AlaskaCare Employee News | January 2020

AlaskaCare knows that regular visits to the dentist can improve both your oral and overall health. Those twice-yearly checkups can help your dentist identify any problems before they cause pain or discomfort. That’s why receiving preventive dental services is important.

Beginning January 1, 2020, members in all AlaskaCare employee dental plans will experience enhanced coverage of preventive services. With the Preventive First Program your diagnostic and preventive visits will not count against your annual individual benefit maximum. This adds value to your dental plan by extending your annual maximum dollars. Not only will your dental benefits go further, but regular preventive care can help you avoid potentially painful and costly restorative treatments down the road.

If you have dental insurance, make the most of it! Protect your health and smile. Make a dentist appointment today.

Your AlaskaCare dental plan lets you see any licensed dentist you want, in-network or not. But when you see a network provider, you’ll save money. You still have access to the same network of Delta Dental Premier dentists, but beginning January 1, 2020, you have access to an additional network of dental providers: Delta Dental’s Preferred Provider Organization (PPO) network. When you visit a PPO dentist, you’ll pay less out-of-pocket.

You do not need to do anything to enroll in this benefit, but if you want to take advantage of the PPO’s discounted services, use the dentist locator tool to search for providers who participate in the PPO network or contact Delta Dental customer service at (855) 718-1768.

Calculating how much you can expect to pay for your prescription drugs can be difficult. This year, we’re simplifying the process and reducing the cost for some medications. You can now get your generic and preferred brand-name prescription drugs for a flat maximum copay. 

AlaskaCare has also added an additional, lower cost prescription drug tier for generic maintenance medications, reducing your costs for generic medications that you take regularly over an extended period to manage chronic conditions.

See the new pharmacy benefit schedule in the AlaskaCare Employee Insurance Booklet for the complete prescription drug schedule. Not sure what tier your medication falls into? You can visit optumrx.com, or call OptumRx at (855) 409-6999.

These changes simplify your prescription drug benefits, encourage use of generic and preferred brand-name drugs, and make it less costly for you to adhere to your maintenance medication regimen.

Do you avoid going to the doctor in January because you haven’t met your deductible? We want to make sure you can get care whenever you need it. Beginning January 1, 2020, if you elect the Standard or Economy medical plan, you and your dependents will now pay a flat copay amount for in-network primary care and specialty care office visits.

Instead of paying the full cost of your office visit before you meet your deductible and a percentage of the cost (coinsurance) after you do, you will only pay a flat copay for all office visits. These copays cost less than what you would typically pay for a visit through your deductible or coinsurance. Copays do not apply to your deductible, but they do apply to your annual out-of-pocket maximum.

IMPORTANT! Keep in mind that copays only apply to in-network providers, and only cover the office visit. Facility charges, ancillary services, and other services such as labs that are not billed as part of an office visit will be subject to a deductible and coinsurance.

Find a network provider, or check to be sure that your current provider is in-network by calling Aetna at (800) 821-2251 or by using the online DocFind tool.

The Division of Retirement and Benefits has updated the AlaskaCare health eligibility rules related to employees in Leave Without Pay (LWOP) status to provide continued health insurance coverage for eligible AlaskaCare members. This change will eliminate unnecessary gaps in member health insurance coverage related to LWOP. LWOP rules during a new hire’s initial 30 day wait period remains the same.

Previous Rule
Employees were required to be in pay status a minimum of four hours on the first workday of the month to be eligible for AlaskaCare coverage. If a member’s coverage was terminated due to LWOP on the first workday of the month, it would be reinstated effective the first day they return to work.

Updated Rule, effective January 1, 2020
AlaskaCare eligible employees in LWOP status on the first working day of the month will continue their health insurance coverage if they continue to timely pay their monthly insurance premium (through payroll deduction or self-pay). The employee will no longer be required to be in pay status for four hours on the first workday of the month.

IMPORTANT! It is the employee’s responsibility to ensure the AlaskaCare premium is paid in order to remain covered. This may require action on the employee’s part as the AlaskaCare premium may not automatically be deducted from an employee’s paycheck when the employee is in LWOP status.