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RETIREE MEDICARE ADVANTAGE PROGRAM
Frequently Asked Questions
November 2013

The following are some frequently asked questions and the answers that have been provided by Central Management Services. These may be helpful for you in understanding what is going on with the new Medicare Advantage program.

However, all information should be verified by knowledgeable sources such as:

--Central Management Services (CMS) TRAIL website,
--Medicare Advantage seminars put on by CMS,
--Group Insurance Representative (GIR) from the State Employee Retirement System,
--Insurance companies that are offering the new Medicare Advantage plans.

Who will be required to make a choice regarding being enrolled in the state’s new Medicare Advantage program? Only retirees who meet the following two conditions: 1) the retiree must be enrolled in Medicare Parts A and B; 2) all of a retiree’s dependents who are on the retiree’s insurance coverage must be enrolled in Medicare Parts A and B.

What conditions will allow a retiree or survivor to remain with their existing state health insurance policy? 1) if the retiree/survivor or any dependent on his/her insurance policy is not enrolled in Medicare Parts A and B; or 2) if the retiree/survivor does not live in the United States; or 3) if the retiree/survivor turns age 65 on or after October 1, 2013.

If I and my covered dependents are Medicare eligible, must I do anything to remain in the state’s healthcare program? Yes. You must choose which of the state’s four Medicare Advantage insurance plans you wish to use and then submit the appropriate enrollment form before December 13

If I am required to make a choice and fail to do that by December 13, 2013, what will happen? You will be dropped from your current health insurance plan, you will not be enrolled in the new Medicare Advantage program, and you will be dropped from the state’s life insurance program. You will continue to have coverage under original (regular) Medicare only.

When will the changes in health insurance be effective? February 1, 2014.

Is the choice I make during this enrollment process permanent? No. Each year, during October - December, the state will schedule an open enrollment period. During the open enrollment period, you may choose to be in either original (regular) Medicare or the state’s Medicare Advantage program. You may also change which Medicare Advantage insurance plan you wish to be enrolled in.

Will there be informational meetings to explain the new Medicare Advantage program and the choices to be made by retirees? Yes. Medicare Advantage seminars have been scheduled throughout the state starting November 11 and continuing through December 11. The schedule of meetings is available on the CMS TRAIL website.

When does the enrollment period for the Medicare Advantage program end?  December 13, 2013. Enrollment materials must be post-marked with a date on or before December 13, 2013.

Will the 1% annuity deduction that began July 1, 2013 continue to be deducted if someone chooses to enroll in the state’s Medicare Advantage program? Yes, this deduction will continue to be taken. It will increase to 2% starting July 1, 2014.

Will the Medicare premium payment currently paid by Medicare eligible retirees and their Medicare eligible dependents be required if someone chooses to enroll in the state’s Medicare Advantage program? Yes. This payment will be required no matter what choice is made – enroll in Medicare Advantage or opt out of the state’s healthcare program and remain in original (regular) Medicare.

Will medical providers provide services and accept payment from the state’s Medicare Advantage insurance plans? Medical providers who accept original (regular) Medicare are required to accept insurance coverage under the state’s Medicare advantage program.

Do the state’s Medicare Advantage insurance plans include prescription drug coverage? Yes. All four of the Medicare Advantage plans have prescription drugs coverage with no gap (i.e. donut hole) in the coverage.