SPECIAL MEDICFILL OPEN ENROLLMENT October 9 20, 2017 FREQUENTLY ASKED QUESTIONS
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1 1. What is Highmark Delaware Special Medicfill? 2. What is Express Scripts Medicare (PDP) for the State of Delaware? 3. What are the dates for open enrollment? 4. What is the effective date for any changes I make? 5. If I don t want to make any changes, do I need to do anything? 6. Do I need to complete a Spousal Coordination of Benefits form? 7. Where do I get the Spousal Coordination of Benefits form & can I do it online? 8. Is the rate changing? 9. Are the drug co-pays changing? 10. How and/or where can I receive my medications? 11. Can I make changes to dental, vision and/or blood bank now? 12. Can a non-medicare pensioner, spouse and/or dependent make changes to his/her health plan now, during this Fall Special Medicfill Open Enrollment? 13. Can I get coverage for prescriptions only? 14. Will there be any benefit fairs for this Open Enrollment? 15. Where can I view the Plan Booklet for Highmark Delaware Special Medicfill? 16. Where can I view information about the Express Scripts Medicare (PDP) Prescription Drug Plan for the State of Delaware? 17. What is the phone number for the Office of Pensions? 18. Can I fax my documents to the Office of Pensions? 19. Can I scan and my documents to the Office of Pensions? 20. What is the mailing address for the Office of Pensions? 21. Contact Phone Numbers 1
2 1. What is Highmark Delaware Special Medicfill? Highmark Delaware Special Medicfill is the supplement plan to your Medicare Parts A & B. 2. What is Express Scripts Medicare (PDP) for the State of Delaware? This is the prescription plan available through the State of Delaware Group Health Insurance Program to retirees and their spouses and dependents who are enrolled in Medicare. The State of Delaware s Medicare Prescription Drug Plan is an enhanced Part D prescription plan. Enhancements o Eliminates Annual Deductible o Eliminates Coverage Gap (Donut Hole) o Additional coverage for some Medicare Part B & non-part D drugs not normally covered in a standard Part D plan For more information regarding the Express Scripts Medicare (PDP) for the State of Delaware, follow this link to the Medicare Retiree Prescription Plan page on the Statewide Benefits Office website: 3. What are the dates for open enrollment? Open Enrollment begins October 9, 2017 and ends October 20, If you are submitting forms to the Office of Pensions, they must be received by the Office of Pensions no later than October 20, What is the effective date for any changes I make? January 1, If I do not want to make any changes, do I need to do anything? If you do not cover a spouse No. If you do nothing, your benefit elections will remain the same. If you do cover a spouse You may need to complete a Spousal Coordination of Benefits form even though you are not making any changes to your coverage. See Question #6. 2
3 6. Do I need to complete a Spousal Coordination of Benefits form? You only need to complete a form if your spouse is enrolled in the Highmark Delaware Special Medicfill Supplement Plan and your spouse s employment or health insurance status has changed since the last time you completed a form. 7. Where do I get the Spousal Coordination of Benefits form & can I do it online? You can complete the electronic Spousal Coordination of Benefits form online at Be sure to choose the option for State of Delaware Pensioners. If you need assistance contact the Office of Pensions Benefits Section at or Is the rate changing? No, the rates are the same for 2018 as they were in Plan Monthly Rate Effective 1/1/18 Special Medicfill with Prescription Special Medicfill without Prescription $459.38* $260.44* *The actual premium you pay is determined by your date of hire, years of service and date of retirement. 9. What are the current prescription copayments? The Express Scripts Medicare (PDP) Prescription Drug Plan copays* for calendar year 2018 are as follows: Generic: $8.00 for 30 day Rx; $16.00 for 60 or 90 day Rx Preferred Brand: $28.00 for 30 day Rx; $56.00 for 60 or 90 day Rx Non-Preferred Brand/Generic: $50.00 for 30 day Rx; $ for 60 or 90 day Rx *Subject to change. Please read all communications from Express Scripts. 3
4 10. How and/or where can I receive my medications? You may have your prescriptions filled at any pharmacy that participates in the Express Scripts network. There are network pharmacies in all 50 states. To determine network changes or to locate a network pharmacy, please visit the Express Scripts website at; or contact Express Scripts Medicare Member Services directly at Can I make changes to dental and/or vision coverage now? No, changes to dental or vision coverage can be made during the State of Delaware Open Enrollment period scheduled in May Can a non-medicare pensioner, spouse and/or dependent make changes to his/her health plan now, during this Fall Special Medicfill Open Enrollment? No, non-medicare State of Delaware pensioners, spouses and/or dependents will be invited to make changes in their health, dental and vision coverage during the Open Enrollment period scheduled in May Can I get coverage for prescriptions only? No. In order to have the State of Delaware s enhanced Part D prescription drug plan, you must enroll in Highmark Delaware Special Medicfill with Prescription plan. 14. Will there be any benefit fairs for this Open Enrollment? No, there are no State of Delaware sponsored health fairs or information sessions being offered as part of this Open Enrollment. If you have questions, please call the Office of Pensions at (302) or Where can I view the Plan Booklet for Highmark Delaware Special Medicfill? This link will take you to the information found at the Statewide Benefits Office website Where can I view information about the Express Scripts Medicare (PDP) Prescription Drug Plan for the State of Delaware? This link will take you to the information found at the Statewide Benefits Office website. 4
5 17. What is the phone number for the Office of Pensions? or Can I fax my documents to the Office of Pensions? Yes, the fax number is Can I scan and my documents to the Office of Pensions? Yes, the address is pensionoffice@state.de.us 20. What is the mailing address for the Office of Pensions? Office of Pensions McArdle Building 860 Silver Lake Blvd, Ste 1 Dover, DE Contact Phone Numbers Highmark Delaware: Express Scripts Medicare Member Services: State of Delaware Office of Pensions: Statewide Benefits Office: Delaware Medicare Assistance Bureau (DMAB):
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