• Retiree Health Plan Advisory Board Meeting
• Update on the 2021 Fall Health Fairs
• Keyword of the Month: Prior Authorization
• Have You Checked Your Beneficiaries Lately?
• Frequently Asked Questions
• Is Your Address a P.O. Box?
• COVID-19 Vaccine Information
• Future AlaskaCare Town Hall Event
• We Value Your Feedback!
• Health Benefit Contact Information

Retiree Health Plan Advisory Board Meeting

You’re invited to participate in an upcoming Retiree Health Plan Advisory Board (RHPAB) meeting on Thursday, August 5, starting at 9 a.m. Alaska Time. The RHPAB meeting is just one way members can learn more about how the health plan is administered and about improvements or changes that are under consideration.

Meetings are held at least once every quarter with additional meetings scheduled as necessary. The meetings are recorded and posted online along with all of the board packets and materials. To learn more or to join in next week’s meeting, click here.

The board is made up of seven members with diverse backgrounds and was created to facilitate engagement and coordination between the State of Alaska’s retirement system members, the Alaska Retirement Management Board, and the Commissioner of the Administration regarding the administration of the retiree health plan. More information about the board is available here.

Update on the 2021 Fall Health Fairs

AlaskaCare typically partners with the Pacific Health Coalition in the fall to hold health fairs for AlaskaCare members. The Pacific Health Coalition has announced that due to uncertainty around COVID-19, health fairs will not be held in 2021.

For those of you who usually receive an annual flu shot at the health fair events, remember that during the COVID-19 public health emergency, the AlaskaCare retiree health plans are temporarily covering the Trivalent and Quadrivalent flu vaccines, along with the pneumococcal (pneumonia) vaccine through December 31, 2021:

• If you get your flu or pneumonia vaccine at a network pharmacy, AlaskaCare will cover 100% of the cost. Call OptumRx at (855) 409-6999 if you need help locating a network pharmacy.
  
  
• If you get your flu or pneumonia vaccine at an out-of-network pharmacy, you will need to pay for the vaccine upfront and submit a claim to OptumRx to be reimbursed for the cost, up to the recognized charge.
  
  
• If you get your flu or pneumonia vaccine at your doctor’s office, the standard deductible and coinsurance will apply.

Keyword of the Month: Prior Authorization

The world of health care is complex and uses a lot of jargon. You don’t need to be a health care specialist to get the most out of your benefits and knowing some of the technical terms makes it a little less mysterious. This month’s keyword is Prior Authorization.

Prior Authorization, also known as precertification, is a pre-approval process that reviews your treatment, prescription, medical device, or other healthcare-related service against clinical, evidence-based standards to verify that the service is medically necessary and will be covered under your plan. Prior authorization may be necessary before receiving a service, except in emergency situations or if the plan states the service does not require prior authorization. Prior authorization may also depend on your individual health situation and diagnosis: many services are covered without additional review in some circumstances but may require additional review or prior authorization for others. Prior authorization is a separate process from reviewing and processing claims, which occurs after the service is provided and billed to the health plan. At this point, the plan determines whether and how to cover the services in the claim.

If you use a network provider, they will handle any necessary precertification for you. You are responsible for obtaining any necessary precertification from Aetna before receiving medical services from an out-of-network provider.

Check out a glossary of more health care terms here.

Have You Checked Your Beneficiaries Lately?

Make sure your money goes where you want it to, by keeping your beneficiaries up-to-date on your accounts. Any time you have a major life event, especially if you have gotten married, divorced, or had children, it’s a good time to review your policies.

For further information and beneficiary forms, visit the Division's webpage.

Frequently Asked Questions

We update the frequently asked questions regularly, please keep checking back for new information!

Here are some commonly asked questions:

• Question: Why aren't dependents covered to age 26 under the AlaskaCare retiree health plan?
  • Answer: The AlaskaCare retiree health plan is exempt from Affordable Care Act requirements that expand coverage to dependents up to age 26. Dependent coverage in the AlaskaCare retiree health plan is outlined in the State statute which stipulates that qualifying dependent children are covered up to age 19, or up to age 23 if they are full-time students. The Division of Retirement and Benefits understands that there is strong interest in expanding dependent coverage but doing so would require a statutory change.
    
    
• Question: Can I receive my Explanation of Benefits (EOBs) online instead of by mail?
  • Answer: Yes, you can choose to receive your Aetna Explanation of Benefits (EOBs) online instead of by mail. You can securely access your current and past EOBs, at your convenience, day, or night. Sign in to the Aetna member portal to update your preferences and select Go Paperless. Once you select paperless delivery, Aetna will send you an email notification whenever you have an EOB available for review. If you change your mind and want to receive your EOB by mail again, simply update your preferences or contact the Aetna Concierge at (855) 784-8646.
    
    
• Question: Does my pharmacy spend count towards the $ 2 million lifetime medical limit?
  • Answer: Pharmacy benefits do not count toward the lifetime maximum benefit; this is limited to medical charges. Please contact Aetna to determine your current benefit use and what health plan services do or do not count toward the limit. Please note, there are some pharmacy-related services that are covered under the medical plan instead and will count towards the lifetime maximum benefit, such as infusion treatments. Each explanation of benefits (EOB) includes a statement of services used compared with the lifetime maximum.
    
    
• Question: If you travel out of the country are you covered by Medicare? What about by Aetna?
  • Answer: Medicare does not provide coverage when you are out of the county, but your AlaskaCare retiree health plan does provide coverage. AlaskaCare benefits are good worldwide. You usually must pay for the care up front, and then receive reimbursement from Aetna. It is still an 80% benefit, and you would pay 20%.

Is Your Address a P.O. Box?

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 enrolled in the EGWP who have provided a P.O. Box for their address must also provide a physical/residential address in order 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 do not have a typical residential (street) address, please call the Division at (907) 465-4460 and we can work with you to record an address that will satisfy the Centers for Medicare & Medicaid Services (CMS) requirement.

COVID-19 Vaccine Information

Getting vaccinated against COVID-19 is easier than ever. Vaccines are available to both Alaskan residents and visitors. People 18+ may receive either Pfizer, Moderna, or Johnson & Johnson vaccines. 12– to 17-year-olds may receive the Pfizer vaccine only. Text your ZIP code to 438829 or call the Alaska Vaccine hotline at (907) 646-3322.

• Find a COVID-19 vaccine near you
• Sleeves Up for Summer calendar of events
• COVID-19 vaccine text-line
• Help for people with disabilities 
• Call for support

Future AlaskaCare Town Hall Events

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:

• Thursday, August 19, 2021 at 10 a.m. Alaska Time

We Value Your Feedback!

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 plans 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

Please Note: The DRB offices are now open to the public. 

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

Long Term Care Benefits: CHCS Services, Inc.
Member Services: (888) 287-7116

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

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