Your Health Benefits Program: News, Facts and Reminders

Transcription

1 nafhealthplans.com 2019 DoD NAF Open Enrollment: November 1 30, 2018 Your Health Benefits Program: News, Facts and Reminders Fresh for 2019! New look, same great benefits.

2 What s new for 2019 The changes and new programs for 2019 allow us to continue to offer valuable and costeffective benefits. These changes and enhancements take effect on January 1, Group health coaching and support at no cost to you With Healthy Lifestyle Coaching,* you can participate in group sessions with people who want to make the same healthy changes you want to make, along with one-on-one sessions with your wellness coach. When you join, you ll take part in weekly interactive group coaching sessions over a six-week period. You ll enjoy the support and encouragement of your peers as you work toward your goals to: Lose weight Eat better Exercise more Quit smoking or tobacco Manage stress And more Make time to focus on yourself in Remember, Healthy Lifestyle Coaching is part of your DoD NAF health plan, so you don t pay extra to take advantage of the program. To learn more, call or log in to aetna.com > Wellness > Healthy Lifestyle Coaching. *Healthy Lifestyle Coaching is not available to Aetna International members. Two new Teladoc programs* Currently, Teladoc lets you consult with a doctor and get diagnosed, treated and prescribed without the travel and waiting room time for just a $10 copay. You will continue to enjoy this service! In 2019, your DoD NAF health plan will add two new Teladoc services each for a $45 copay to the program s current general medicine services. These include: Dermatology, for help with skin conditions. You ll be able to share a photo of your skin condition for review by a credentialed dermatologist and receive a diagnosis and treatment plan within two business days. A behavioral health program, for video counseling from an experienced psychiatrist, psychologist or masters-level therapist. Get help with issues such as anxiety, depression, substance abuse and stress. Appointments can be scheduled by visiting teladoc.com/aetna, by downloading the Teladoc app or by phone at * Teladoc is not available to Aetna International members. 2

3 Family medical deductible and out-of-pocket maximum changes If you cover yourself and one or more dependents, your in-network family deductible will be $1,500 in The new in-network family out-of-pocket maximum will be $8,000. These changes do not impact those who have employee-only coverage. As of January 1, 2019, the new family deductible and out-of-pocket maximum can be met by one or any combination of family members. Once the expenses of any family member(s) reaches the deductible, the deductible will be considered met for all family members. The same holds true for the out-of-pocket maximum. Know more: Your plan s Summary of Benefits Chart shows benefits and out-of-pocket costs. To view your plan s summary chart, visit nafhealthplans.com > Health Benefits > Medical Plans. You can then click on the name of a plan OR enter your ZIP code to find the plan(s) available to you. Premium rate change Medical premiums will increase for Dental premiums will remain the same. Go to nafhealthplans.com/retiree to see the rates. Be aware of changes to prescription drug benefits There will be a new formulary in Formulary changes will affect prescription medications covered by the plan. Some NAF employees will be impacted by this change, but most will not. The formulary is a list that shows which drugs are covered by your plan and the cost share (pharmacy tier) that applies. For any drugs excluded from coverage, there will be alternative drugs covered by the plan. Aetna will mail letters in late 2018 to those employees taking drugs that will have a change in coverage for Health Incentive Credit program changes In 2019, retirees enrolled in retiree-only coverage will be able to earn up to $300 in health incentive credits. Retirees who cover dependents can earn up to $600. Also, completing a health assessment will no longer be a requirement for earning credits! You ll still be able to earn $150 for getting the screening, but now you can earn an additional $75 for completing the assessment! There s still time to earn your 2018 health incentive credits Schedule your biometric screening now, so you complete it by the November 30, 2018 deadline! Remember that no incentives can be earned in 2018 until you complete your online health assessment. Visit nafhealthplans.com > Wellness > Health Incentive Credit Program to see all the healthy actions you may take to earn credits. 3

4 What you need to know and do Retirees and family members under age 65 This year s Open Enrollment will take place November 1 30, Here s what you should know: You may switch to another NAF employer-sponsored plan (if available in your geographic region) if you are currently enrolled in medical coverage. Standard eligibility criteria will apply. If another plan is not offered in your area, you will not be able to switch at this time. Go to nafhealthplans.com to determine if there is another plan offered in your area. Any changes made during the enrollment period will be effective January 1, If you are not making any changes, you don t have to do anything. Your existing coverage will remain in effect for Keep in mind, you may not enroll or re-enroll in a plan that you were not eligible for at the time you retired. Plus, you may only make changes to your coverage elections during the year if you have a qualified family status change (adding or removing family members). Retirees and family members turning age 65 Depending on your NAF employer, you may not be automatically enrolled in the Aetna Traditional Choice indemnity plan. You will need to check in with your servicing Human Resources Office to see if there are any actions you need to take to enroll in the Traditional Choice indemnity plan once you turn age 65. You are strongly advised to enroll in Medicare Parts A and B. Failure to enroll in Parts A and B will have a negative impact on how your Traditional Choice claims are paid. Retiree and family members over age 65 Since you are already enrolled in Traditional Choice medical coverage, you do not need to take any action during Open Enrollment. 4

5 Understanding how Medicare interacts with your DoD NAF Health Benefits Program (HBP) Medicare provides health insurance for Americans age 65 and older. The program is administered by the Centers for Medicare & Medicaid Services (CMS) and is divided into different parts, as explained in this section. Get to know Medicare and how it works with your DoD NAF Health Benefits Program. Medicare Part A You become eligible for Medicare Part A when you turn 65. Medicare Part A covers: Inpatient hospital services and supplies, including blood, and skilled nursing facility care Home health care and hospice services Medicare Part B Medicare Part B covers medical services, such as: Doctors services Lab services Outpatient medical and surgical services and supplies Durable medical equipment, such as a wheelchair or other assistive device Preventive care, including routine physical exams, flu shots, bone density screening, mammograms, colorectal cancer screenings and more 5

6 Coordination of benefits The DoD NAF HBP pays secondary to Medicare, and the benefits are calculated as though you have enrolled in Part B whether or not you ve actually enrolled. This is why it s important to enroll in Part B as soon as you become eligible for it. Refer to the Coordination of Benefits Chart in the Understanding Medicare presentation at nafhealthplans.com/retiree. Medicare Direct Once you are retired and eligible for Medicare, your DoD NAF HBP becomes secondary to Medicare. This means Medicare pays its benefits first, then the DoD NAF HBP pays as secondary. Medicare Direct is a service offered by Aetna that takes care of filing secondary claims. Here s how it works: When your doctor s office submits claims to Medicare, Medicare will pay its portion of the claim, then send the remaining balance to Aetna for processing. Aetna will then pay its portion of the claim and notify you. You are automatically enrolled in Medicare Direct once Aetna receives confirmation of your Medicare coverage. If you are not automatically enrolled, you can call Aetna Member Services at to enroll. Your spouse and eligible dependent(s) are not automatically enrolled in Medicare Direct but can be enrolled by calling Aetna Member Services at the number above. For more information about Medicare, including enrolling in Medicare Parts A and B, go to nafhealthplans.com/retiree and review the Understanding Medicare presentation. Medicare Part D Medicare Part D covers prescription drugs. You do not need to enroll in Medicare Part D because you have prescription coverage through your HBP that has been deemed creditable. You may decide at a later time to enroll in Medicare Part D. If you do, you will not pay a late enrollment penalty, as the DoD NAF HBP provides creditable drug coverage. Remember, you will not receive benefits from both Medicare Part D and the DoD NAF HBP for prescription drug expenses. 6

7 For help and information Visit nafhealthplans.com/retirees for more information about Medicare, including answers to questions such as: What happens if my doctor doesn t accept payment from Medicare? What can I do if Medicare denies a claim? On the site, you ll also find information about the DoD NAF HBP, Medicare facts and reminders, and what s new in the year ahead. Visit medicare.gov to learn more about Medicare coverage, costs, coordination of benefits and other topics. You can call Medicare at MEDICARE ( ). Learn more join a conference call Participate in a group conference call to learn more about your Aetna plan and how Medicare coordinates benefits with your DoD NAF HBP and more. U.S. (CONUS) call schedule Call ; participant code: Monday, November 12 Thursday, November 15 Monday, November 19 Tuesday, November 20 Monday, November 26 1:00 1:30 PM EST 9:00 9:30 AM EST 1:00 1:30 PM EST 9:00 9:30 AM EST 9:00 9:30 AM EST Aetna International (OCONUS) call schedule Call ; participant code: Monday, November 19 Wednesday, November 21 Monday, November 26 9:00 9:30 AM EST 8:00 8:30 AM EST 9:00 9:30 PM EST 7

8 Aetna DoD NAF Health Benefits Program Farmington Avenue, RE11 Hartford, CT INDICIA FPO FPO FSC logo here CCG DoD-0162 Retiree (10/18) 2018 Aetna Inc. Aetna administers the DoD NAF Health Benefits Program. Health benefits plans contain exclusions and limitations. If you received this information in error, please disregard. For more information, visit nafhealthplans.com or call Aetna Member Services at