• COVID-19 Public Health Emergency ended May 11, 2023
• Notice of Proposed Updates to the AlaskaCare Defined Benefits Retiree Health Plan
• How to Give a Family Member or Caregiver Permission to Call Medicare on your Behalf
• Retiree Health Plan Advisory Board
• Keyword of the Month: Prior Authroization
• Rehabilitative Care
• We Want to Hear from You - AlaskaCare Town Hall Event
• We Value Your Feedback!
• Health Benefit Contact Information

On May 11, 2023, the federal government has ended the COVID-19 public health emergency and national emergency declarations. Here at AlaskaCare, we made temporary changes, permanent changes, and limited benefit expansions to your health plan during the public health COVID-19 response to assist you in accessing the care you needed. While the national public health emergency has ended, your health benefits will continue to be there when you need them.

Here is what you need to know:

COVID-19 Vaccines

Remains Covered. Your AlaskaCare health plan covers preventive vaccines under both the medical and pharmacy plans. AlaskaCare members receive preventive vaccines, including the COVID-19 vaccine, at no cost when received at a network pharmacy or from a network provider. Standard cost-sharing provisions apply for non-preventive vaccines. 

COVID-19 Treatment

Remains Covered. Your AlaskaCare health plan covers your medically necessary treatment when diagnosed with COVID-19, the same as other covered medical expenses. You must first meet the annual deductible of $150 per person. After you meet the annual deductible, the medical plan pays 80% or more for covered expenses, up to the annual individual out-of-pocket limit of $800. When your deductible is satisfied and your out-of-pocket maximum is reached, the medical plan pays 100% of most covered medical expenses for the rest of the benefit year.

COVID-19 Laboratory Testing

Remains Covered. Your AlaskaCare health plan covers laboratory testing for COVID-19, the same as other covered diagnostic testing expenses. Standard cost sharing provisions apply for COVID-19 laboratory tests (Polymerase Chain Reaction or “PCR” and antigen tests) that are deemed medically necessary under the terms of the plan.

Over-the-Counter COVID-19 Testing

Temporary coverage expires on June 30, 2023.Your AlaskaCare health plan pharmacy benefit will continue to cover at-home, over-the-counter, FDA-authorized COVID-19 tests, 8 per month per covered person through June 30, 2023. Beginning July 1, 2023, the temporary coverage for over-the-counter COVID-19 test kits will no longer be in effect. COVID-19 laboratory testing (PCR and antigen tests) will continue to be covered per the plan provisions. 

Telemedicine Services

Remains Covered. Your AlaskaCare plan covered telemedicine before and during the COVID-19 public health emergency and will continue to cover telemedicine services delivered by your regular providers per the plan provisions. If you or your provider are unsure which telehealth services are eligible for coverage, please contact the Aetna Health Concierge at (855) 784-8646 for more information.

Notice of Proposed Updates to the AlaskaCare Defined Benefit Retiree Health Plan

The Department of Administration, Division of Retirement and Benefits, is working with the Retiree Health Plan Advisory Board (RHPAB) to review the following proposed updates to the AlaskaCare Defined Benefit (DB) Retiree Health Plan.

• Update to the Lifetime Benefit Maximum
• Addition of Supplemental Non-Emergent Surgery and Travel Benefits
• Addition of Virtual Physical Therapy and Musculoskeletal Care

You can view the proposed updates on the Latest News webpage on the DRB website or on the Online Public Notice system. You may comment on the proposed updates by submitting written comments:

• By Mail: State of Alaska Department of Administration Division of Retirement and Benefits P.O. Box 110203 Juneau AK, 99811-0203
• By Email: doa.drb.alaskacare.retiree.plan@alaska.gov.

Public comments will be accepted through 4:30 pm Alaska time on June 16, 2023.

For more information about the AlaskaCare plans, visit AlaskaCare.gov.

If you have questions about the AlaskaCare Retiree DB Health Plan or your benefits, please contact the Division at (907) 465-4460.

The Retiree Health Plan Advisory Board

The Retiree Health Plan Advisory Board (RHPAB) was created through Administrative Order No. 288 on September 29, 2017 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.

The RHPAB provides valuable input and has been instrumental in evaluating new proposals that would help modernize the retiree health plan while sustaining the benefit level.

Upcoming Retiree Health Plan Advisory Board Modernization Subcommittee Meeting: June 22, 2023

We invite you to attend or listen to any or all the meetings. Members are always welcome. The meeting dates are posted to Online Public Notices and to AlaskaCare.gov/RHPAB. If you would like to offer public comment for the board to review, send an email to alaskarhpab@alaska.gov

How to Give a Family Member or Caregiver Permission to Call Medicare on your Behalf

Would you like a family member or caregiver to be able to call Medicare on your behalf? Medicare can't give your personal health information to anyone unless they have permission in writing first. There are two ways you can give permission:

• Print and fill out Medicare Form CMS-10106, "Authorization to Disclose Personal Health Information" and mail it in: 

Medicare CCO, Written Authorization Dept.
PO Box 1270
Lawrence, KS 66044

• Submit the form online at mymedicare.gov.

You can call 1-800-MEDICARE (1-800-633-4227) for more information.

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.

Keyword of the Month: Prior Authorization

The world of health care is complex and uses a lot of jargon. You don’t need to be a health care specialist to get the most out of your benefits and knowing some of the technical terms makes it a little less mysterious. This month’s keyword is Prior Authorization.

Prior Authorization, also known as precertification, is a pre-approval process that reviews your treatment, prescription, medical device, or other healthcare-related service against clinical, evidence-based standards to verify that the service is medically necessary and will be covered under your plan. Prior authorization may be necessary before receiving a service, except in emergency situations or if the plan states the service does not require prior authorization. Prior authorization may also depend on your individual health situation and diagnosis: many services are covered without additional review in some circumstances but may require additional review or prior authorization for others. Prior authorization is a separate process from reviewing and processing claims, which occurs after the service is provided and billed to the health plan. At this point, the plan determines whether and how to cover the services in the claim.

If you use a network provider, they will handle any necessary precertification for you. You are responsible for obtaining any necessary precertification from Aetna before receiving medical services from an out-of-network provider.

Check out a glossary of more health care terms here.

We Want to Hear From You!
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. Town hall events occur on the third Thursday of each month, and you are welcome to join us.

You can pre-register now online to 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. Upcoming Town Hall Events:

Upcoming Town Hall Events:

• Thursday, June 15, 2023, at 10 a.m. Alaska Time
• Thursday, July 20, 2023, 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: Optum Rx
Member Services: (855) 409-6999