AlaskaCare Retiree Health News | Monthly e-newsletter | November 2018

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AlaskaCare Retiree Health News

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Volume 5 | November 2018

In This Issue

The Division of Retirement and Benefits sends monthly e-newsletters to provide you with accurate, timely information about your AlaskaCare retiree health benefits. You can expect to receive an e-newsletter each month, and the Division may also send out timely information and updates through this email list. If you prefer not to receive these email updates, you can unsubscribe at any time. Either way, you will continue to receive the HealthMatters newsletter in the mail, as well as your important health plan information.

Draft AlaskaCare Retiree Health Plan Booklets Available for Review: Public Comment Accepted Through December 3, 2018

The January 1, 2019 DRAFT Retiree Health Insurance Information Booklet and DRAFT DCR Benefit Plan Booklet are available for review!

These drafts include important changes that take effect on January 1, 2019, including:

  • Information about pharmacy benefits have changed to reflect implementation of an enhanced Employer Group Waiver Plan (EGWP) for Medicare-eligible retirees and Medicare-eligible dependents.

The AlaskaCare enhanced EGWP is a Medicare Part D group pharmacy plan and represents an administrative change to how the health plan receives federal subsidies for Medicare-eligible retirees and dependents. Read more about the enhanced EGWP on the AlaskaCare website.

  • The booklets are updated to reflect the change from Aetna/CVS Caremark to OptumRx as the pharmacy benefit manager (PBM).
  • AlaskaCare is expanding habilitative services for pervasive developmental delays such as Autism Spectrum Disorder (ASD). Habilitative services can include occupational therapy, speech therapy and other services, including early intensive behavioral interventions such as applied behavioral analysis for treatment of ASD. Applied behavioral analysis will require precertification. Not all habilitative services are covered. Those services provided in an educational or training setting, to teach sign language, or vocational rehabilitation or employment counseling continue to be excluded under the plan.

We want to know what you think!

Your feedback is important to us. The draft booklets are available on

The booklets are available for review and public comment through December 3, 2018. Please submit comments on the draft documents by email to:

Reminder: 2019 Transition of Pharmacy Benefits, OptumRx Concierge Service Open


Beginning January 1, 2019, OptumRx will become the Pharmacy Benefits Manager (PBM) for all AlaskaCare plans. Aetna, with their subcontractor CVS/Caremark, is currently the PBM for AlaskaCare and will continue managing the health plans’ medical benefits in 2019.

AlaskaCare members received information about this transition in the Fall 2018 HealthMatters newsletter, mailed in October. Members will receive a welcome kit from OptumRx this month with everything you need to know about your pharmacy plan and a new ID card.

As we shared in last month’s newsletter, we know you will have questions about this transition and may need to take action regarding your current prescriptions. As of November 12, the OptumRx concierge service is available to help with your individual account needs with access to member-specific information. They are here to help make sure you are ready for the transition on January 1, 2019. You can reach OptumRx Member Services at (855) 409-6999. Representatives are available from 8 a.m. to 8 p.m. Alaska time until December 31, 2018. After January 1, 2019, OptumRx member services will be open 24 hours a day, 7 days a week.

An electronic version of the HealthMatters newsletter, including the current issue and past issues, is posted on the AlaskaCare website for your convenience. 

Next Tele-Town Hall: Thursday, December 20 at 10 a.m.

The Division hosts monthly Tele-Town Hall Meetings for all interested AlaskaCare retirees to ask questions about their health plan. This format gives retirees a chance to connect directly with Division staff, ask questions and learn more about the plan. So far, we have hosted four events in 2018 and overall the participants have found the format easy to use and the information very helpful.

Tele-Town Halls are usually scheduled for the third Thursday of the month at 10 a.m. Alaska time. Registration information is available on the AlaskaCare website approximately one week before each event. Please register to ensure we have your correct phone number, as we automatically call all registered participants when the event starts!

If you missed an event and want to catch up on the discussion, you can access recordings of all past Tele-Town Hall events on the AlaskaCare website

We Want to Hear from You! Join the Conversation Thursday, December 20

Hosted by the Alaska Department of Administration, Division of Retirement and Benefits for all interested AlaskaCare retirees and families.
Thursday, December 20, 2018 | 10 to 11 a.m. AKST (1 hour)

Join the call to learn more about your health plan and ask Division staff any questions you have about your benefits.

If you haven’t participated in a Tele-Town Hall before, here’s how it works: Registered AlaskaCare retirees will automatically receive a phone call that will connect to a shared line when the event starts. If you would like to participate, just answer that call and stay on the line! Division staff will give a brief introduction and an update, then the rest of the event will be dedicated to answering your questions. We will answer as many questions as we can during the call.

Still have questions?

You can read more about EGWP and the 2019 pharmacy benefits transition on the AlaskaCare website. If you have other questions about your benefits or cannot find the information you are seeking online, you can also contact the Division at (907) 465-4460 or by email at

News from the Retiree Health Plan Advisory Board

The Retiree Health Plan Advisory Board (RHPAB) is tasked with facilitating engagement and communication among the Commissioner of Administration, the Division of Retirement and Benefits, and the community of AlaskaCare retirees. The seven-member board meets four times per year.

Next Quarterly Board Meeting: Wednesday, November 28

The next full board meeting is scheduled for Wednesday, November 28, from 9 a.m. to 4 p.m., with locations in Juneau and Anchorage. Teleconference will be provided as well. The agenda will include continued discussion of the Retiree Health Plan Modernization Project, building  on the work of the board’s modernization committee at the September 28 and October 30 meetings.

Members of the public are always welcome to attend and observe the meeting or listen in via phone. Each RHPAB board meeting includes time on the agenda for public comment, and written comments may be submitted to the board at If you want to be sure that your comments are included in the agenda packet for the next quarterly board meeting, please submit them at least thirty days in advance of the next scheduled meeting. Please see the RHPAB public comment guidelines for more information and what to expect in a board meeting.

For more information regarding RHPAB and upcoming meetings, including meeting locations, teleconference information, and meeting materials, please click here.

Keyword of the Month: Prior Authorization

The world of health care is complex and uses a lot of jargon. You don’t need to be a health care specialist to get the most out of your benefits, but knowing some of the technical terms makes it a little less mysterious. This month’s keyword is Prior Authorization.

Prior Authorization is a determination made by your health plan, through the pharmacy benefit manager, about whether a prescribed medication is medically necessary and whether it will be likely covered under your pharmacy plan. Although similar, this is different from the “precertification” process that applies to medical plan benefits. In addition, prior authorization may be required for safety reasons, such as those for controlled substances. Prior authorization may also depend on your individual health situation and diagnosis—certain prescriptions are covered in some circumstances but may require additional review or prior authorization in others.

A prior authorization is routine paperwork regarding your prescription that your provider can usually submit on your behalf, without needing a doctor visit. The processing time for prior authorization is normally 48-72 hours. However, the prescribing doctor may request an expedited review which would take 24 hours. 

The changes to AlaskaCare’s pharmacy plan, effective January 1, 2019, may require you and your provider to secure a new prior authorization for your current prescription(s), although the Division is working with its vendors to transfer as much of this information as they can automatically. If you are currently taking a medication that requires prior authorization, you will be contacted and given information on what forms you or your doctor need to complete. You may also contact OptumRx at (855) 409-6999 to determine if your medication requires a prior-authorization.

Check out a glossary of more health care terms at

Ounce of Prevention: Stay Healthy This Winter

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We cannot prevent all the health issues we will experience in a lifetime, but taking care of ourselves and our family’s physical, mental and emotional well-being helps us avoid and address problems early and maintain a good quality of life. This month’s prevention tip is about staying healthy during the cold winter months.

Winter has finally arrived in Alaska! The changing season brings colder temperatures, snow, ice, and many temptations to indulge a little extra during the holiday season. Below are some simple steps you can take to protect you and your family’s health, reduce risk of illness or injury, and have a happy and healthy holiday season!

  • Watch your step: Winter’s snow and ice increases the risk of fall-related injuries. Keep sidewalks and driveways clear, take extra time when walking to your destination, and consider wearing boots with sturdy soles and ice cleats.

  • Maintain a healthy diet: Cold weather, in combination with the celebrations of Thanksgiving, Christmas and other winter holidays, makes sweets and other unhealthy foods hard to resist. Avoid overindulging during this season and incorporate a variety of healthy fruits, vegetables, and proteins into each meal or snack to keep your body and immune system functioning well.

  • Keep up your exercise routine: Cold, dark days make it tough to stay motivated. Set daily or weekly physical activity goals to stay on track, whether it’s getting outside during daylight hours, meeting friends to go for a winter walk, or spending time at the gym!

  • Wash your hands: Winter is flu season. Protect yourself and others around you against illness by regularly washing your hands and keeping counters, tables and other surfaces clean.

  • Get your home ready for winter: This is the time of year to check your furnace filter, replace the batteries in your smoke detectors, and make sure you have a carbon monoxide monitor on every floor of your home.