2 TODAY S AGENDA Opening Comments, Kevin B. Huber, CTPF executive director Open Enrollment Overview Enrollment and Eligibility 2013 Health Plan Options
3 STATE OF PENSION FUND Illinois Pension Reform The Future of Health Insurance Subsidy How You Can Help
4 2013 PREMIUM SUBSIDY CTPF helps you pay for health insurance premiums and Medicare premiums Subsidy for 2013 remains at 60% of total premium cost
5 2013 OPEN ENROLLMENT October is Open Enrollment month Open enrollment runs Oct. 1 31, 2012 Changes effective January 1, 2013 Open Enrollment is the time to: Enroll for first time Change health plans Add dependent Return all enrollment forms to CTPF
6 ENROLLMENT REQUIREMENTS Enrollment application Copy of Medicare card or entitlement letter Documentation for dependents (page 9 of handbook) Here to assist you today
7 Are You Turning 65 in 2013? Mark your calendar with these important dates: 3 months prior to birthday month start enrollment in Medicare Parts A & B Attend a CTPF Medicare Birthday Party enrollment event (by invitation) At least 1 month prior to birthday month submit enrollment application and proof of Medicare to CTPF
8 WHAT S CHANGING IN 2013 Premium rates have decreased for BCBS plans No increase for Humana plan UHC AARP Plan F 2013 rates not yet available but Rx premium has decreased Name change for Medco plan
9 CTPF PLANS FOR MEMBERS WITH MEDICARE All plans include comprehensive medical and enhanced Medicare Part D prescription drug coverage Guaranteed enrollment Do not enroll in other Medicare Part D prescription drug insurance or you will lose ALL CTPF coverage
10 MEDICAL PLANS BCBS Supplement to Medicare $350 Deductible Covers 80% after Medicare pays Nationwide coverage: use any medical provider that accepts Medicare Preventive care and emergency room covered at 100% Foreign travel coverage Prescription coverage through Express Scripts Medicare (PDP)
11 MEDICAL PLANS BCBS HMO Illinois Traditional HMO Plan Chicago area only Select Primary Care Physician (PCP) Referrals required No deductibles $20 office visit copayment Inpatient 100% coverage Prescription coverage through Express Scripts (PDP)
12 MEDICAL PLANS UnitedHealthcare - AARP Plan F No deductible Pays 100% after Medicare for covered services Premiums based on age/state of residence Prescription coverage through Express Scripts Medicare (PDP) Get quote and application today
13 PRESCRIPTION DRUG PLAN NAME CHANGE Express Scripts Medicare Prescription Plan (PDP) is the new name for the prescription drug plan formerly known as Medco Current enrollees continue using current Rx card New enrollees receive card with new plan name Benefits and everything else remain the same!
14 PRESCRIPTION DRUG PLAN Express Scripts Medicare (PDP) is an enhanced Medicare Part D Plan Plan covers Part D drugs Plan covers drugs normally excluded from Medicare No coverage gap
15 PRESCRIPTION DRUG PLAN Express Scripts Medicare (PDP) Generics - $5 Preferred name brand - $30 Non-preferred brand - $45 Up to 90-day supply at local pharmacy or Express Scripts Pharmacy (mail service) for two copays ($10/$60/$90)
16 MEDICAL PLANS Humana Group Medicare HMO with Part D Pharmacy Medical Benefits Traditional HMO Primarily Chicago Area with limited coverage in areas of FL, AZ, LA, TX, CO, MO, NM, NV, PR, UT Choose Primary Care Physician (PCP)
17 MEDICAL PLANS Humana Group Medicare HMO with Part D Pharmacy Medical Benefits Referrals required No deductibles $10 PCP office visit copayment Inpatient $150 copayment, 1st five days
18 MEDICAL PLANS Humana Group Medicare HMO with Part D Pharmacy Prescription Benefits Coverage continues through the gap Generics - $5: preferred name brand $30; non-preferred brand - $45 Specialty drugs: 25% with $150 maximum per Rx Mail service - $0 for preferred generics or two 30-day copayments
19 2013 PREMIUMS Retiree share = 40% of total cost Blue Cross and Blue Shield Supplement to Medicare with Express Scripts Medicare (PDP) for CTPF $110.08 AARP Medicare Supplement Plan F (UnitedHealthcare) with Express Scripts Medicare (PDP) for CTPF Blue Cross and Blue Shield HMO Illinois with Express Scripts Medicare (PDP) for CTPF Average by age: 67-67 $112.00 68-70 $127.00 71+ $148.00 $153.24 Humana Group Medicare HMO with Part D Pharmacy $83.20
20 HEALTH INSURANCE CHECK-UP Do the math and consider: Your medical needs Yearly premium costs Annual deductible, coinsurance, and copayments Yearly out-of-pocket expenses for medical services, hospital care, and prescriptions
22 CHOOSING A PLAN Do the math and consider: Number and type of prescriptions: calculate Rx copayments based on plan formulary Choice of network providers
23 ADDITIONAL ASSISTANCE Questions and Answers