AlaskaCare Retiree Health News | Monthly e-newsletter | December 2021
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AlaskaCare Retiree Health News
| Volume 43| December 2021 |
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How to Set Your IRMAA
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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.
Medicare-eligible individuals will receive a letter from Social Security that outlines their Medicare premiums. For all Medicare plans, the IRMAA will be deducted directly from your monthly Social Security check (if you qualify for Social Security) or will otherwise 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.
OptumRx will handle all your IRMAA needs. Follow these steps to establish your Part D IRMAA reimbursement account online:
If you have any questions on how to submit your IRMAA documents online or if you do not have internet access and would like to submit paper documentation, please contact OptumRx at (855) 409-6999 or email alaskacare_irmaa@optum.com. |
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New Benefits in 2022!—Preventive Care
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Your health benefits are getting even better—AlaskaCare is adding coverage for preventive care services, effective January 1, 2022. Covered services include but are not limited to routine physical exams, well-woman preventive visits, routine cancer screenings (including screening colonoscopies!), and preventive care immunizations. If you see a network doctor, preventive screenings are covered at 100%—no cost to you! If you see an out-of-network doctor, your regular $150 deductible will apply and then the plan will cover 80% of the recognized charge. It's important to note that your out-of-pocket maximum will not apply. If you don’t have a network doctor in your area call Aetna Concierge at (855) 784-8646 to get precertification to receive network-level benefits. Join us in 2022 as we explore the preventive care benefits that will be offered by your AlaskaCare Retiree Insurance Plan. Each month from January through June, we will take a closer look at preventive services and give you tips for maximizing your AlaskaCare benefits and staying healthy. Learn more about this upcoming benefit expansion at AlaskaCare.gov/retireeupdate. |
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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 certain 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. You can also call OptumRx at (855) 409-6999 for information about your specific medications. If I’m taking a specialty medication that requires prior authorization, what should I do next? If your specialty drug requires prior authorization, you were sent a notification letter in November and will be sent a reminder letter in January advising the medication requires prior authorization review. You can initiate the prior authorization in one of two ways:
Can I request prior authorization for my prescription before January 1, 2022? While it is not necessary to obtain prior authorization for your specialty medication prescription before January 1, 2022, you may call OptumRx at (855) 409-6999 and the customer service agents can help you to submit all of the required pieces of information ahead of time. If you do so, OptumRx will initiate your specialty medication prior authorization on your behalf after January 1, 2022. Is my prescription drug coverage changing? There is no change to coverage for prescription medications that are prescribed under the terms outlined in the Plan booklet. 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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Aetna Local Office in Juneau Reopening to the Public
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Want to Talk to an Aetna Representative in Person? AlaskaCare members can make an appointment to visit the Aetna office in Juneau and talk directly with an Aetna representative beginning on January 3, 2022. They can assist you with questions about your benefits, and with services such as:
To schedule an appointment, contact the Aetna Concierge at (855) 784-8646. Appointments are available:
If you are visiting Aetna’s Juneau office, please note that City and Borough of Juneau (CBJ) COVID-19 mandates may be in effect. For updated information visit the CBJ COVID-19 webpage. |
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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. 5–17-year-olds may receive the Pfizer vaccine only. Eligible individuals may choose which vaccine they receive as a booster dose. Some people may have a preference for the vaccine type they originally received while others may prefer to get a different booster. Booster doses are available for Moderna, Pfizer, and Johnson & Johnson COVID-19 vaccines with mixed dosing allowed. COVID-19 vaccines are available at most pharmacies and provider offices in Alaska. Visit vaccines.gov to find convenient appointments or walk-in vaccine clinics near you, or browse the events calendar for special vaccine events. |
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During the 2021-2022 cold and flu season, getting a flu vaccine is important to protect yourself, your loved ones, and your community from the flu. While it’s not possible to say with certainty what will happen this winter, the Centers for Disease Control and Prevention (CDC) believes it’s likely that flu viruses and the virus that causes COVID-19 will both be spreading. Relaxed COVID-19 mitigation measures (such as stay-at-home orders, or mask mandates) may result in an increase in flu activity during the 2021–2022 flu season. Take action today to protect yourself and your family! REMEMBER! Permanent coverage for flu and pneumonia shots is part of the addition of preventive care coverage to the retiree health plan and will go into effect on January 1, 2022! This means that beginning January 1, 2022, you can get a flu shot at your pharmacy or at your doctor’s office. And if your network or doctor is in-network there is no cost to you. Does the AlaskaCare Retiree Plan Cover Flu Shots before January 1, 2022? Yes, through December 31, 2021, the AlaskaCare retiree plan is temporarily covering trivalent and quadrivalent influenza vaccines along with the pneumococcal (pneumonia) vaccine.
Permanent coverage for flu and pneumonia shots is part of the addition of preventive care coverage to the retiree health plan and will go into effect on January 1, 2022. |
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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: |
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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
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