMed
icareBlue
Rx(PDP
) 66
Grou
pMed
icareBlue
Rx(PDP
)
•Not
everyone
willenterthe
coverage
gapbe
causetheird
rug
costsw
on’tbe
high
enou
gh
•With
IowaCh
oice
orNationalCho
iceandGrou
pMed
icareB
lue
Rx,you
dono
texperienceacoverage
gap
•Grou
pMed
icareB
lueRx
andIowaCh
oice
/NationalCho
ice
coordinatesc
overagewhileyouareinthecoverage
gapso
your
copays
remainthesame
67
Grou
pMed
icareBlue
Rx(PDP
)Grou
pMed
icareB
lueRx
Form
ulary
Howmuchyoupayforp
rescrip
tiondrugsd
epen
dson
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sby
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ontheform
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arkform
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ecktheGrou
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icareB
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ourd
rugs
68
Grou
pMed
icareBlue
Rx(PDP
)
Moreinform
ationab
outG
roup
Med
icareB
lueRx
•CallMed
icareB
lueRx
Custom
erService
187
78383827
8:00
a.m.to8:00
p.m.,daily,CentralTime
69
Health
InsuranceafterM
edicare
2018
Prem
iums
Basic
Plus
Grou
pProgram
N$171.40
$171.40
Med
icareB
lueRx
$100.20
$148.60
Total
$271.60
$320.00
Basic
Plus
Grou
pProgram
F$260.10
$260.10
Med
icareB
lueRx
$100.20
$148.60
Total
$360.30
$408.70
70
Wha
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prem
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71
Health
insuranceen
rollm
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AutomaticEn
rollm
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Ifyoudo
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rollm
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perio
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rolledinaplan:
•Cu
rren
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automaticallyen
rolledinIowaCh
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•Cu
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willbe
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rolledinNationalCho
ice
•Cu
rren
tlyen
rolledinGrou
pProgram
For
Grou
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N,you
will
automaticallyremaininyour
curren
tplan.
72
Health
insuranceen
rollm
ent 73
Ifyouwan
ttoen
rollinon
eof
the2018
retiree
insuranceop
tions
Ifyouareen
rolled
inon
eof
the2017
health
plan
sIowaCh
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lCho
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Grou
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FGrou
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N
Blue
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Completeane
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Completeane
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Completeane
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Completeane
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Noap
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need
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mpleteane
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Completeane
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IowaSelect
Completeane
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Noap
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need
edCo
mpleteane
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Completeane
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Program
3Plus
Completeane
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Noap
plication
need
edCo
mpleteane
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Completeane
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Grou
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FCo
mpleteane
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Completeane
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Noap
plication
need
edCo
mpleteane
wapplication
Grou
pProgram
NCo
mpleteane
wapplication
Completeane
wapplication
Completeane
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Noap
plication
need
ed
Health
insuranceen
rollm
ent
Whe
reto
send
your
applications
and/or
form
s
•Retire
dfrom
anExecutiveBranch
agen
cy(excluding
theDe
partmen
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Transportatio
n),the
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dministrativeServices
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partmento
fTranspo
rtation,Co
mmun
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sed
Correctio
ns,orthe
IowaStateFairAu
thority,sen
dyour
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your
previous
employer
•For
Grou
pProgram
For
Grou
pProgram
Nen
rollm
ento
rchanges,sen
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applicationto
theDe
partmento
fAdm
inistrativeServices
74
Wha
twediscusstod
ay
•Overviewof
thene
wplan
•Networks
•Plan
desig
n
•He
alth
prem
iumsb
eforeMed
icareeligibleretirees
•He
alth
plansfor
Med
icareeligibleretirees
•He
alth
insuranceen
rollm
ent
•De
ntalinsurance
•Que
stions
andansw
ers
75
Dentalinsurance 76
•Ope
nDe
ntalEnrollm
ent
•Cu
rren
tmem
bersmay
addeligiblefamily
mem
bersto
theire
xisting
dentalpo
licy
2018
Mon
thly
Prem
iums
Single
Family
Delta
Dental
$29.55
$79.43
•Ca
ncontinue
dentalwith
outh
ealth
insurance
Wha
twediscusstod
ay
•Overviewof
thene
wplan
•Networks
•Plan
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icareeligibleretirees
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alth
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Med
icareeligibleretirees
•He
alth
insuranceen
rollm
ent
•De
ntalinsurance
•Que
stions
andansw
ers
7778
79