This is a special edition of the retiree e-newsletters sent from the Division of Retirement and Benefits to provide you with accurate, timely information about your AlaskaCare retiree health benefits. This newsletter is an update on the 2019 Transition of Pharmacy Benefits.
 REMINDER: Beginning January 1, 2019, OptumRx will become the Pharmacy Benefits Manager for all AlaskaCare plans. Aetna, with their subcontractor CVS/Caremark, is currently the Pharmacy Benefit Manager (PBM) for AlaskaCare, and will continue managing the health plans’ medical benefits in 2019.
OptumRx Health Care Advisors can help with your individual account needs and ensure you are ready for the transition on January 1, 2019. You can reach OptumRx Member Services at (855) 409-6999. Representatives will be 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.
What’s New?
AlaskaCare members are beginning to receive information in the mail. Some communications are going to all retirees; others are specific to the AlaskaCare enhanced Employer Group Waiver Program (EGWP)and will be sent to only Medicare-eligible retirees and dependents.
If you have questions about any of the mailings you have received, you can go to AlaskaCare.gov to our EGWP FAQ and Transition Guide web pages and see if your questions are already addressed in the FAQs. We’ve included the new FAQs below for your convenience. We are updating these regularly as we receive and respond to member questions.
You can also contact OptumRx Member Services at (855) 409-6999, or the Division toll-free at (800) 821-2251 or in Juneau at (907) 465-4460. You can also email the Division at doa.drb.benefits@alaska.gov.
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Please visit our EGWP FAQ page at AlaskaCare.gov for the full list.
When can I expect to receive my new ID card?
Welcome kits with information including ID cards will be mailed the first week of December 2018. The welcome kit will include ID cards, plan information, and other resources to help members.
I am receiving letters and phone calls from OptumRx, asking for personal information. Is this a scam?
A small number of members may receive letters or a phone call from OptumRx or their subcontractor, Convey, asking to confirm certain personal information including: your name, address, birthday, and Medicare Beneficiary Identifier. Providing this information assists with expedited enrollment and helps avoid any potential issues related to discrepancies or errors between the health plan and Medicare. This is not a scam. To provide this information, you can call the toll-free number provided in the letter, (855) 235-1405 (TTY 711) or mail the return form to:
OptumRx
Attention: Enrollment Services
P.O. Box 269027
Fort Lauderdale, FL 33326
I received a letter from OptumRx telling me I must opt out within 21 days. What if I need more time to make this decision?
Members have received a letter from OptumRx dated November 15, stating they have 21 days to opt-out of the AlaskaCare enhanced EGWP. This is not a hard deadline. Members may elect to opt out at any time. However, to help ensure you will not experience any disruption in your service on January 1, 2019, members are encouraged to submit their opt-out elections no later than December 26, 2018.
Remember: If you opt out of the enhanced EGWP you will be enrolled in a plan that is much different than the benefits offered today. This will result in increased out-of-pocket expenses for you or your Medicare-eligible dependents.
I received a letter from my other Medicare prescription drug plan saying I have been disenrolled due to my participation in the AlaskaCare enhanced EGWP. What do I do?
You cannot be enrolled in more than one EGWP at a time. If you are already covered under an EGWP through a non-AlaskaCare plan, please contact the Division. We can dis-enroll you from the AlaskaCare enhanced EGWP and will leave you in the plan available to non-Medicare eligible members. You will receive a letter from AlaskaCare confirming that you have been removed from the AlaskaCare enhanced EGWP. Please share this letter with your other Medicare prescription drug plan.
I currently have an individual Part D plan and qualify for low-income subsidies (LIS). Will I need to reapply for the LIS assistance, once I am enrolled in the AlaskaCare enhanced EGWP?
No, you will not need to reapply for the LIS. Your LIS cost sharing/copays will remain the same.
What is the Late Enrollment Penalty (LEP)?
The Late Enrollment Penalty is an amount added to the Medicare Part D plan premium for a member who meets one or both of the following criteria:
- The member did not obtain creditable prescription drug (Rx) coverage when they were first eligible for Medicare Part D.
- The member had a break in creditable prescription drug (Rx) coverage of at least 63 consecutive days.
Note: The LEP, once assessed, remains with the member for the life of their participation in Medicare Part D.
What if I get a Late Enrollment Penalty (LEP) Letter? Will I have to pay the fee?
No, AlaskaCare will pay the Late Enrollment Penalty fee for Medicare Part D on behalf of the members. You are receiving a LEP letter since you were identified by the Centers for Medicare & Medicaid Services (CMS or Medicare) as having uncovered months prior to their enrollment into the Medicare Part D plan.
You may have had a LEP already in place under your former Medicare Part D plan.
What can be done to remove the LEP?
You can remove a LEP in the following ways:
- You can call Convey, the OptumRx Enrollment Vendor at (855) 235-0294 and speak to an agent who will explain process to remove the LEP.
- You can complete the Declaration of Prior Creditable Coverage form included with the LEP letter and mail it to the following address:
Convey Health Solutions
P.O. Box 269027
Fort Lauderdale, FL 33326
There is a limited amount of time to correct a LEP notice if you feel this has been applied in error. You can contact Convey for up to 90 days after receiving notification to complete an attestation and have the LEP removed.
I have received an Evidence of Coverage letter from OptumRx. This letter references an Initial Coverage Stage, what does this mean?
Initial Coverage State is a term used by Medicare and is part of the Medicare mandatory information sent to all Medicare prescription drug plan participants. However, due to the additional benefits provided through the AlaskaCare enhanced EGWP, this does not apply and will not impact your benefits. Your copay will not change. |
