• Dental Preventive Cleanings & Hearing and Vision Screening
• Retiree Health Plan Advisory Board
• Rehabilitative Care
• Ounce of Prevention: Preventing Falls and Injuries
• Save the Date—Health Fairs Will Be Returning this Fall!
• Future AlaskaCare Town Hall Event
• We Value Your Feedback!
• Health Benefit Contact Information

Dental Preventive Cleanings & Hearing and Vision Screening

The AlaskaCare plan expanded preventive care coverage to the Retiree Defined Benefit health plan effective January 1, 2022.

Thank you for joining us over the past few months as we explored the preventive care benefits offered by your AlaskaCare Retiree Insurance Plan. Each month from January through June, we took a closer look at some of the preventive services. If you missed any of the previous newsletters, find a copy here.

This is the final article in the preventive care series. Thank you for reading along with us as we reviewed some of the preventive care benefits available in the AlaskaCare Retiree Health Plan. For more information, please see the AlaskaCare Retiree Insurance Information Booklet, or contact the Aetna Concierge at (855) 784-8646.

 This month we are featuring preventive dental, vision, and hearing care.

Dental Preventive Cleanings & Hearing and Vision Screening

The dental-vision-audio (DVA) plan is an optional plan that retirees can elect at the time of retirement. Your covered DVA benefits did not change with the addition of preventive care coverage to the medical plan in 2022, but dental, vision, or hearing preventive screenings are part of an overall wellness strategy. If you’re due—or overdue—for your dental, vision, or hearing screening consider scheduling an appointment soon.

Vision Screening

Being able to see whatever you want without glasses or contacts would be fantastic. Unfortunately, people don’t have the vision of a Bald Eagle, and most of us experience at least one vision condition at some point during our lives. Our eyes are incredibly complicated and even the slightest disruption in the lens, cornea, retina, or iris can drastically change your vision. The good news is that many vision conditions can be corrected through a comprehensive eye exam followed by the correct prescription for glasses or contact lenses.

The following services and supplies are a covered benefit for members who elected DVA coverage at the time of retirement.

• One complete eye examination, including a required refraction, by a legally qualified ophthalmologist or optometrist, during a calendar year.
• Up to two single vision, bifocal, trifocal, or lenticular lenses per calendar year. 
• Frames, but not more than one pair during any two consecutive calendar years.
• One pair of cosmetic contacts elected in lieu of glasses. These will be covered the same as any other single-vision spectacle lenses appropriate to the member’s vision prescription. This means that you must pay the difference between the recognized charge for spectacle lenses and contact lenses.
• Contact lens fitting provided by an ophthalmologist or optometrist, or by a technician under the direct supervision of the prescribing practitioner, when contact lenses are elected in lieu of glasses.
• One pair of contact lenses required following cataract surgery or because visual acuity is correctable to 20/70 or better only with the use of contact lenses. The maximum lifetime amount payable for necessary contact lenses is $400. After you reach this maximum, necessary contacts are covered the same as cosmetic contacts.
• Certain lens options, limited to those listed below:
  • Scratch-resistant coating
  • Antireflective coating
  • Polycarbonate lenses

Exercise Your Way to Healthier Eyes

Regular exercise is good for your eyes, and there are plenty of fun ways to get moving. Decrease your risk for glaucoma, diabetic retinopathy, and age-related macular degeneration with exercise.

It's no secret that exercise is the best way to get in shape and avoid serious health conditions. But you may be surprised to learn that you can exercise your way to healthy eyes too. Like your heart, brain, and lungs, your eyes are impacted by how you care for your body. Regular exercise can help prevent eye conditions linked to obesity and being out of shape.

• Glaucoma causes damage to the optic nerve. Simply walking 2 or 3 times a week can help lower pressure on the nerve in the eyes.
• Diabetic Retinopathy can lead to blindness unless a regimen of the right diet and exercise is followed.
• Age-related Macular Degeneration (AMD) is a leading cause of vision loss in Americans 60 years of age and older. Lowering blood pressure through a good diet and exercise may help slow the progress of AMD.

Do you live in Ketchikan? Ketchikan does not currently have any in-network vision providers. Until a network provider is available in Ketchikan, you can call the Aetna Concierge at (855)784-8646 before your vision appointment to discuss temporary approval that allows your out-of-network provider claims to be processed as in-network.

Hearing (Audio) Screenings

The Retiree DVA Plan provides audio benefits up to $2,000 for each person in a covered rolling 36-month period. You pay no deductible under this plan, and the plan pays 80% of the recognized charge for audio services. Covered services that are preventive in nature include an otological (ear) examination by a physician or surgeon and an audiological (hearing) examination and evaluation by a certified or licensed audiologist, including a follow-up consultation.

While it may sound strange, the effects of hearing loss reach well beyond your ears. In fact, it can affect you from head to toe. Hearing problems play a role in everything from your brain health and mood to your risk of physical injury. It shouldn’t be that way. You can catch hearing loss early by staying on top of your annual hearing exams. And there are many ways your doctor can help improve your hearing. They can remove wax blockages, for instance, or recommend hearing aids and amplification devices.

Dental Wellness Exams

The DVA plan is an optional plan that retirees can elect at the time of retirement. Within the DVA plan, there are two dental plan options, the Standard Plan and the Legacy Plan. Below is a summary of the preventive services in the Standard Dental Plan and the Legacy Dental Plan. 

Covered Dental Services: Class I - Preventive	Standard Plan		Legacy Plan
Cleanings (prophylaxis)		Covered two times per benefit year; additional cleanings available for persons with diabetes, periodontal disease, or in last trimester of pregnancy. Other exceptions allowed.		Covered
Periodontal maintenance		Covered as a class I service at 100% and no deductible. Two times per benefit year; additional cleanings available for persons with diabetes, periodontal disease, or in last trimester of pregnancy. Other exceptions allowed.		Covered as a class II service at 80% and $50 deductible.
Topical fluoride: 18 years or younger		Covered two times per benefit year.		Covered
Topical fluoride: 19 years or older		Covered two times per benefit year if recent periodontal surgery or high risk of decay due to chemotherapy or medical disease.		Covered
Sealants: 18 years or younger		Covered once every five years with tooth limitations.		Covered
Sealants: 19 years or older		Covered once every five years with tooth limitations		Not Covered
Space maintainers		Covered for 14 years and younger, once per tooth space with tooth limitations.		Covered as a class II service at 80% and $50 deductible.

How to Find a Dental Provider That Is In-Network

When you need dental care, selecting a provider that is in-network can save both you and the plan money. To find an in-network dental provider, call Delta Dental Member Services at (855) 718-1768 or use the Find a Dentist search tool.

Retiree Health Plan Advisory Board

The purpose of the Retiree Health Plan Advisory Board (RHPAB) is to facilitate engagement and coordination between the State of Alaska’s retirement systems’ members, the Alaska Retirement Management Board, and the Commissioner of Administration regarding the administration of the retiree health plan.

On June 8, 2022, Governor Mike Dunleavy issued Administrative Order 336 continuing the operations of the Retiree Health Plan Advisory Board (the Board), expanding the Board’s membership to include an additional seat designated for a member representing the Retired Public Employees of Alaska, Inc (RPEA), and removing the prior “sunset clause” which terminated the Board on its sixth anniversary pending a recommendation for a further extension.

How Does Administrative Order 336 Impact the Board and Retirees?

1. Continuation of the Board’s Operations: The Board was originally established in 2017 via an Administrative Order issued by the Governor. The most recent Administrative Order confirms the purpose and role of the Board, and the continued operations of the Board going forward.
   
   
2. Expanding the Board’s Membership: The members of the Board represent you, the retirees. Expanding the membership to include a seat specifically designated for a member of RPEA provides an additional opportunity for State of Alaska retirees to get involved and work collaboratively with the Division to improve and sustain the AlaskaCare retiree health plans.
   
   
3. Removal of the Sunset Clause: Prior Administrative Orders authorizing the Board’s operations included a “sunset clause” that provided that unless otherwise extended by the Governor, the Board would terminate on the sixth anniversary. Removing this sunset clause from the current Administrative Order means that the Board will not automatically expire.

Interested in Serving on a State of Alaska Board or Commission?

At any given time, approximately 1,200 Alaskans are serving on over 135 boards and commissions. Alaska’s boards and commissions relate to nearly every industry and interest and have varying levels of demands, functions, authority, and involvement.

The Boards and Commissions office actively recruits, interviews, and vets board candidates throughout the year. Board members are appointed by the Governor. Applications can be submitted at any time.

• Apply Online
• Apply via Email: boards@alaska.gov
• Application Form (for mail or fax)

Rehabilitative Care

Your AlaskaCare retiree health plan currently covers outpatient rehabilitative care designed to restore and improve bodily functions lost due to an injury or illness. This care is considered medically necessary only if significant improvement in body function is occurring and is expected to continue (see Section 3.3.12 Rehabilitative Care in the AlaskaCare Retiree Insurance Information Booklet).

What are some examples of rehabilitative services?

Rehabilitative care includes physical therapy, chiropractic care, occupational therapy, speech therapy, and certain rehabilitative counseling services.

Is there an annual limit on the number of rehabilitative services I can receive?

The Plan does not contain an annual service or visit limit for outpatient rehabilitative care.

How does the Plan currently verify that I’m experiencing significant improvement in body function?

After the 20th claim in a year for rehabilitative services from the same provider for a specific episode of care, the Claims Administrator (currently Aetna) will request clinical records that demonstrate you continue to experience significant improvement.

Starting at the 26th visit, Aetna will begin to pend claims until they receive clinical records demonstrating significant improvement in accordance with the established clinical criteria.

If sufficient records are not provided within 45 days, or if the records fail to demonstrate significant improvement, the services are denied.

Benefit Clarification

As part of a settlement agreement with the Retired Public Employees Association of Alaska, Inc. (RPEA), the Plan has issued a benefit clarification related to rehabilitative services for musculoskeletal conditions.

The benefit clarification states: When the medical necessity review is performed after the 25th visit for therapy visits for musculoskeletal disorders for a specific episode of care, if the treatment is determined to be maintenance care, the beneficiary will receive coverage for up to 10 additional visits per year for that specific episode of care.

This means that each year, members can receive up to 25 rehabilitative care visits for an episode of care to treat a musculoskeletal condition before a review of the clinical notes must be conducted. After that point, if the review determines that the services do not meet the clinical policy standards, the Plan will authorize up to 10 additional visits for maintenance care.

Ounce of Prevention: Preventing Falls and Injuries

We cannot prevent all the health issues we will experience in a lifetime, but taking care of ourselves and our family’s physical, mental, and emotional well-being helps us avoid or address problems early and maintain a good quality of life. This article provides tips about preventing falls and related injuries.

Falling is a serious health risk for older adults and a leading cause of injury among older adults. Over one-third of Americans over age 65 suffer a fall each year, and the risk of injury and complications increases with age. Anxiety or fear about falling can also negatively impact seniors’ daily life, making people reluctant to engage in physical activity, social activities, or other things they enjoy.

The good news is that falls are preventable, by making some common-sense choices as you age that can help you remain confident, steady, and stay on your feet!

• Wear comfortable, stable, and supportive shoes. Tight, ill-fitting, or unsteady footwear (especially high heels!) can greatly increase your risk of falling. Choose shoes that support you well.
  
  
• Exercise and stay active! By keeping your body moving, you help maintain muscle strength and tone, balance, cardiovascular health, and many other benefits. Staying active helps you stay upright and can help you recover more easily if you do have a fall.
  
  
• Identify your personal fall risks: are you taking medications that make you dizzy, nauseous, light-headed, or otherwise unsteady on your feet? Do you get dizzy when standing up too quickly? Do you consume alcohol regularly? All of these are major risk factors for falls and fall-related injuries. Maintain awareness of when and how you might be at extra risk of a fall.
  
  
• Evaluate fall risks in your home and take steps to keep yourself safe. Your home might be full of hazards: loose rugs or floorboards, cords or other objects in high-traffic areas, or things stored on high shelves. Secure tripping hazards on the floor, store things you use often within easier reach and keep an eye out for any spilled liquids, grease, or small items like beads or screws that might cause you to slip and fall. If you have trouble seeing in low light, keep your home well-lighted. There are many helpful assistive items on the market to make your bathroom less hazardous, from handrails and non-slip pads to seats and armrests for your toilet or bathtub.
  
  
• If you live in a place with regular rain, snow, or ice, keep your exterior walkways clear, salted, or sanded, and/or install non-slip surfaces on hazards like worn-down wooden stairs.
  
  
• If you are worried about falling or are potentially at higher risk with any of the factors above, talk to your doctor to create a fall prevention plan. Your physician can help you identify ways to improve your balance, muscle strength, and walking style.

And if you are recovering from a fall-related injury, you can access rehabilitative care to help you restore functioning as a result of that injury. Consult the plan booklet for details about rehabilitative care.

Save the Date—Health Fairs Will Be Returning this Fall!

The AlaskaCare Health Plan, in partnership with the Pacific Health Coalition, will be offering Health Fairs this fall in five Alaskan cities during September and October. Look for more details in the July newsletter and on the AlaskaCare webpage.

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, July 21, 2022, at 10 a.m. Alaska Time
• Thursday, August 18, 2022, 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 plan 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

Health Benefit Contact Information

Division of Retirement and Benefits
Member Service 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