AlaskaCare Retiree Health News | Monthly e-newsletter | June 2021
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AlaskaCare Retiree Health News
| Volume 37 | June 2021 |
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COVID-19 Temporary Health Plan Changes
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In response to the COVID-19 outbreak, AlaskaCare made temporary changes and limited benefit expansions to your health plan to support the public health COVID-19 response, reduce the strain on the medical system, and to assist you in accessing the care you need. You can find up-to-date information about the temporary changes to your benefits here. The Division of Retirement and Benefits is monitoring the status of COVID-19 in Alaska and is providing you with the following updates: Teladoc® for Retiree Plan Members: Available Through June 30, 2021 What does this mean for you?
Remember: The AlaskaCare retiree and active employee health plans currently cover and will continue to cover telemedicine services delivered by your regular providers. If you or your provider are unsure which telehealth services are eligible for coverage, please contact Aetna at (855) 784-8646 for more information. Flu and Pneumonia Shots for Retiree Plan Members: Available through December 31, 2021 What does this mean for you?
Remember: In 2019, AlaskaCare expanded coverage for vaccines covered by Medicare Part D for all AlaskaCare retiree plan members. Flu and pneumonia vaccines are covered by Medicare Part B and therefore are not included in the regular AlaskaCare retiree plan benefits. Common vaccines that have been added to the AlaskaCare retiree pharmacy benefit include shingles, diphtheria, tetanus, measles-mumps-rubella (MMR), polio, hepatitis, and HPV. |
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Everyone age 12 and older is now eligible for a free vaccine in Alaska! The COVID-19 vaccines are safe, effective, and our best shot at containing the virus and revitalizing Alaska’s economy. Community immunity, achieved when we reach high vaccination rates, will help protect all Alaskans from COVID-19 and will keep our state up and running. This is our shot, Alaska, to help us return to normalcy. Let’s do this! Call (907) 646-3322 from 9 a.m. - 6:30 p.m. on weekdays, and 9 a.m. - 4:30 p.m. on weekends. If you are located outside of Alaska, check with your local health authorities to find out more about vaccine eligibility and availability in your area. |
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Thank you to all the retiree plan members who joined us in May for the monthly Town Hall event dedicated to all things Medicare. You had some great questions! Here is additional information on some of the topics that were covered. Medicare Part A, Part B, Part C, Part D Medicare is a national health insurance program administered by the Centers for Medicare and Medicaid Services (CMS). It provides health insurance for Americans aged 65 and older, younger people with disability status as determined by the SSA, people with end stage renal disease, and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). Alaska statute requires the AlaskaCare retiree plan become supplemental to Medicare when members turn 65. AlaskaCare will begin processing member’s health claims as if they have Medicare Part A & B on the first day of the month, when they turn 65. All members should schedule an appointment with Social Security to apply and enroll for Medicare Part A & B within the three months prior to their 65th birthday. After members receive their Medicare Beneficiary Identifier—or “MBI”—they must call the Aetna concierge to set up Medicare Direct. This way, Medicare will automatically send the Medicare Explanation Of Benefit (MEOB) to Aetna for processing. Once Medicare Direct is set up, Medicare will pay as the member’s primary health insurance and Medicare MEOBs will automatically be sent to Aetna. Most covered medical expenses are paid after Medicare coverage starts and AlaskaCare pays as secondary. The different parts of Medicare help cover specific services: Medicare Part A What does it cost? Medicare Part B What does it cost? Medicare Part C Medicare Part D Medicare-eligible retirees and/or dependents will be automatically enrolled in the AlaskaCare enhanced Employer Group Waiver Program (EGWP). The AlaskaCare enhanced EGWP is a group Medicare Part D prescription drug plan that provides the same prescription benefits as provided to non-Medicare eligible retirees and dependents, while maximizing federal subsidies. You do not need to enroll into an individual Medicare Part D plan, and for most members there is no additional premium for prescription drug coverage under AlaskaCare. However, certain high wage earners will be charged an Income Related Monthly Adjustment Amount (IRMAA) surcharge for prescription drug coverage. If you are subject to the Medicare Part D IRMAA surcharge, you will be reimbursed. What You Need to Know About IRMAA Reimbursement Certain high-income retirees are required to pay an extra premium surcharge, known as an Income Related Monthly Adjustment Amount, or IRMAA. This is similar to the surcharge for high-income enrollees in the Medicare Part B plan. If you are an individual or a married couple earning more than the threshold, you will be required to pay an extra surcharge for being enrolled in the AlaskaCare Employer Group Waiver Program (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 subject to the Medicare Part D IRMAA surcharge, you will be reimbursed. For all Medicare plans, the IRMAA will either be deducted directly from your monthly Social Security check (if you qualify for Social Security) or will be invoiced to you directly each month. If you are charged a Medicare Part D IRMAA for your prescription drug coverage, the Division of Retirement and Benefits will reimburse you for the full cost of the Medicare Part D premium surcharge each month, through a tax-advantaged Health Reimbursement Arrangement (HRA) account. If you receive a bill from Medicare, you should pay the bill timely, and contact the Division to learn about your reimbursement options. Follow these steps to establish your Part D IRMAA reimbursement account online:
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. How Can I Find a Medicare Provider? You may want to establish care with a provider that accepts Medicare before you turn age 65. Use the Medicare find & compare health care providers tool to find hospitals, nursing homes, home health services, dialysis facilities, doctors, and other health professionals, or Durable Medical Equipment (DME) and supplies here. There are three types of relationships a provider can have with Medicare. It’s important to understand the types since they can impact your financial responsibility. Participating Providers Nonparticipating Medicare Providers Providers Who “Opt Out” of Medicare Under a private contract: Medicare will not pay the doctor or you for services you receive. No claim can be submitted to Medicare for services. The AlaskaCare retiree health plan will not pay anything for services provided under a private contract. Medicare and Coordination of Benefits In accordance with state statute, the AlaskaCare retiree health plan benefits become supplemental to Medicare beginning at age 65. For services covered by both plans, the claims are paid first by Medicare and then by AlaskaCare—with AlaskaCare coordinating to pay up to 100% of covered expenses, less any deductible not yet met. Claim Payment: Medicare’s coverage is not the same as the coverage available under AlaskaCare. Any medical service covered by AlaskaCare but not Medicare will be paid at the same coinsurance rate as it was before you were enrolled in Medicare. For expenses covered by Medicare but not by AlaskaCare, such as some routine expenses, Medicare pays, but AlaskaCare does not. Who Pays First: Medicare pays benefits before the AlaskaCare retiree health plan in most cases. However, if you are covered by a plan you or your spouse receive as an actively working employee, predominantly the active plan pays first, with Medicare paying second, and finally the AlaskaCare retiree health plan. However, if you are only enrolled in Medicare Part B, and/or enrolled in Medicare Part A on a premium-paying basis, Medicare will pay primary, the active plan pays secondary, and the AlaskaCare retiree health plan pays third.
Electronic Claim Filing—Medicare Direct If Medicare is your primary plan, the AlaskaCare claims administrator will send a request to Medicare to enroll you in the Medicare Direct program. Dependents on your plan who are enrolled in Medicare may not be reported. You may need to contact the AlaskaCare claims administrator directly to set up Coordination of Benefits. The provider files your claim with Medicare, which then sends you an explanation of benefits (EOB) when the claim is processed and has been transferred to AlaskaCare. Need More Medicare Information? Contact Alaska’s Medicare Information Office:
Additional information is available from the federal Medicare website at medicare.gov. If you have questions about Medicare, contact the nearest Social Security office or call the toll-free number, (800) 772-1213 or go to ssa.gov. |
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As a 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
The DRB offices re-opened to the public on June 1, 2021. We look forward to seeing you! |
