AlaskaCare Retiree Health News | Monthly e-newsletter | January 2019

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AlaskaCare Retiree Health News

Retiree News masthead

Volume 10 | January 2019

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.

Reminder: OptumRx is the New AlaskaCare Pharmacy Benefit Manager in 2019

As of January 1, 2019, OptumRx is the Pharmacy Benefits Manager (PBM) for all AlaskaCare plans. OptumRx now manages pharmacy benefits for our members, including retail, mail order, specialty prescription drugs, claims processing, and prior authorization requests for prescription medications. This does not impact medical, vision, or dental benefits. Those will continue to be administered by Aetna and Moda respectively.

Important Information and ID Cards Are Available in Your Welcome Kit

In October, AlaskaCare members received information in the mail about this transition in the Fall 2018 HealthMatters newsletter. Members were mailed a welcome kit, including new ID cards, from OptumRx with important information about your AlaskaCare pharmacy plan. If you have not received your welcome kit and new ID card, or you need a replacement, please contact OptumRx at (855) 409-6999.

Need to Take Care of Some Prior Authorization Paperwork?

If you or your dependent are Medicare eligible and now enrolled in the AlaskaCare enhanced Employer Group Waiver Program (EGWP), some prescriptions require your provider submit a new prior authorization. OptumRx will continue to cover prescription drugs you are currently taking without a new prior authorization during a 90-day transition period from January 1 through March 31, 2019. If necessary, during that time, you can receive up to a 30-day supply of medications at retail price while the prior authorization process is completed. If you fill a 30-day supply without a prior authorization, you will receive a notification in the mail reminding you to complete the authorization. If you receive one of these letters after filling a prescription, please contact OptumRx and your provider so they can assist you with the necessary paperwork.

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We know you may have questions or need assistance during this transition. You can reach OptumRx Member Services at (855) 409-6999. Representatives are available 24 hours a day, 7 days a week.

OptumRx Transition Frequently Asked Questions

Enhanced Employer Group Waiver Plan (EGWP) Frequently Asked Questions

We are updating the FAQs regularly, please keep checking back for new information!

Here are some recent additions:

OptumRx told me that I won’t be enrolled in the enhanced EGWP until February 1, 2019. Will I still have pharmacy benefits during January 2019?

Some Medicare eligible AlaskaCare retirees may experience a delayed enrollment in the enhanced EGWP until OptumRx can confirm and reconcile that members’ personal information with Medicare. Affected individuals will not experience a disruption in coverage; they will continue to receive full pharmacy benefits through the standard AlaskaCare pharmacy benefit until their enrollment in the AlaskaCare enhanced EGWP can be properly processed. For more information about your specific situation, please contact OptumRx member services at (855) 409-6999.

I submit paper claims for my prescription benefits. Who should I send 2018 claims to if they haven’t been filed prior to January 1?

For all prescriptions filled prior to January 1, 2019, the claims should be submitted to Aetna/CVS. For any prescription filled on or after January 1, 2019, the claims should be submitted to OptumRx. Claims forms for both can be found online at

Why did I receive a new ID card from Aetna? I thought my medical benefits weren’t changing?

The transition to OptumRx does not affect your medical benefits—these continue to be administered by Aetna. However, because Aetna and its contractor, CVS/Caremark, no longer administer AlaskaCare pharmacy claims, all AlaskaCare members will receive updated ID cards from Aetna that reflect their medical benefit coverage. Retirees will receive two new ID cards from Aetna – one for medical coverage, and one for vision/audio coverage. You should use your Aetna ID card(s) at your doctor’s office, and your OptumRx ID card at the pharmacy counter.

I received a letter from OptumRx asking me to provide a residential address. I use a P.O. Box to receive my mail, why am I being asked to provide a residential address?

You are welcome to use a P.O. Box as your mailing address, but in order for you to participate in a Medicare Part D pharmacy plan (i.e. the AlaskaCare enhanced EGWP), Federal regulations require OptumRx to confirm you reside within the Medicare service area: the United States, Puerto Rico, or Guam. Providing a residential address will verify your eligibility to be covered under the AlaskaCare enhanced EGWP.

The letter I received asking me to provide a residential address made it sound like I could lose my prescription drug coverage – is this true?

We apologize for the tone of the letter. The intent was to emphasize that in order for AlaskaCare to continue to receive federal subsidies associated with your enrollment in EGWP, you must provide a residential address. You will not lose your coverage – AlaskaCare will always continue to provide you with prescription drug coverage.

I received a phone call from an OptumRx representative, but my caller-ID says the call is coming from United Health Care. Is this a scam?

OptumRx is a subsidiary of United Health Care, which is why “United Health Care” may appear on your caller-ID when you receive a call from OptumRx. This is not a scam. However, if you are unsure if the call is legitimate, you can always decline the call and then contact OptumRx at (855) 409-6999 to ensure the call is genuine.

I received a call from an OptumRx representative who stated my mail-order prescriptions have transferred over and then asked me for personal information. Is this a scam?

If you were previously enrolled in the Aetna pharmacy mail-order program, most remaining prescription fills were transferred automatically to OptumRx’s home delivery program. The OptumRx home delivery unit has been reaching out to members to assist with setting up their home delivery accounts and to verify the prescriptions they want delivered. If you receive a call to this effect, it is not a scam. However, if you are unsure if the call is legitimate, you can always decline the call and then contact OptumRx at (855) 409-6999 to ensure the call is genuine.

Still Have Questions?

You can read more about the 2019 pharmacy benefits transition on the AlaskaCare website. If you or your family member enrolled in the retiree health plan are Medicare eligible, or will be Medicare eligible soon, you may have more specific questions about the enhanced EGWP—a Medicare Part D group pharmacy plan. For questions about EGWP, visit our EGWP FAQs page. Check these pages frequently, as we are updating the FAQs regularly as we receive and respond to member questions.

You can 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 e-mail the Division at

Medicare Eligible Retirees: What Do You Need to Know About IRMAA?


Certain high-income retirees who are Medicare eligible and enrolled in the AlaskaCare enhanced Employer Group Waiver Program (EGWP) pharmacy plan will have to pay an extra premium surcharge associated with Medicare Part D plans, known as an Income Related Monthly Adjustment Amount, or IRMAA. This is required by Medicare and is the same type of surcharge that high-income enrollees already pay for a Medicare Part B plan. If you are an individual earning more than $85,000 per year or a married couple who earns more than $170,000 per year, you will be required to pay an extra surcharge for being enrolled in the AlaskaCare EGWP because it is a group Medicare Part D plan. Retirees whose household income is below this threshold will not be subject to the IRMAA premium surcharge.

If you are required to pay the IRMAA premium surcharge, the Division will reimburse you for the amount you are charged each month associated with Medicare Part D, so the EGWP plan is no additional cost to you. If this applies to you and you are subject to the IRMAA premium surcharge, read on to find out more about IRMAA and how to set up monthly reimbursement from the Division.

How Will I Know How Much it Will Be and if I Have to Pay IRMAA?

Each year, Medicare eligible individuals are notified by the Social Security Administration about your plan, including if you are required to pay an IRMAA and at what amount. The Social Security Administration uses your Modified Adjusted Gross Income (MAGI) to determine if the IRMAA applies to you and, if so, how much you will have to pay.

The Social Security Administration requests income information from the IRS for the tax year that is two years prior to the surcharge year. IRMAA is automatically re-determined each year as long as you file an income tax return. The MAGI, and therefore the amount of your IRMAA, is subject to change from year to year.

I Believe I Am Required to Pay IRMAA. What Do I Do Next?

If you are subject to the IRMAA surcharge for the EGWP pharmacy plan, you will be reimbursed for this surcharge. For all Medicare plans, IRMAA is deducted directly from your monthly Social Security check if you qualify for Social Security or is invoiced to you directly each month if you don’t receive Social Security. Unfortunately, the Division cannot pay your monthly IRMAA on your behalf—but we can reimburse you each month through a tax-advantaged Health Reimbursement Arrangement (HRA) account for the portion of the surcharge associated with your prescription drug coverage, so there is no additional cost to you.

Each November, you should receive a letter from Social Security that outlines your Medicare premiums. Please submit the most recent letter you’ve received from Social Security that states you are subject to IRMAA surcharge for 2019, and at what amount, to the Division.

You can provide a copy of your letter to the division by:

  • Emailing a copy or a photo of the letter to:
  • Mailing a copy to:
    Alaska Department of Administration
    Division of Retirement and Benefits
    P.O. Box 11023
    Juneau, AK 99811-0203
  • Faxing a copy to: (907) 465-3086

Once the Division receives a copy of your annual letter sent from Social Security, we will establish an HRA for you through PayFlex, Aetna’s subsidiary that administers the HRA on behalf of AlaskaCare. PayFlex will send you a letter that outlines how to access your HRA account information and how to set up claims for reimbursement. We encourage you to set up reimbursement on an automatic reoccurring basis, but you may elect to request reimbursement manually. Reimbursement can be made by check or through electronic funds transfer.

For more information, download a copy of our IRMAA fact sheet.  

Next Tele-Town Hall: Thursday, February 21

The Division hosts monthly Tele-Town Halls for all interested AlaskaCare retirees to ask questions about your health plan. This format gives retirees a chance to connect directly with Division staff, seek out answers, and learn more about the health plan. We have hosted events to discuss your pharmacy benefits, dental benefits, and long term care benefits – you have asked some great questions! If you missed any of these events and want to catch up on what you missed, you can find written summaries of the discussion and recordings of the calls on the Tele-Town Hall web page.

Tele-Town Halls are typically scheduled for the third Thursday of each month at 10 a.m. Alaska time. Registration information is available on the AlaskaCare website approximately 1 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!

Tele-Town Hall: Thursday, February 21

Hosted by the Alaska Department of Administration, Division of Retirement and Benefits for all interested AlaskaCare retirees and families
Thursday, February 21, 2019 | 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: many AlaskaCare retirees will be called into a shared line automatically when the event starts. If you would like to participate, just answer that call and stay on the phone! Division staff will give a brief introduction and update, and the rest of the event will be dedicated to answering your questions. We will answer as many questions as we can during the call.

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, with additional meetings of the modernization committee each quarter.

Next Quarterly Board Meeting: Wednesday, February 6, 2019

The next full board meeting is scheduled for Wednesday, February 6, 9 a.m. to 4 p.m., with locations in Juneau, Anchorage, and teleconference provided. The agenda will include updates and in-depth discussion about the modernization project: a collection of initiatives and proposed changes to the health plan under consideration by the Division to provide updated and improved benefits for all retirees.

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 [PDF] for more information and what to expect in a board meeting.

For more about RHPAB and upcoming meetings, including meeting locations, teleconference information and meeting materials, please visit

Ounce of Prevention: Coping with Seasonal Affective Disorder (SAD)

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 or address problems early and maintain a good quality of life. This month’s prevention tip is about coping with seasonal affective disorder, or SAD.


Alaskans are very familiar with seasonal affective disorder (SAD), but anyone who lives where there are seasonal changes in temperature, weather, and length of daylight can be affected by SAD. SAD symptoms typically appear or intensify during the fall and early winter and go away in the spring and summer when longer days return. SAD is said to occur due to changes in the body’s internal clock and changes in brain and body’s chemicals. Feeling depressed on most days, feelings of hopelessness, worthlessness, reduced energy, concentration, and lack of interest in the activities you enjoy are common symptoms. SAD can also be a sign of depression, especially if these feelings persist beyond the dark, winter months. Talk to your doctor: treatment for SAD is available in the form of medications, light therapy, and psychotherapy. And don’t forget about self-care!

Here are some tips to help cope with SAD during the winter months:

  • Keep your house well lit.
  • Sit closer to bright windows at home and when you are out and about, such as a coffee shop.
  • Take a walk outside each day, especially during daylight hours.
  • Exercise regularly, indoors and outdoors.
  • Eat a well-balanced diet.
  • Stick to your treatment plan.
  • Practice relaxation techniques such as yoga, tai chi, and meditation.
  • Practice music or art therapy.