Helping you make the right Medicare decisions. Use. Choose. your benefits effectively. your health. care plan. Improve. and manage.

Transcription

1 Helping you make the right Medicare decisions Choose your health care plan Use your benefits effectively Improve and manage your health Your Guide to Selecting Medicare Coverage for 2015

2 What s Inside 6 Easy as Get Ready Your Health Information Worksheets 10 Compare Plans 12 Your Plan Comparison Worksheets 14 Take Action 15 The ABCs of Medicare 17 Glossary 19 Health Advocate Call RightOpt starting October 1 at or visit Welcome Medtronic Retirees! It s great to have choices, and that s what Medtronic wants to provide for its retirees. Although you will still have access to the Medtronic coverage you are currently enrolled in, you now have other options for 2015 you may want to consider. Those choices are offered to you by RightOpt, a Retirement Assistance Program partner. RightOpt is a private health insurance exchange that helps you find, compare and enroll in the Medicare plan that best suits your health care needs and budget. This service is available at no cost to you! Choose Use This workbook explains how RightOpt can help you research your medical and prescription drug plan options and enroll in the plans that are best for you. The comprehensive RightOpt website provides tips, tools and other resources to help you use your benefits effectively. Improve RightOpt medical plan enrollees have access to Health Advocate TM, with representatives trained to answer questions about your coverage and claims, help you find doctors, and connect you with resources to help you manage and improve your health. See page 19 for details. RightOpt services are available at no cost to you! PRINT OR SAVE THIS GUIDE This Guide includes information and worksheets that may be helpful as you work with RightOpt and weigh your options for Medicare insurance. Please print this guide or save it to your computer so it will be easy to refer to it as you compare plans and costs. SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

3 RightOpt As a private health insurance exchange, RightOpt can open up a whole new world of possibilities when it comes to Medicare plans. Similar to travel websites that help you compare air fares and buy flights, private health insurance exchanges provide benefit plan information and help you compare costs so you can enroll in the health care plan that best meets your needs. Using RightOpt means you no longer have to choose from the few group plans offered by Medtronic. Now you can choose from many carriers and plan combinations. But you aren t alone in trying to figure out which plan is best for you. RightOpt has specially trained and licensed agents, called Enrollment Advocates, who are only a phone call away. And, best of all, the service is available at no cost to you. So you might be asking yourself Why would I want to switch from my Medtronic plan? RightOpt might be able to find you a plan that better meets your individual health care needs and budget. We can help you shop the vast health insurance marketplace that includes a large pool of retirees, just like you. Since the pool of Medicareeligible retirees is large and growing, the cost per retiree is often lower than the cost of employers group health care plans. You could pay significantly less by switching to a plan offered through RightOpt. 3

4 Here s an example of how your coverage options might compare: Retiree Joe is 70 years old, has high cholesterol, high blood pressure and an enlarged prostate, and takes five generic prescription drugs. Currently enrolled in Medtronic s group plan * ASSUMES USE OF MAIL ORDER FOR PRESCRIPTION DRUGS. Individual Medicare Supplement Plan & Stand-alone Prescription Drug Plan Individual Medicare Advantage Prescription Drug Plan Annual premiums $4,764 $2,190 + $151 (Rx) $1,020 LESS: Annual subsidy from Medtronic - $1,400 $0 $0 Total annual premium cost $3,364 $2,341 $1,020 PLUS: Estimated medical costs $300 $147 $498 PLUS: Annual prescription costs $380 $0* $463 Total annual cost $4,044 $2,488 $1,981 This is just an example of how our Enrollment Advocates can help you compare the overall plans. Your Enrollment Advocate will gather complete information about your health care needs, prescription drugs, provider choice and much more. This will help them provide you with an apples-to-apples comparison to your current group plan. 4 SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

5 The whole private exchange concept sounds confusing. Why would I consider looking into that when I am comfortable in my current plan? You re right this can be confusing, especially with so much information about it in the news and conflicting reports about what it really entails. That s why RightOpt has specially trained Enrollment Advocates who are available to answer all of your questions about choosing health care insurance, how it works, how it compares to your current coverage, etc. Once you understand your options and learn about how the plans compare, then YOU can decide if an individual insurance plan makes sense for you. If, after reviewing your options, you still want to remain with your Medtronic group plan, you can do that. What should I consider when selecting Medicare insurance? There are many factors to consider when selecting Medicare insurance. Although price is top of mind for many of us, you also should consider coverage, access to your preferred providers and hospitals, prescription drug costs and more. What happens if I decide to go with a RightOpt plan? If you select a plan through RightOpt, an Enrollment Advocate will help you enroll in coverage and provide all of your information to the carrier you choose. This personalized service is available AT NO COST to you. Once you enroll in coverage through RightOpt, you can no longer go back to your Medtronic group plan. Coverage for any of your eligible dependents who were covered under a Medtronic medical plan would also end. 5

6 Using RightOpt Easy as Follow These Steps RightOpt makes it easy to understand and evaluate your Medicare options and enroll in coverage. Follow these three steps: 1 GET READY. Learn about your coverage options. a. Read this RightOpt Enrollment Workbook and review the different types of Medicare health insurance available to you. b. Gather information about your health, doctors, use of medical services and prescriptions, and use it to complete the worksheets that begin on page 7. 2 COMPARE PLANS. Call RightOpt at or visit the RightOpt website at to start comparing your coverage options. The information on your completed worksheets will help RightOpt find plans available in your area and show you what they may cost in out-of-pocket expenses and monthly premiums. You can use the pages provided in this guide to take notes regarding your options and costs. 3 TAKE ACTION. Enroll in the plan of your choice from October 15 through December 7 by calling a licensed RightOpt Enrollment Advocate at or logging on to 6 SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

7 Get Ready Be Prepared Your Health Information Worksheets Completing the Health Information Worksheets will make things easier when you are ready to call RightOpt or use the RightOpt website. The information about your health and prescription needs will help RightOpt assist you in selecting the plan(s) that best meet your individual needs. Be assured that the information you provide to RightOpt, whether on the phone or online, will remain completely confidential. Have your completed worksheets with you when you speak with a RightOpt Enrollment Advocate or when you visit the RightOpt website at RightOpt Question Your Answer (Please check the appropriate box below) YOUR MEDICARE COVERAGE 1. Do you currently have a Medicare Insurance Card that looks like this? Yes. Go to question 2. No. Please call a RightOpt Enrollment Advocate so we can help you get your Medicare Insurance Card. I don t know. Please call a RightOpt Enrollment Advocate so we can help determine if you have a Medicare Insurance Card. 2. Are you enrolled in both Medicare Part A and Part B? Yes. Go to question 3. No. Please call a RightOpt Enrollment Advocate so we can help you get enrolled in Medicare Part A and Part B. I don t know. Please call a RightOpt Enrollment Advocate so we can help determine if you are enrolled in both Medicare Parts A and B. 3. What is the ZIP code of your primary residence where you will be using your health and drug plans? 4. Do you spend more than one month in another state? is the ZIP code of my primary residence. Go to question 4. I don t know. Please call a RightOpt Enrollment Advocate so we can help determine where to enroll you in coverage. No. Go to question 5. Yes. Here are the state(s) and ZIP code(s) where I reside for more than one month during the year: 7

8 Need help? Please call RightOpt at Monday through Friday, 8 a.m. 8 p.m. Eastern time. RightOpt Question Your Answer YOUR PRESCRIPTION DRUG INFORMATION 5. Do you currently take any prescription medications? To complete this section accurately, please gather your actual pill or medicine containers and copy the information you see on the labels to the worksheet. No. Go to question 6. Yes. Here are my current medications, with quantities and dosage for each. Drug Name: Dosage: Number of Pills/Doses Per Month: Drug Name: Dosage: Number of Pills/Doses Per Month: Drug Name: Dosage: Number of Pills/Doses Per Month: Drug Name: Dosage: Number of Pills/Doses Per Month: Drug Name: Dosage: Number of Pills/Doses Per Month: Drug Name: Dosage: Number of Pills/Doses Per Month: Drug Name: Dosage: Number of Pills/Doses Per Month: PLEASE ADD ADDITIONAL SHEETS AS NEEDED. 8 SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

9 RightOpt Question 6. What is the name of the pharmacy where you most often fill your prescriptions? Your Answer Check here if you also prefer to use a mail order pharmacy. YOUR DOCTOR INFORMATION 7. For what reasons do you see your current doctor(s)? (check all that apply) I see my doctor(s) primarily for preventive care or an occasional health problem. I see my doctor(s) for one chronic condition or multiple health issues. I see my doctor(s) for more than one chronic condition or may need an occasional major procedure. 8. Who are your doctors? The doctors I see most often are (please confirm spelling of first and last names): Name: Address: Phone: Name: Address: Phone: Name: Address: Phone: ADD OTHER NAMES/ADDRESSES/PHONE NUMBERS ON A SEPARATE PAGE, AS NEEDED. 9. Please rank the four items to the right based on what s most important to you in selecting health coverage, with 1 the most important and 4 the least important. Be sure to enter a different number (1, 2, 3 or 4) on each line. Low monthly premium Doctor choice Low payment when admitted to hospital Low payment for doctor office visit 9

10 2 Compare Plans Call RightOpt at , Monday through Friday, 8 a.m. 8 p.m. Eastern time, or visit On the Phone: Your RightOpt Enrollment Advocate RightOpt is staffed with knowledgeable and licensed Enrollment Advocates who are dedicated to helping you choose the plan that is right for your needs and budget. Based on the information you provide about your health care needs and use of prescriptions, your RightOpt Enrollment Advocate will: Locate high-quality available plan options in your preferred geographic area, Review with you how benefits, costs and network doctors compare under these options, and Help you estimate your total potential health care costs in terms of premiums and out-ofpocket expenses. If you live in different areas of the country during the year, your RightOpt Enrollment Advocate can even help you find a plan that provides coverage at those locations. Before calling RightOpt, please complete the worksheets that begin on page 7. These worksheets are just for your use, but provide a convenient, at-a-glance record of the information your RightOpt Enrollment Advocate needs to help you review your coverage options. Have your completed worksheets handy when you contact RightOpt. If you are assisting a Medicare beneficiary with enrollment If you are an adult child or authorized representative of a Medicare beneficiary, you can call a RightOpt Enrollment Advocate or visit the RightOpt website to learn about their choices and help elect coverage. If you are authorized to act on the Medicare beneficiary s behalf, you may be asked to provide legal documentation, such as a power of attorney, at some point during the enrollment process. 10 SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

11 On the Web: Plan Comparison Tools You can access RightOpt s user-friendly online tools to help you learn about different plan options and compare potential costs based on your personal needs and preferences. Visit To make using the RightOpt website as easy as possible, you can increase the screen text size or activate accessibility features. You can store all of your prescription information in the area called My Medicine Cabinet. You also can use the RightOpt website to: View and store your health information Look up the cost of prescription drugs Search for medical, prescription, vision and dental coverage Link to insurance carriers online directories of hospitals and doctors Visit to see how your Medigap, Part D and Medicare Advantage plan options compare in dollars and cents. If you have questions about using this website, you can always call RightOpt at Your Information is Secure To save and access your personal account information, you can set up a user name and password. If you need assistance, just contact an Enrollment Advocate. RightOpt will guide you through the next steps. You will be asked to enter personal information about your health care status and prescription drugs. Completing the Health Information Worksheets that begin on page 7 beforehand will make things easier when you are ready to use the RightOpt website or speak with a RightOpt Enrollment Advocate. 11

12 Your Plan Comparison Worksheets Your RightOpt Enrollment Advocate will review your health care options that are based on the personal information you provide from your completed worksheets. To help keep track of these details, it s a good idea to take notes on the information your RightOpt Enrollment Advocate provides or that you find on the RightOpt website. You can take notes on these pages as you review and compare your plan options. If a plan requires you to use a provider network, be sure to note whether your current doctors are in the network. (Your Enrollment Advocate can help you determine this.) Carrier Name Medtronic Plan Type (check one or more) Medigap plan Part D Prescription Drug plan Medigap plan Part D Prescription Drug plan Medigap plan Part D Prescription Drug plan Medicare Advantage plan Medicare Advantage plan Medicare Advantage plan Annual Deductibles Health coverage Health coverage Health coverage Prescription coverage Prescription coverage Prescription coverage Health Benefits Doctor Choice: Any/Network If Network: Doctors Included: Doctor Choice: Any/Network If Network: Doctors Included: Doctor Choice: Any/Network If Network: Doctors Included: Out-of-Pocket Spending Limit: Out-of-Pocket Spending Limit: Out-of-Pocket Spending Limit: $ $ $ Drug Benefits All My Drugs on Formulary*: Yes/No All My Drugs on Formulary*: Yes/No All My Drugs on Formulary*: Yes/No Gap Coverage: Yes/No Gap Coverage: Yes/No Gap Coverage: Yes/No My Drugs not on Formulary: My Drugs not on Formulary: My Drugs not on Formulary: Additional Notes * DEFINED IN GLOSSARY. 12 SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

13 Your Notes: Plan Costs Use this chart to help calculate your costs in terms of both premium payments and out-of-pocket charges such as deductibles, copayments and coinsurance under different plan options. If you need assistance, contact your RightOpt Enrollment Advocate at When evaluating your plans, please remember to consider factors other than cost. Your RightOpt Enrollment Advocate can help you compare the true value each plan can offer to you based on your individual needs, plan cost, level of coverage and more. Plan Name Medtronic Option I Option II Plan Type (check one or more) Medigap plan Part D Prescription Drug plan Medigap plan Part D Prescription Drug plan Medigap plan Part D Prescription Drug plan Medicare Advantage plan Medicare Advantage plan Medicare Advantage plan Total Premium Costs (Add a + b + c + d) a) Part B: b) Medigap: a) Part B: b) Medigap: a) Part B: b) Medigap: c) Part D: c) Part D: c) Part D: d) Medicare Advantage: d) Medicare Advantage: d) Medicare Advantage: (1) Premium Total: (1) Premium Total: (1) Premium Total: Total Estimated Annual Out-of- Pocket Costs* a) Health care: a) Health care: a) Health care: (Add a + b) *Deductibles, coinsurance, copayments b) Prescription purchases: (2) Out-of-pocket Expenses Total: b) Prescription purchases: (2) Out-of-pocket Expenses Total: b) Prescription purchases: (2) Out-of-pocket Expenses Total: Total Estimated Medical and Rx Spending (3) Total: (3) Total: (3) Total: (Add totals) 13

14 3 Take Action Enroll for Coverage After you decide which plan(s) will be best for you for 2015, you can enroll for coverage during the enrollment period (Oct. 15-Dec. 7). Steps to enroll 1. If you enroll in an individual Medicare plan via RightOpt, you need to cancel your current Medtronic retiree health plan coverage by completing a Group MedicareBlue Rx Disenrollment Form and returning it to them. The form and additional information can be found at A RightOpt Enrollment Advocate can also help you with the cancellation process. (Please note that once you enroll for coverage via RightOpt you can no longer return to a Medtronic group plan.) 2. Call a RightOpt Enrollment Advocate at or log on to to complete the enrollment process. After you enroll, RightOpt will coordinate your enrollment with the insurance carrier of the plan you elect. Your 2015 enrollment will be complete when the insurance carrier sends you verification that you are enrolled. Paying for Your 2015 Health Insurance Once you enroll in an individual health care plan it is your responsibility to pay your insurance premiums promptly. Most insurance companies offer a variety of payment options. 14 SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

15 The ABCs of Medicare You have Medicare Part A and Part B coverage, known as Original Medicare coverage. You can choose to supplement or replace your Medicare coverage with one or more of the plans below. RightOpt connects you to a national network of leading health insurance carriers whose plans offer a range of benefit levels and monthly premiums. Note that if you elect this additional coverage you will be responsible for the full monthly premium cost. Here are the types of plans available to you: Medigap Plan (Medicare Supplement Insurance) This type of plan can help pay some of the costs for hospital and doctor services that Original Medicare doesn t cover, such as copayments, coinsurance and deductibles known as gaps in traditional Medicare coverage. This coverage offers flexibility because it is accepted by doctors and hospitals around the country. In return, Medigap plans often charge higher premiums than other types of plans. Medigap plans do not cover prescription drugs. If you elect a Medigap plan and want prescription coverage, you must also elect Part D coverage (see the Part D information to the right). Is a Medigap plan right for you? You may prefer this plan if: You want to keep seeing the same doctors. Medigap allows you to see any doctor that accepts Medicare. You visit the doctor often. Since your monthly premium payment covers all doctor and hospital visits, most Medigap plans do not require you to pay a copayment or coinsurance for each doctor or hospital visit. You travel frequently or live elsewhere during the year. With its flexibility, Medigap makes it easier to cover medical care when you are away from home. Part D Plan (Medicare Prescription Drug Coverage) Medicare Part D plans help cover the cost of prescription drugs from participating pharmacies across the United States. Each plan can vary in premium cost and drugs covered. Be prepared to provide detailed information about your current medications. Your prescriptions may be covered at a different level under different plans, so this information is important to know as you compare your potential costs. To better understand your prescription drug costs under each plan, use the RightOpt website or contact a RightOpt Enrollment Advocate. Is a Part D prescription plan right for you? You may want this plan if: You have significant drug costs or want the security of insurance to protect against higher drug costs in the future. You want to avoid a possible late enrollment penalty down the road. You enroll in a Medigap plan that does not provide prescription drug benefits. You understand how much you may pay out of pocket for prescriptions, through deductibles, coinsurance and the donut hole. (Your RightOpt Enrollment Advocate can help you.) 15

16 Medicare Advantage Plan You ll use a Medicare Advantage card rather than your Medicare card when you go to the doctor because your Medicare Advantage plan replaces your Medicare coverage. Prescription coverage is usually included, sometimes for an extra cost. You usually pay a copayment or coinsurance for covered services. Most Medicare Advantage Plans require you to use participating doctors, hospitals and other health care providers or else you pay some or all of the costs. Medicare Advantage Plans include: PPOs, HMOs and PFFSs. See the glossary (page 17) for a description of each type of plan. Other than for emergencies, these plans may not cover medical services throughout the United States. Plan costs, coverage and rules can vary by plan. Is a Medicare Advantage Plan right for you? You may want this type of plan if: You are willing to change your doctors if necessary. In exchange for premiums that usually are lower than Medigap plans, Medicare Advantage plans require you to receive medical care from a certain network of doctors. It is possible your current doctor will not belong to one of these networks. You don t go to the doctor often. If your doctor visits are infrequent, and you can pay the copayments or coinsurance usually charged for office visits, the lower premiums offered by Medicare Advantage plans may appeal to you. You want a single plan and a single premium. By enrolling in a Medicare Advantage Plan, you receive all of your Medicare coverage (including benefits covered by Original Medicare) through one plan. You pay a single monthly premium for this coverage. If you have Medicare questions Visit the Centers for Medicare & Medicaid Services website: Consult the Medicare & You booklet, available at Call MEDICARE ( ) 24 hours a day, 7 days a week. Your RightOpt Enrollment Advocate can help you understand how each type of Medicare plan works and which plan (or combination of plans) may be best for you, based on your individual needs and budget. Call RightOpt at , Monday through Friday, 8 a.m. 8 p.m. Eastern time. 16 SPEAK WITH A RIGHTOPT ENROLLMENT ADVOCATE AT

17 Glossary Coinsurance The amount (usually a percentage of covered charges) you may be required to pay for services after you pay any plan deductibles. In a Medicare Prescription Drug Plan, the coinsurance varies depending on how much you have spent. Copayment (Copay) In some plans, the flat dollar amount you pay for each medical service, such as a doctor s visit or prescription. Deductible The amount you must pay out of pocket each year for covered health care or prescriptions, before a plan begins to pay benefits. Drug Formulary A list of prescription drugs, both generic and brand name, that are preferred by your health plan. Health Maintenance Organization (HMO) A type of Medicare Advantage Plan available in some areas of the country. Plans must cover all Medicare Part A and Part B health care. Some HMOs cover extra benefits, such as extra days in the hospital. In most HMOs you can only go to doctors, specialists or hospitals on the plan s list, except in an emergency. Your costs may be lower than in Original Medicare. Medicare Part A (Hospital Insurance) This helps cover inpatient care in hospitals and skilled nursing facilities, as well as hospice and home health care. You generally don t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. Medicare Part B (Medical Insurance) This helps cover doctors services, outpatient care and lab services. It also covers some preventive services to help maintain your health and keep certain illnesses from getting worse. You pay a monthly premium for Part B coverage. Out-of-Pocket Maximum The most you will pay for covered charges (through deductibles and coinsurance) during each calendar year. Preferred Provider Organization (PPO) A type of Medicare Advantage Plan in which you pay less if you use doctors, hospitals and providers that belong to the network. You can use doctors, hospitals and providers outside of the network for an additional cost. Private Fee-for-Service (PFFS) Plan A type of Medicare Advantage Plan that lets you visit any Medicare-approved doctor or hospital that accepts the plan s payment. The insurance plan, rather than the Medicare program, decides how much it pays and what you will pay for the services you get. You may pay more or less for Medicare-covered benefits. You may have extra benefits that Original Medicare doesn t cover

18 What You Can Expect Note these important dates on your calendar: Now through Dec. 7 RightOpt Enrollment Advocates are available to help you compare plans and answer general questions about Medicare and enrollment. Call RightOpt at Monday through Friday, 8 a.m. to 8 p.m. Eastern time. You also can view personalized plan comparisons online at Time to enroll for your 2015 coverage (to become effective January 1, 2015). Oct. 15 to Dec. 7 Call RightOpt at Monday through Friday, 8 a.m. to 8 p.m. Eastern time. Visit December 2014/ January 2015 Confirmation from your selected insurance carrier including plan booklets and ID cards will be mailed to your home. January 1, 2015 Effective date for your new coverage. 18 SPEAK WITH WITH A A RIGHTOPT ENROLLMENT ADVOCATE AT AT

19 Ongoing Support with Health Advocate TM After you complete your medical plan enrollment, RightOpt is still here to help as you use your benefits and manage your health care throughout the year. Health Advocate is a RightOpt service, available at no cost to retirees who enroll in a medical plan through RightOpt. Your personal Health Advocate is trained to: Help you understand how your coverage works, Answer questions about health care issues, Help resolve medical billing questions and concerns, Identify external or community resources to help address needs not met by your plan, Find a doctor or specialist, Help you get a second opinion, Help you prepare for doctor visits and much more. You can access Health Advocate via RightOpt or contact them directly at or via their website:

20 Notes 20 SPEAK WITH WITH A A RIGHTOPT ENROLLMENT ADVOCATE AT AT

21 Medtronic has arranged for RightOpt to provide you more options when selecting, comparing and enrolling in health care coverage. For personal assistance at no cost to you, call RightOpt at Insurance services are provided by Buck Consultants, A Xerox Company, and by Buck s contracted and licensed insurance agencies. MERO/ W