AlaskaCare Retiree Health News | Monthly e-newsletter | October 2021
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AlaskaCare Retiree Health News
| Volume 41| October 2021 |
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Open Enrollment for the AlaskaCare Retiree Dental-Vision-Audio Plans Is Open and Runs Through November 24, 2021
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Open Enrollment for the AlaskaCare Retiree Dental-Vision-Audio Plans is open and runs through November 24, 2021 This is your annual opportunity to review your Dental-Vision-Audio (DVA) coverage options and make benefit elections for you and your family for the next plan year, which begins on January 1, 2022. This does not apply to or impact your medical benefits. If you do not participate in DVA Open Enrollment, your benefit elections will not change from what you have now. You can make changes to your benefit elections online at AlaskaCare.gov/DVA during the Open Enrollment period, now through November 24, 2021. The plan options and monthly premiums are the same as they were last year. You can review the 2022 Benefit Comparison Guide and 2022 Enrollment Guide containing monthly premium information and coverage comparisons online:
If you are not a current Retiree DVA plan member, you are not eligible to participate in Open Enrollment. Need more information?
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Get the Facts: Prior Authorization for Specialty Drugs
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In addition to adding coverage for preventive care services on January 1, 2022, the plan will also add prior authorizations for specialty medications. We know you may have some questions about the prior authorization process, and we want you to get the facts straight from us. What is prior authorization? Prior authorization is a pre-approval process that checks to make sure drugs are being used safely and effectively. Before you fill your specialty medication, the prior authorization process will verify your drug is medically necessary, appropriately prescribed, and meets clinical, evidence-based standards including those established by the FDA to promote safe and effective use of those medications. What are specialty medications? Specialty Medications are prescribed to treat chronic, complex, or rare conditions such as cancer, rheumatoid arthritis, and hepatitis C, and can have severe side effects if taken incorrectly. Only about 1% of prescriptions filled under the plan are specialty medications. How do I know if I’m taking a specialty medication? You can review the OptumRx Specialty Pharmacy Drug List to see if any of your current medications are specialty drugs that may require a prior authorization starting January 1, 2022. Please note this list may change over time and may be updated prior to January 1, 2022. If I’m taking specialty medication that requires prior authorization, what should I do next? If your specialty drug requires prior authorization, you will receive a notification letter at the beginning of November advising the medication requires prior authorization review. Prior authorization is common in health plans and physicians are already familiar with the process. Providers may submit prior authorization requests electronically, over the phone, or by mail. Is my prescription drug coverage changing? No, your prescription drug coverage is not changing. The plan will continue to cover medically necessary and clinically appropriate prescription drugs. There is no change to member copayments which will remain $8 for brand medications, $4 for generic medications, and $0 for medications filled through mail order. Have more questions? We’re here to help.
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EGWP Enrollees: 2021 IRMAA Submission Reminder
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Certain high-income retirees who are Medicare-eligible and enrolled in the AlaskaCare enhanced Employer Group Waiver Program (EGWP) pharmacy plan are required to pay a 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 who earned more than $87,000 or a married couple who earned more than $174,000 in 2019, you will be required to pay the IRMAA for 2021. Retirees enrolled in EGWP whose household income was 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 for the Part D IRMAA premium surcharge through a tax-advantaged health reimbursement arrangement (HRA) account, so the EGWP plan has no additional cost to you! For steps on completing your 2021 IRMAA reimbursement, please visit our IRMAA webpage or contact OptumRx at 855-409-6999. The deadline to receive reimbursement for the 2021 Part D IRMAA is December 31, 2022. Every year in November, Social Security sends a letter outlining what the next year's IRMAA premium surcharges are, if applicable to you. Once you receive your letter from Social Security or a bill from Medicare for your 2022 Part D IRMAA premium surcharge, you may complete the same steps listed on our IRMAA webpage to begin the reimbursement process for 2022. |
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WA Cares Fund—Long Term Care for Washington residents
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Beginning January 2022, Washington workers will pay up to $0.58 per $100 of earnings to the WA Cares Fund. The WA Cares Fund is a new fund to which Washington residents contribute while working, and through which can access long-term care benefits. To qualify for benefits from the WA Cares Fund, you must have worked and contributed to the fund for:
People who have a need for long-term services and supports may begin applying for benefits in January 2025. Each person who is eligible to receive the benefit can access services and supports costing up to $36,500. To qualify for benefits, you must have met the WA Cares contribution requirements by the time you apply. You must also need help with activities of daily living. You must be at least 18 years old and a current resident of Washington to receive long-term care benefits. For more information on WA Cares Fund premiums, see RCW 50B.04.080 and RCW 50B.04.085. |
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Future AlaskaCare Town Hall Events
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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: |
Check with your local public health office, primary care provider, or local health authorities for more information. |
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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 plans and partner contact information can be found on our website. AlaskaCare – Plan Administrator
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