Reimbursement Requests Tutorial 2011

1. Reimbursement Requests Tutorial 2011

2. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Make sure you are using the current form • The most current form is always available on the Trust website • Versions older then 2010 are no longer acceptable. • The date of the form will be found at the bottom right hand corner

3. Retiree Name • Current Contact Information PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Filling Out Your Reimbursement Forms Please make sure we have your current e-mail address. It's an important method of communication with you. Check this box if you have a new address. Make sure we can notice it.

4. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Filling Out Your Reimbursement Forms (continued) Date the service was actually provided. Statement date or payment date only OK if service date not available. • Date of Service • Name Of Patient • Total Amount of Expense • If applicable, amount insurance covered, any discounts applied • Patients responsibility • Retiree Signature and Date Joe Retiree

5. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Substantiation • Prescriptions • Must Include: • Drug name • Cost • Date • Patients name • Examples • Pharmacy stubsor print out • Over the counter drugs with Dr. prescription only • Will not accept: • Cash register receipt or payment confirmation alone.

6. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Cash Register Receipts Alone is Not Sufficient

7. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Substantiation (Continued) • Bills • Must include: • Date of service • Patients name • Description of what service or product was purchased • Any payment transactions • Will not accept: • Cash register receipt or payment confirmation alone.

8. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Substantiation (Continued) Balance forward does not describe service provided. Proof must indicate what product or service was purchased

9. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org What if Your Insurance doesn’t cover it?? It still might be eligible for reimbursement The following expenses are currently eligible as of 2011: • Lasik eye surgery • Dental implants • Viagra • Cialis • Or anything that meets with the current IRS guidelines

10. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Long –Term Care Premium Premiums are eligible for reimbursement but they are subject to aged base annual reimbursement limit. Following are the reimbursement limits for 2011. Attained age before the close of Max reimbursement for year of the taxable year • 40 or less $340 • More than 40 but not more than 50 $640 • More than 50 but not more than 60 $1,270 • More than 60 but not more than 70 $3,390 • More than 70 $4,240

11. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org PAY Attention to what you submit • Please make sure not to submit anything to the Trust until it has been fully processed by your insurance. • You may submit reimbursement claims no later then 365 days after the end of the calendar year in which the expense is incurred. • Remember you can only get reimbursed for an expense once. Do not submit the same expense more then once.

12. P.O. Box 196650 Anchorage, AK 99519-9980 Office: (907) 267-5094 Fax: (907) 249-7622 Email: bretzld@muni.org Contact Information Thank you