New Coverage New Choices 10/31/2011

Transcription

1 New Coverage New Choices 10/31/2011

2 What We Will Cover Today What is changing and why. How this affects you. Get to know Extend Health and the services available to you. A look at the Medicare marketplace. Going forward...what to expect. Questions and answers. 2

3 Changes City of Colorado Springs has changed the way it provides health care benefits to eligible sworn retirees and spouses who are age 65 and older. City of Colorado Springs health care and prescription coverage for Medicare eligible retirees and spouses age 65 and older ended 12/31/2010. Eligible retirees and dependents will have new choices for health care that has the potential to more closely match individual needs and lifestyles. Extend Health will help you find and enroll in the coverage that works for you. 3

4 Why This Approach? Allows retirees to have more choice and the ability to customize their health care coverage. Extend Health specializes in providing these services for retirees across the U.S. 4

5 How This Affects You What you pay May change depending on what coverage you choose. How you enroll You will work with Extend Health to enroll in a plan that meets your medical and prescription needs. We will also help you establish your Health Reimbursement Account. Your support Extend Health Advisors will help you understand the costs associated with your coverage premiums, co-payments, deductibles and all other costs. 5

6 Introducing Extend Health

7 Who is Extend Health? Independent company, dedicated to serving Medicare eligible retirees. Partner with 65+ health plan carriers to provide you coverage to fit your individual needs. Objective and Trusted US based benefit advisors. Focused on helping each participant make an informed and confident decision. 7

8 Why Extend Health We are experienced in helping people just like you having helped nearly 500,000 people in the last five years. Our services are provided at no cost to eligible City of Colorado Springs retirees, spouses, and surviving spouses. 8

9 Plans & Partners All Medicare plan types: Medicare Advantage Medigap Prescription Drug (Part D) Dental Vision 9

10 The Process Educate Evaluate/Enroll Manage 10

11 Education Enrollment Guide Prepare you for enrollment discussion Review Medicare basics Give us a call

12 Evaluate and Enroll Hours of Operation Monday Friday 7 a.m. 7 p.m. MT Licensed Benefit Advisor Salt Lake City Your objective advocate Single point of contact Well trained 12

13 Decision Support Tools Help Me Choose Prescription Profiler 13

14 Enrollment Process Benefit Advisors can discuss coverage options with anyone need to speak to the participant to complete the enrollment. Once you have made a coverage selection, enrollment is conducted via telephone. 100% of calls are recorded. 14

15 Medicare & You 15

16 Your Future Coverage Primary Medicare A & B Medicare Advantage Plan with PDP, or Medigap Plan + PDP Complete Coverage 16

17 Colorado Springs Plans available 17

18 Medicare Prescription Drug Coverage Initial Coverage You pay *Deductible and Co Pays for your plan *Coverage for the first $ 2930in Actual Cost of Medications Coverage Gap Donut Hole You pay *50% of Brand Drugs and 86% of Generics Until out of pocket costs reach $4700 Catastrophic Coverage You pay *$2.60 for generics and $6.50 for Brand or 5% which ever is greater 21

19 What Is An HRA? Tax-advantaged account used to reimburse you for eligible health care expenses. You must meet City of Colorado Springs s eligibility requirements to qualify for HRA. Your HRA funds will be available January 1,

20 How An HRA Works You work with Extend Health to enroll in individual coverage City of Colorado Springs allocates benefit dollars to your HRA account Your HRA Account Administered by Extend Health You are reimbursed for your health care expenses using HRA benefit dollars 23

21 Health Reimbursement Account- Reimbursement The following process will allow you to access your HRA funds. 1 You Pay your premium directly to your insurance provider Insurance Company 2 You /Carrier Submit your claim to Extend Health Paper Auto-Reimb Extend Health 3 Extend Health Reimburses you from your HRA account You Direct Deposit Receive Check 24

22 What is Auto-Reimbursement? It allows retirees to be automatically reimbursed for monthly medical, prescription, dental and vision premiums without submitting a claim form Auto-reimbursement only applies to premiums paid, not out-ofpocket expenses like copayments, deductibles, coinsurance Available on many of the plans you may select. Eliminates the need for you to file for monthly premiums. Ask your Benefit Advisor to activate during your enrollment call. 25

23 How Auto-Reimbursement Works Customer pays plan premium to insurance carrier Extend Health reimburses customer Insurance carrier forwards receipt of payment to Extend Health Extend Health verifies receipt of payment and eligibility 26

24 Post Enrollment Customer Service Advocacy and support services. Toll Free number to contact Extend Health representative. Direct support for claims issues, appeals and network questions. Renewal process ability to pick new coverage for future years not locked into this year s coverage choice. Ongoing enrollment services as retiree or spouse turns age

25 Next Steps Review Enrollment Guide Gather Medicare card, prescriptions, & doctor information Call Extend Health

26 Questions And Answers 29