Solutions that work. Group Retiree Medicare Benefits

Transcription

1 Solutions that work Group Retiree Medicare Benefits

2 We give you the full spectrum of choices and support you can rely on. Our Medicare Advantage group plans give you the flexibility you need and the freedom your retirees want. When you offer your retirees an Anthem Blue Cross Medicare Advantage plan, you are giving them coverage that helps them improve the quality of their lives. Just as important, you are giving yourself the power to design benefits that work for you. Your retirees get access to our Medicare Advantage network of quality health care providers and extended wellness coverage. And as an added bonus, you re offsetting your retiree liability expenses. Anthem Blue Cross has decades of experience serving America s retirees, so we know how to stay ahead of trends and design cost-effective health plans that work for you and your retirees. Anthem Blue Cross Medicare Advantage plans may help reduce retiree health benefit liability for group sponsors. As other post-employment benefit liabilities continue to bring up questions about how to provide quality health care for your retirees, Anthem Blue Cross Medicare Advantage plans may be the answer for controlling your future health care costs. That s because a group retiree health plan may reduce your long-term financial obligations. 1

3 Take a look at your many choices for medical and prescription drug plans designed with you and your retirees in mind. Medicare Advantage plans are health plans with a Medicare contract. These plans can be offered to retirees 65 and older and other Medicare-eligible individuals. Medicare Advantage and Medicare prescription drug plans provide a win-win scenario. You get the full spectrum of choices so you can offer the ideal balance of benefits. Medicare Advantage plans Our complete portfolio of in-network and out-of-network based plans gives you the choices you need to achieve your financial goals while continuing to offer valuable benefits to your retirees. We offer plans with a variety of benefit designs and cost-sharing options to national and local group sponsors. PPO plans Medicare Advantage preferred provider organization (PPO) members have the freedom to receive covered services from the physicians and specialists they choose, including in- and out-of-network providers across the country. Those members who receive medical care outside of the network may have to pay more for services provided. Medicare Advantage PPO plans cover all 50 states, Washington, D.C., and Puerto Rico. PPO members will be able to receive services at in-network rates from designated local Medicare Advantage PPO networks hosted by other Blue Cross and Blue Shield plans through the Medicare Advantage PPO Network Sharing program. Providers have the ability to file claims and receive reimbursement through their local Blue plan. HMO plans Medicare Advantage health maintenance organization (HMO) plans provide all health services offered by Medicare, plus additional benefits such as routine vision and hearing aid coverage. Members elect a primary care physician (PCP) from our participating network to be their main health care provider. They are free to receive covered services from any network specialists no referrals are required. 1 Members can receive services only within the HMO network. 2 Ask your account representative about LiveHealth Online! 1 In the state of California, a referral is required by the member s PCP. 2 HMO plans are not available in all areas. Please contact your Anthem Blue Cross account executive for details. 2

4 Prescription drug plans Our Medicare prescription drug coverage offers comprehensive copay options, several formulary options and customization for larger groups. We offer a preferred pharmacy option that allows retirees and employers to save money. Our Medicare prescription drug plans comply with all applicable federal and state regulations, and enable group sponsors to capture the savings from the 50% manufacturer discount (known as the Coverage Gap Discount). We offer Medicare prescription drug coverage (Part D) on a stand alone basis or integrated with a Medicare Advantage medical plan. 3

5 Extended wellness coverage for your retirees Anthem Blue Cross health and wellness programs can improve your retirees quality of life at every stage. We are focused on supporting the patient/ provider relationship and closing gaps in care. Our programs help those retirees get the care that they need. Benefits include: Help in getting connected to community resources Case management and care coordination Live calls with friendly reminders about needed screenings or medication adherence issues Help with connecting members with their doctor 24/7 nurse information help line SilverSneakers * helps members achieve their health and fitness goals Dedicated customer service support Our Customer Service professionals and employer service consultants are fully trained to assist you and your retirees. During the annual open enrollment period, your retirees can rely on our First Impressions Welcome Center representatives for support and to answer simple or complex benefit questions. This added support reduces the amount of inquiries to your retiree benefits staff. Your retirees will appreciate one membership card for medical and prescription drug coverage from a name they know and trust. Add a dental or a vision eyewear plan with any Medicare Advantage product, and keep your retirees smiling! You can offer your retirees preventive coverage that includes exams, cleanings and X-rays. Or opt for our comprehensive plan. This plan features preventive care and additional dental care, such as oral surgery, endodontics (root canals), periodontics (scalings) and prosthodontics (dentures). Vision changes can occur more rapidly with age, making regular eye checkups a vital preventive health measure for retirees. Eye exams can help detect diseases, like glaucoma, macular degeneration or cataracts, before they lead to costly complications. We offer a standard routine vision exam on our plans, as well as a selection of vision plans that include eyewear that can work for you and your retirees. * The SilverSneakers Fitness Program provided by Healthways, Inc., an independent company. Healthways and SilverSneakers are registered trademarks of Healthways, Inc. and/or its subsidiaries Healthways, Inc. All rights reserved. 4

6 Are your retirees on the go? Not a problem! With our mobile app, retirees can: Search for a nearby doctor, specialist, urgent care center or hospital. Get turn-by-turn directions to get there. Manage their prescription drug benefits, including pricing medications, switching from retail to home delivery and ordering refills. Carry a virtual member ID card. Emergency and urgent care Whether they re traveling for work or on vacation, going to the emergency room (ER) or urgent care is probably the last thing retirees want to worry about. The good news is that our plans cover emergency and urgent care in all 50 states. 5 You can learn more about us at

7 Your retirees can save by accessing discounted products through on our website. Eyewear at popular retail locations Vitamins, supplements, and other health and beauty products Services from local dietitians, chiropractors and massage therapists Allergy control products Discounted gym memberships and weight loss programs (including Lindora, Living Lean and Jenny Craig) Home care/adult day care. Assisted living, private nursing services, hospice services Questions? Please contact your account representative for more information. And more! * SpecialOffers@AnthemSM is a discount program that is not part of your retirees health coverage plan. It is a value-added online service we provide to give our Medicare Advantage members access to discounts offered by different vendors. Vendors and offers are subject to change without prior notice. Anthem Blue Cross does not endorse and is not responsible for the products, services or information provided by the vendors. 6

8 This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits may change upon renewal. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are Medicare Advantage Organizations and Prescription Drug Plans with Medicare contracts. Enrollment in Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Y0114_17_27240_I_002 05/06/ WPEENMUB_ WPEENABS_005 EBS All 2016 Capabilities BR 02 15