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Groton Dunstable Regional School District. Medicare Retiree Open Enrollment – July 1, 2019. March 2019. Agenda. Open Enrollment Harvard Pilgrim Medicare Enhance Aetna, a CVS Company - Prescription Drug Plan Enrollment and Beyond $150 Fitness Reimbursement Discounts & Savings.
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Groton Dunstable Regional School District Medicare Retiree Open Enrollment – July 1, 2019 March 2019
Agenda • Open Enrollment • Harvard Pilgrim Medicare Enhance • Aetna, aCVS Company - Prescription Drug Plan • Enrollment and Beyond • $150 Fitness Reimbursement • Discounts & Savings
Open Enrollment: March 18 – May 3, 2019 What you need to know this year • Due to plan changes, all Medicare retirees must decide whether to enroll in the District’s Medicare Supplement plan for July 1, 2019 • If you’re not eligible for Medicare Enhance during open enrollment, you can become eligible to enroll on the date when you retire and sign up for Medicare Parts A and B • You must complete an enrollment form to obtain coverage for July 1, 2019
Harvard Pilgrim Medicare Enhance • Must be enrolled in Medicare Parts A and B to enroll in Medicare Enhance • You can visit any doctor or hospital that accepts Medicare patients – anywhere in the country • Similar to the current Medicare Enhance plan offered by the GIC
What is Medicare Enhance? • Supplements a member’s Medicare coverage by paying the Medicare deductibles and coinsurance • Medicare pays primary, Medicare Enhance pays secondary • Members can receive care from any doctor, hospital, or other health care provider that accepts Medicare • Members are not locked into a provider network • Don’t have to choose a primary care physician • Free to visit specialists for covered services • No need for referrals or authorization • Show both your Medicare and Medicare Enhance ID cards when you visit the doctor or hospital
What Will Happen July 1, 2019 • Harvard Pilgrim Health Care will be the carrier for your Medicare Enhance medical benefits • Pharmacy benefit through Aetna/CVSPrescription Drug Plan (PDP) • Seamless integration – HPHCpartnership with Aetna/CVS • 65,000+ pharmacies nationwide pharmacy network • Offers prescription mail order service • Rx formulary
Rx Drug Plan – Formulary • Medicare Prescription Drug Plan covers many of the most common prescribed generic and brand-names • We will be providing updated information on the formulary soon.
Rx Drug Plan – Pharmacy Network • Pharmacy network includes national chains and local options. • All major and regional chains such as CVS, Rite Aid, Wallgreens, are included in the network. • Additional information on the network is being updated and will be forthcoming.
Rx Drug Plan – Home Delivery • Most prescription drugs are available through their mail-order pharmacy. • Get up to a 90-day supply of medicine; free standard shipping • Reorder online, by phone or by mail. • Inform your doctor that your plan is changing and that you will need a new mail order Rx.
Medicare Rx Copayments Retail 30 days 90 days • Tier 1 – Generic $10 $25 • Tier 2 – Preferred Brand $30 $75 • Tier 3 – Non Preferred Brand $65 $165 • Tier 4 – Specialty $65 30-day limit Mail order 90 days • Tier 1 – Generic $25 • Tier 2 – Preferred Brand $75 • Tier 3 – Non Preferred Brand $165 • Tier 4 – Specialty 30-day limit
Medicare Enhance: 2019-2020 • Members will have two separate ID cards starting July 1 • HPHC Medicare Enhance (medical) • Aetna/CVSMedicare PDP (pharmacy) • Questions prior to July 1? • HPHC TotalAssist: (866) 874-0817 Inform your doctor of the change and all new ID numbers
What to Expect After You Enroll • Harvard Pilgrim Medicare Enhance ID cards will arrive in mid-to-late June • If you currently have Medicare Enhance or another GIC Medicare plan option, continue to use that ID card through June 30, 2019 • Medicare Rx (PDP) members will receive a welcome letter, a new ID card, Evidence of Coverage, and mail order information mid-to-late June • Continue to use your current GIC Rx plan through June 30, 2019.
Fitness Reimbursement • Up to $150 per Harvard Pilgrim policyholder (i.e., per subscriber) per calendar year • Must be a member of both Harvard Pilgrim and a qualified fitness facility for at least four months in a calendar year • Qualified fitness facilities are full service, health clubs that include cardiovascular and strength-training equipment and facilities for exercising and improving physical fitness (most “traditional” health clubs, YMCAs and JCCs qualify) • Also included: fitness studios/facilities that offer yoga, Pilates, Zumba, aerobic/group classes, indoor cycling/spinning classes, kickboxing, CrossFit, strength training, tennis, indoor rock climbing and personal training (taught by a certified instructor).
Exceptional Discounts for Members Unlock your discounts starting July 1 at www.harvardpilgrim.org • Up to $150 Fitness Reimbursement • Free eyewear program and discounts at many popular retailers • Laser vision procedures • Hearing aids • Complementary and Alternative Medicine (acupuncture, yoga, chiropractic, massage therapy, mindfulness) • Healthy eating programs, like Jenn Craig, PlateJoy and Eat Right Now • Marathon Sports, Appalachian Mountain Club and other fitness savings • Family and senior care services • Smoking cessation programs • And more!
Recap • Must complete an enrollment form and return to the Human Resources Office no later than May 3, 2019 • You will receive a termination letter from your current medical carrier mid-June as coverage through the GIC is terminating June 30, 2019 • PDP members will receive a welcome letter, a new ID card, Evidence of Coverage, and mail order information mid-to-late June • You will now have two ID cards (medical) & (prescriptions) • Continue to use your current GIC plan through June 30, 2019.