• Join Us for the Fall Health Fairs
• Medicare Information
  • Medicare Part A, Part B, Part C, Part D
  • How Can I Find a Medicare Provider?
  • Medicare and Coordination of Benefits
  • Electronic Claim Filing—Medicare Direct
  • Need More Medicare Information?
• The 988 Suicide & Crisis Lifeline is Coming to Alaska!
• Join the Conversation—Retiree Town Hall Events
• We Value Your Feedback!
• Health Benefit Contact Information

Join Us for the Fall Health Fairs

The AlaskaCare Health Plan, in partnership with the Pacific Health Coalition, is offering Health Fairs this fall in five Alaskan cities. Health Fairs give AlaskaCare plan participants easy access to flu shots as well as convenient blood screening, prostate-specific antigen testing, thyroid testing, Vitamin D testing, and other preventive care services at reduced rates.

The pre-registration website is scheduled to open beginning August 8, 2022. Pre-registration can be completed online only. Health fair services are limited to members who successfully use the online tool to complete pre-registration and receive an appointment.

The Health Fair offers preventive care lab tests to adults age 18 and over and there are no charges for lab services provided at the health fairs. Screenings like these can help you learn about your health and detect potential problems early on.

This year, the comprehensive lab tests being provided are:

• Chemistry/Hematology Profile (includes A1C): This screens the kidney function, liver enzymes, electrolyte (salt) imbalance, diabetes, tissue disease or damage, coronary heart disease, and more. Thyroid Screen: The Thyroid Stimulating Hormone (TSH) screening tests thyroid function. The thyroid gland regulates the way the body uses energy.
  
  
• Prostate Disease Screen (PSA): The PSA is a blood test primarily used to screen for prostate cancer. This test is offered to men 40 years of age and older.
  
  
• Vitamin D Screening: Vitamin D deficiency increases the risk of heart disease, and is also linked to high blood pressure, diabetes, and obesity.

For more information on the Health Fairs visit the AlaskaCare website.

Medicare Information

We often receive questions about Medicare so this month’s newsletter and next month’s town hall event are dedicated to all things Medicare. At the August 18 town hall event, we will be joined by Jeanne Larson from Medicare Information Office, to help answer your questions. We hope you can join us!

For additional information, check out the Medicare and the AlaskaCare Defined Benefit Retiree Health Plan brochure.

Medicare Part A, Part B, Part C, Part D

Medicare is the federal health insurance program for people 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. The AlaskaCare Retiree Health Plan assumes that you and your eligible dependents are enrolled in both Parts A and B of Medicare at age 65. At that time, AlaskaCare becomes supplemental and coordinates with Medicare to pay most of your medical expenses.

The different parts of Medicare help cover specific services:

• Medicare Part A
  Part A covers inpatient hospitalization, skilled nursing facilities, services provided by hospitals and other facilities, and certain home health care and hospice services.
  
  • What does it cost?
    Most people are eligible for premium-free Part A. Social Security will send you a letter if you are not eligible for premium-free Part A. If you receive such a letter, you do not need to enroll in Part A, but you must provide a copy to the AlaskaCare health claims administrator, and AlaskaCare will continue to pay as your primary plan for Part A services.
    
    
• Medicare Part B
  Part B covers physician and other outpatient medical services, ambulatory surgery center services, medical equipment, and ambulance services.
  • What does it cost?
    Everyone is eligible and must pay a premium for Part B, whether or not you are eligible for premium-free Part A.
    
    
• Medicare Part C
  Part C, also known as Medicare Advantage is an “all-in-one” alternative to Original Medicare. 
  
  
• Medicare Part D
  Part D covers prescription drugs.
  
  Medicare-eligible retirees and/or dependents will be automatically enrolled in the AlaskaCare enhanced Employer Group Waiver Program (EGWP). The AlaskaCare enhanced EGWP is a group Medicare Part D prescription drug plan that provides the same prescription benefits as provided to non-Medicare eligible retirees and dependents, while maximizing federal subsidies. You do not need to enroll in an individual Medicare Part D plan, and for most members, there is no additional premium for prescription drug coverage under AlaskaCare. However, certain high-wage earners will be charged an Income Related Monthly Adjustment Amount (IRMAA) surcharge for prescription drug coverage. If you are subject to the Medicare Part D IRMAA surcharge, you will be reimbursed.

How Can I Find a Medicare Provider?

You may want to establish care with a provider that accepts Medicare before you turn age 65. Use the Medicare website to find hospitals, nursing homes, home health services, dialysis facilities, doctors, and other health professionals, or search for Durable Medical Equipment (DME) or supplies.

There are three types of relationships a provider can have with Medicare. It’s important to understand the types since they can impact your financial responsibility.

1. Participating Providers
   Participating providers are required by their Medicare contract to accept the assignment of your claims. Because you don’t owe any amount over the Medicare allowed amount, AlaskaCare pays the difference between Medicare’s payment and the allowed amount if both plans cover the expense. Therefore, for covered expenses, the claim is usually paid in full, unless you have not yet met your deductibles. Your provider must bill Medicare and Medicare’s payment will be sent directly to the provider.
   
   
2. Non-Participating Providers
   Nonparticipating providers may choose whether or not to accept Medicare assignment on an individual, case-by-case basis. You should ask any non-participating providers you see if they will accept the assignment of your claim. If your provider does not accept, there is still a limit on the amount you pay for most services. This limit is 115% of the Medicare allowed amount and is called the limiting charge. Medicare calculates payment based on the Medicare allowed amount and pays 80%. If the service is covered by AlaskaCare, it recognizes 115% of the allowed amount and pays the difference between what Medicare paid and the 115% that your provider can collect. A non-participating provider who does not accept the assignment of your claim must still file your Medicare claim for you. Suppliers of medical equipment such as wheelchairs, walkers, etc., have no limit on the amount they may charge for the equipment if they are a non-participating provider. Medicare still pays 80% of the Medicare allowed amount and AlaskaCare pays the balance of the charges allowed by the plan.
   
   
3. Opt-out Providers
   Providers who “opt-out” of Medicare have signed a contract with Medicare stating they will not bill Medicare for services provided to any Medicare beneficiary. These providers are prohibited from filing any claims with Medicare and may charge you any amount for their services, with no limit. You may purchase services from such a provider, but the provider will require you to sign an agreement (a private contract) stating that you are responsible for payment in full. These services are considered to be under a private contract.
   • Under a private contract: Medicare will not pay the doctor or you for services you receive. No claim can be submitted to Medicare for services.
     
     
   • The AlaskaCare Retiree Health Plan will not pay anything for services provided under a private contract. You will have to pay whatever the doctor charges you and there is no limit to what can be charged.

Medicare and Coordination of Benefits

In accordance with state statute, the AlaskaCare Retiree Health Plan benefits become supplemental to Medicare beginning at age 65. For services covered by both plans, the claims are paid first by Medicare and then by AlaskaCare – with AlaskaCare coordinating to pay up to 100% of covered expenses, less any deductible not yet met.

Claim Payment: Medicare’s coverage is not the same as the coverage available under AlaskaCare. Any medical service covered by AlaskaCare but not Medicare will be paid at the same coinsurance rate as it was before you were enrolled in Medicare. For expenses covered by Medicare but not by AlaskaCare, such as some routine expenses, Medicare pays but AlaskaCare does not.

Who Pays First: Medicare pays benefits before the AlaskaCare Retiree Health Plan in most cases. However, if you are covered by a plan you or your spouse receive as an actively working employee, predominantly the active plan pays first, with Medicare paying second, and finally the AlaskaCare Retiree Health Plan. However, if you are only enrolled in Medicare Part B, and/or enrolled in Medicare Part A on a premium-paying basis, Medicare will pay primary, the active plan pays secondary and the AlaskaCare Retiree Health Plan pays third.

Electronic Claim Filing—Medicare Direct

If Medicare is your primary plan, the AlaskaCare claims administrator will send a request to Medicare to enroll (you) in the Medicare Direct program. Dependents on your plan who are enrolled in Medicare may not be reported. You may need to contact the AlaskaCare claims administrator directly to set up Coordination of Benefits. The provider files your claim with Medicare, which then sends you an explanation of benefits (EOB) when the claim is processed and has been transferred to AlaskaCare.

Need More Medicare Information?
Contact Alaska’s Medicare Information Office: In Anchorage: (907) 269-3680 Toll–free within Alaska: (800) 478-6065 TTY: (800) 770-8973 hss.medicare@alaska.gov

Additional information is available from the federal Medicare website at medicare.gov. If you have questions about Medicare, contact the nearest Social Security office or call, toll-free, (800) 772-1213 or go to socialsecurity.gov.

The 988 Suicide & Crisis Lifeline is Coming to Alaska!

Effective July 16, 2022, anyone in the United States can call or text 988 or use the chat function via 988lifeline.org to access the National Suicide Prevention Lifeline, which will now be known as the 988 Suicide & Crisis Lifeline. The state has been partnering with stakeholders for over a year to ensure that Alaska is ready for 988.

ABOUT 988

• 988 will accept calls, texts, and chats from anyone who needs support for a suicidal, mental health, and/ or substance use crisis. People can also contact 988 if they are concerned about a loved one in crisis.
  
  
• Alaskans who dial 988 will be connected with the Alaska Careline, an in-state call center where trained counselors answer calls, chats, and texts.

ABOUT THE ALASKA CARELINE

• The Careline is operated by Careline Crisis Intervention, Inc., an agency based in Fairbanks that serves all of Alaska and is a National Suicide Prevention Lifeline call center.
  
  
• The Alaska Careline supports Alaskans experiencing any level of crisis. Counselors provide emotional support and work collaboratively with the person in crisis to address their needs, working with them to increase their wellness and safety.
  
  
• The Alaska Careline is supported and funded by the Alaska Department of Health, Division of Behavioral Health.

Join the Conversation—Retiree Town Hall Events

Retiree 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.

Town hall events occur on the third Thursday of each month and you can pre-register now online. We want to hear from you!

Please join us for a Town Hall event on:

• Thursday, August 18, 2022, at 10 a.m. Alaska Time
• Thursday, September 15, 2022, at 10 a.m. Alaska Time

We Value Your Feedback!

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
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