AlaskaCare Retiree Health News | Monthly e-newsletter | January 2022
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AlaskaCare Retiree Health News
| Volume 44| January 2022 |
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New Benefits—Preventive Care Benefit Overview
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The AlaskaCare plan expanded preventive care coverage to the Retiree Defined Benefit health plan, effective January 1, 2022. Join us throughout 2022 as we explore the preventive care benefits offered by your AlaskaCare retiree insurance plan. Each month from January through June, we will take a closer look at some of the preventive services now eligible for coverage by your AlaskaCare health plan.
Preventive Care Benefit Overview You don’t need to feel sick in order to see your doctor. In fact, the best time to go might be when you feel well. Perhaps you need a flu shot or a screening test. Or maybe you’re just looking for some health tips. That’s preventive care—and it can help you stay healthy or catch health issues early. AlaskaCare covers preventive care for you and your eligible dependents. There are no copays, deductibles, or coinsurance for covered preventive services when you see a network provider. Call your doctor to schedule your appointment and be on your way to good health. What Preventive Services are Covered? Preventive care and recommended screenings are important tools to keep you and your family healthy. AlaskaCare retiree members can now get many checkups, screenings, vaccines, prenatal care services, contraceptives, and more with no out-of-pocket costs. These include, but are not limited, to:
Coverage for preventive services is based on recommendations by the U.S. Preventive Services Task Force (USPSTF) and other governmental advisory groups and may include additional services as outlined in the AlaskaCare Third-Party Administrator’s clinical guidelines. These guidelines will change over time as they are updated to reflect the most current research and evidence. How are Preventive Services Covered? If you see a network provider for preventive services, your AlaskaCare plan will pay 100% of the cost and your deductible will not apply. If you see an out-of-network provider, you will first have to meet the $150 deductible, and then the plan will pay 80% coinsurance (up to the recognized charge) for covered services. Your AlaskaCare out-of-pocket maximum will not apply to preventive care services received from out-of-network providers. Many retiree plan members have other health coverage, such as Medicare, or additional coverage through their spouse. The AlaskaCare plan will continue to coordinate with other plans the way it does today when determining payment for covered services. How Do I Find an In-Network Provider? For assistance finding an in-network provider, call the Aetna Concierge at (855) 784-8646 or search online using the Aetna DocFind tool. If you do not have access to an Aetna network provider in your area, you may contact Aetna to pre-certify the use of an out-of-network provider, and if approved, those services will be paid as though they were received in-network. Preventive Versus Diagnostic. What’s the Difference? Many procedures, imaging, or services can be diagnostic in nature or preventive. For example, you are symptom-free and your doctor wants you to have a routine colonoscopy because of your age. If you have a colonoscopy, it’s considered preventive care and this costs you nothing extra. If you are having symptoms, your doctor may suggest a colonoscopy to help determine what is causing those symptoms—that’s diagnostic care. When your doctor’s office submits a claim for your service, they indicate if the service is preventive or diagnostic. The amount you owe will depend on how the service is reported by your doctor. Services are considered preventive care when you:
Services are considered diagnostic care, and not preventive care, when:
Have More Questions? Contact the Aetna Concierge at (855) 784-8646 for information about whether or not a service is diagnostic or preventive or if you would like more information about your health plan benefits. |
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AlaskaCare Retiree Health Plan Booklets
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Plan Booklets are available for all members of the AlaskaCare health plans, they are designed to help you understand your plan and the benefits it provides. You’ll find a benefit summary and information about plan coverage, how benefits are paid, travel coverage, precertification, what expenses are covered, and more. For your convenience, the Plan Booklets are available on the AlaskaCare website. You can view the booklets online or download them to your computer. |
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AlaskaCare Dental-Vision-Audio Benefits
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You may have heard about a lawsuit related to the AlaskaCare Dental-Vision-Audio (DVA) plan. In 2014, in an effort to protect you from rising premiums and to preserve the value of your benefits, the Division updated the dental portion of the DVA plan to align with best dental practices and reduce the cost of services through an expanded dental network. This sought to preserve the plan’s value while maintaining members’ access to care and averting premium increases. In January 2016, a lawsuit was filed contesting the Division’s efforts. In April 2019, the Alaska Superior Court ruled in favor of the plaintiff. This decision resulted in two DVA plans being offered, the Standard DVA plan and the Legacy DVA plan. This decision was appealed to the Alaska Supreme Court. On January 21, 2022, the Alaska Supreme Court vacated the Superior Court’s judgment. The Division is evaluating the decision. There will be no immediate changes to the AlaskaCare Retiree Dental-Vision-Audio benefits. The Division of Retirement and Benefits is dedicated to providing affordable, valuable, and sustainable dental benefits to retirees. The AlaskaCare retiree Dental, Vision, and Audio plan is fully funded by your monthly premium payments, and the Division works hard to maximize the benefits you receive while keeping premiums affordable. What is the AlaskaCare retiree Dental Vision Audio (DVA) Plan? Upon retirement, AlaskaCare retiree beneficiaries may choose to participate in a voluntary Dental, Vision, and Audio (DVA) plan to provide coverage for themselves and their eligible dependents. Unlike the medical and pharmacy plans, the DVA plan benefits are funded entirely by member-paid premiums. Will my DVA coverage change as a result of the Supreme Court decision? There will be no immediate changes to the AlaskaCare Retiree Dental-Vision-Audio benefits. The Division will provide any updates to retirees as they become available. |
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Coverage for At Home
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The federal government recently announced new guidelines for health plan coverage of over-the-counter COVID-19 tests. Though the AlaskaCare Retiree plan is exempted from the new guidelines, the Division is temporarily providing coverage for test kits to the Retiree Plan to support members during the national public health emergency.* Effective January 15, 2022, and through the national public health emergency as determined by the Plan Administrator, your AlaskaCare health plan will cover at-home over-the-counter FDA authorized COVID-19 tests, 8 per month per covered person, up to $12 per covered test. You can purchase an FDA-authorized over-the-counter COVID-19 test kit at stores or online retailers. Keep your purchase receipt(s) to submit to OptumRx for reimbursement. You will be reimbursed for up to 8 tests per covered member, per month without a prescription. AlaskaCare will reimburse you up to $12 per covered test. You can submit an online claim form here. For questions about claim form submission contact OptumRx at (855) 409-6999. Testing may also be available through non-network pharmacies, at community testing sites, at your school or your health care provider, and at private testing sites.
Remember Medicare pays for COVID-19 tests performed by a lab, such as PCR or antigen/rapid tests, at no cost to you when the test is ordered by an authorized health care professional but is not currently covering over-the-counter COVID-19 tests. *The preceding temporary administrative changes are prospective in nature and shall remain in effect until earlier of the date of: 1) the termination of the suspensions contained in the applicable COVID-19 Disaster Order of Suspension; 2) the termination of the Declaration of Public Health Disaster Emergency issued by Governor Mike Dunleavy; or 3) the national public health emergency is terminated by the Secretary of Health and Human Services; including any extensions or amendments thereof. The temporary administrative changes listed above are in response to a State of Alaska and federally recognized health emergency and do not provide a vested right to coverage for any individual. The Division of Retirement and Benefits retains the sole discretion to rescind or modify these temporary administrative changes depending on the circumstances. |
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Below you will find the best ways to protect yourself and the people around you from getting and spreading COVID-19. A layered approach—using multiple prevention methods—provides the strongest protection.
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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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Health Benefit Contact Information |
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Division of Retirement and Benefits Medical Benefits: Aetna Long Term Care Benefits: CHCS Services, Inc. Dental Benefits: Moda/Delta Dental Pharmacy Benefits: OptumRx |