AlaskaCare Retiree Health News | Monthly e-newsletter | February 2021

Alaska Department of Administration sent this bulletin at 02/26/2021 08:37 AM AKST

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AlaskaCare Retiree Health News

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Volume 33| February 2021
 

What AlaskaCare is Doing for You

In response to the COVID-19 national public health emergency declared on January 31, 2020 and the State of Alaska public health disaster emergency declared on March 11, 2020 by Governor Mike Dunleavy, the Division of Retirement and Benefits has implemented temporary plan changes and suspensions in the AlaskaCare health plans. Please note, these temporary changes are the result of Federal and State health mandates, suspension orders, and other guidance. The Division's compliance with these various requirements is temporary in nature and does not create a vested benefit in relation to these changes. All temporary administrative changes will be automatically rescinded upon the expiration of relevant enabling documents.

The Division is monitoring the status of the Alaska COVID-19 public health disaster emergency and will provide updates regarding the effective dates of the temporary changes. The Division will provide members with written advance notice of the end of any temporary changes.

COVID-19 Vaccine Update

COVID-19 Vaccine Eligibility Opens for Additional People!

As of Thursday, February 25, more vaccine phases and eligibility tiers have opened, meaning additional people will be eligible to receive COVID-19 vaccines in Alaska. We are encouraging Alaskans to continue to visit the covidvax.alaska.gov or call (907) 646-3322 to check eligibility and find a vaccine provider. For complete details about who can get vaccinated in Alaska, check the eligibility guidelines!

Those who are eligible to get vaccinated right now include:

  • *NEW* People who assist someone 65 years of age or older in getting a vaccine are now eligible to be vaccinated at the same time
  • *NEW* People 50 years and above with a high-risk medical condition*
  • *NEW* People 50 years and above working as a frontline essential worker*
  • *NEW* Pre K-12 and childcare education staff*
  • *NEW AND EXPANDED* People living or working in congregate settings*
  • People 65 years and above
  • Most health care workers
  • Long-term care residents and staff

*Limitations apply. See covidvax.alaska.gov for details.

If you are eligible, please locate a clinic near you and book an appointment. If all slots are full in your area, please keep checking back. As more vaccines become available, more time slots will be added to the scheduling calendar.

Alaska’s vaccine supply is currently limited, but in the coming months the vaccine will become more widely available. Vaccine doses will be distributed across the state in a series of phases.

The AlaskaCare health plan covers 100% of the cost for FDA approved COVID-19 vaccines under both the medical and pharmacy plans, at any authorized site of care.

1095-B Form on MyRNB

Form 1095-B is a tax form that reports the type of health insurance coverage you have, any dependents covered by your insurance policy, and the period of coverage for the prior year. The Division of Retirement and Benefits has provided this form to members under age 65 to verify on your tax return that you and your dependents have at least minimum essential health insurance coverage. If you are 65 or older, contact Medicare at (800) MEDICARE to obtain a copy of your form 1095-B.

Since this information is already provided to the Internal Revenue Service (IRS) by Medicare, it is no longer necessary to have a printed copy of form 1095-B in order to file your taxes. Starting last year, the Division provides members under age 65 access to an electronic version of form 1095-B online. Forms will be available online in March. You will be able to access your 1095-B form in your MyRNB account under myDocuments.

If you would like to request a printed copy of your 2020 Form 1095-B be mailed to you, please contact the Division toll-free at (800) 821-2251, or in Juneau at (907) 465-4460. If you would like more information about the 1095-B form, check out our FAQ’s.

Do you have a new phone number or email account?

Be sure to update your MyAlaska profile and keep your information current. MyAlaska allows you to interact with multiple State of Alaska services, including MyRNB. Manage your profile through the registered user portal, located here. 

Medicare Part D IRMAA Reimbursement Extension—December 2021

Are you enrolled in the AlaskaCare enhanced Employer Group Waiver Plan? Are you being assessed a premium surcharge for your Medicare Part D coverage? If you answered yes to both questions, you may be eligible for reimbursement from AlaskaCare for your Medicare Part D Income Related Monthly Adjustment Amount (IRMAA).

The deadline for submitting reimbursement requests for 2020 IRMAA charges is December 31, 2021.

What is an IRMAA? Certain high-income retirees are required to pay an extra premium surcharge, known as an Income Related Monthly Adjustment Amount. This is similar to the surcharge for high-income enrollees in Medicare Part B plan, or Medicare Part D prescription drug plan. If you are an individual or a married couple earning more than the threshold, you will be required to pay an extra surcharge after being enrolled in the AlaskaCare EGWP because it is a group Medicare Part D plan. Retirees whose household income is below this threshold are not assessed the IRMAA premium surcharge.

If you are assessed a Medicare Part D IRMAA surcharge, you will be reimbursed for the surcharge related to your prescription drug coverage.

Follow these steps to establish your 2021 IRMAA reimbursement account online:

  1. Register and/or log in to your OptumRx account either online or through the mobile app.

  2. Navigate to forms by clicking on the "Information Center" tab on the Navigation bar at the top, select "Programs and Forms", then click on “IRMAA HRA Enrollment Form”.

  3. Complete the online IRMAA HRA Enrollment form.

  4. Navigate to forms by clicking on the "Information Center" tab on the Navigation bar at the top, select "Programs and Forms", then click on “IRMAA HRA Enrollment Form”.

  5. OptumRx will confirm eligibility and set up your Health Reimbursement Account (HRA).

  6. Once your HRA has been created, Optum Bank will send you a Welcome Packet.

  7. Log in to Optum Bank to view your HRA account status/balance or to sign up for Direct Deposit. Your banking information that may be with PayFlex cannot be transferred on your behalf to Optum Bank.

If you have any questions on how to submit your documents online or if you do not have internet access and would like to submit paper documentation, please contact OptumRx at (855) 409-6999.

Get to Know Your Benefits—Travel

Travel Benefits

The Retiree Defined Benefit Medical Plan pays travel and ambulance costs within the contiguous limits of the United States, Alaska, and Hawaii. This includes:

  • Transportation to the nearest hospital by professional ambulance.

  • Round-trip transportation, not exceeding the cost of coach class commercial air transportation, from the site of the illness or injury to the nearest professional treatment.
∅

Travel benefits do not include reimbursement of airline miles to purchase tickets, the cost of lodging, food, or local ground transportation such as airport shuttles, cabs, or car rental. 
∅ Travel benefits do not apply to the audio, dental, or vision plans.

Contact the Aetna Concierge at (855) 784-8646 for pre-certification before you or your dependent travel.

Travel Coverage

ο Travel is covered for emergencies

Travel is covered if you have an emergency condition requiring immediate transfer to a hospital with special facilities for treating your condition. Precertification is waived if you are immediately transferred in a ground or air ambulance; you do not need to call the claims administrator before this occurs.

An emergency condition is a recent, severe medical condition, including but not limited to severe pain, which would lead a prudent layperson possessing an average knowledge of medicine and health to believe their condition, sickness or injury is of such a nature that failure to get immediate medical care could result in:

  • Placing the person’s health in serious jeopardy.
  • Serious impairment to bodily function.
  • Serious dysfunction of a body part or organ.
  • In the case of a pregnant woman, serious injury to the health of the fetus
ο Travel is covered for treatment not available locally

Travel is covered for you to receive treatment which is not available in the area you are currently located in. Treatment is defined as a service or procedure, including a new prescription, which is medically necessary to correct or alleviate a condition or specific symptoms of an illness or injury. It does not include any diagnostic procedures or follow-up visits to monitor a condition. Treatment must be received for travel to be covered. Benefits for travel to receive treatment which is not available locally are limited during each benefit year to:

  • One visit and one follow-up visit for a condition requiring therapeutic treatment;
  • One visit for prenatal or postnatal maternity care and one visit for the actual maternity delivery;
  • One pre-surgical or post-surgical visit and one visit for the surgical procedure;
  • One visit for each allergic condition.

If you need transportation for a nonemergency condition which cannot be treated locally, you must contact the claims administrator prior to traveling. Failure to pre-certify travel will result in a denial of travel benefits.
ο Travel is covered for second surgical opinions Travel is covered if you require a second surgical opinion which cannot be obtained where you are currently located. If you require transportation for a second surgical opinion which cannot be obtained locally, you must contact Aetna prior to traveling. Failure to pre-certify travel will result in a denial of travel benefits.
ο Travel is covered for surgery in other locations if less expensive Travel is covered if you have surgery which is provided less expensively in another location. If the actual cost of surgery, hospital room and board, and travel to another location for the surgery is less expensive than the recognized charge for the same expenses at the nearest location you could obtain the surgery, your travel costs may be paid. The amount of travel costs paid cannot exceed the difference between the cost of surgery and hospital room and board in the nearest location and those same expenses in the location you choose. Travel costs include round trip coach airfare or ground transportation if the most direct route exceeds 100 miles. Precertification from the claims administrator is not required for this situation but is recommended.
∅ Travel is not covered for diagnostic purposes Travel is not covered for diagnostic purposes.
∅ Travel is not covered for co-travelers Travel is not covered for co-travelers. Travel charges for a physician or a registered nurse are covered when authorized by Aetna. If the patient is a child under 18 years of age, a parent or legal guardian’s travel charges are allowed. Travel must be pre-certified to receive reimbursement under the Medical Plan.

Limitations*

  • Limit on travel for transplant services 
    • $10,000 per transplant occurrence
  • Visit Limits Travel Benefits: Therapeutic treatments
    • One visit and one follow-up per benefit year
  • Visit Limits Travel Benefits:
    • One visit per benefit year
      • Prenatal/postnatal maternity care
      • Maternity delivery
      • Presurgical or postsurgical
      • Surgical procedures

What you will need for claim submission after you travel:

  • Medical Benefit Request Form (claim form)
  • Precertification Acknowledgment Letter
  • Boarding Passes and Passenger Receipts
  • Proof of expense such as a receipt or bank statements.
  • Any other supporting documentation you would like to provide

Contact the Aetna Concierge at (855) 784-8646 for pre-certification before you or your dependent travel. Travel Claims can be submitted to:

Aetna
P.O. Box 14079
Lexington, KY 40512-4079

For complete benefit information, see the Retiree Health Plan Information Booklet Section 3.3.18 Travel.

Current Address for EGWP Eligibility

Is your address a P.O. Box? Make sure you’ve provided required information to remain eligible for EGWP prescription drug coverage.

Effective January 1, 2019, AlaskaCare implemented an enhanced Employer Group Waiver Program (EGWP) to provide prescription drug coverage for all Medicare-eligible members covered under the AlaskaCare Retiree health plan. Members who have provided a P.O. Box for their address must also provide a physical address to maintain EGWP eligibility. No mail will be sent to this address, it will only be used to verify that you live inside the Medicare service area.

If you have only provided a P.O. Box as your address, please contact OptumRx Member Services at (855) 235-1405 or the Division's Member Service Center at (907) 465-4460 to provide your physical address.

If you do not have a typical residential (street) address, please call the Division and we can work with you to record an address that will satisfy the CMS requirement.

AlaskaCare Town Hall

Town Hall Events are group calls hosted by the Alaska Department of Administration, Division of Retirement and Benefits for all interested AlaskaCare retirees and families to ask questions about the AlaskaCare health plans. You can join the call to learn more about your health plan and ask Division staff any questions you have about your benefits. This format gives retirees a chance to connect directly with Division staff to hear the latest news on all things AlaskaCare, raise questions, share comments, and learn more about the health plans. Pre-register now online.

Please join us for a Town Hall event on:

We Value Your Feedback!

As State of Alaska retiree, your input is valued and important. Below, please see a list of ways to contact us with your feedback. Also, a full list of AlaskaCare health plan and partner contact information can be found on our website. 

AlaskaCare – Plan Administrator

  • Toll Free: (800) 821-2251
  • In Juneau: (907) 465-4460
  • TDD: (907) 465-2805
  • Fax: (907) 465-3086
  • Email: doa.drb.mscc@alaska.gov

Come Visit Us:

State Office Building
6th Floor
333 Willoughby Avenue
Juneau, AK 99801

Send Us a Letter: 

State of Alaska
Division of Retirement and Benefits
P.O. Box 110203
Juneau, AK 99811-0203

 

2020 Survey Thanks!

We surveyed more than 1,400 State of Alaska Retirees and Employees in December 2020. For those who participated, thank you so much for giving us your valuable time and feedback! Know that no matter the time of year, your feedback helps us create a better health care plan. You are always welcome to share with us parts of the plan that make you feel supported and able to move through the healthcare world with ease, or areas that could use improvement. The best way to reach the Division is listed above.

Thank you for another great year in keeping yourselves and others protected, safe and healthy.

 

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Retiree newsletters are sent electronically to Health Plan members that have subscribed to receive updates. Each month we feature an article that helps you Get to Know your Benefits, provides you with updates about the Health Plan, and information about health events and resources. You can subscribe or unsubscribe at any time by managing your preferences here.

Health Benefit Contact Information

Division of Retirement and Benefits
DRB Call Center: (907) 465-4460 |Toll Free: (800) 821-2251

Medical Benefits: Aetna
Member Services: (855) 784-8646

Dental Benefits: Moda/Delta Dental
Member Services: (855) 718-1768

Pharmacy Benefits: OptumRx
Member Services: (855) 409-6999

Health Flexible Spending Accounts (HFSA): PayFlex
Member Services: (800) 416-7053

Surgery Plus
Member Care Advocate: (855) 715-1680

Vision & Audio Benefits: Aetna VSP
Member Services: (855) 784-8646

Teladoc
Member Services: (855) 835-2362