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Welcome Presenters: MVP-Joe Durse MVP-Amber Wallace ECSD-Maryjane Carpenter ECSD-Jake Sheehan.

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Presentation on theme: "Welcome Presenters: MVP-Joe Durse MVP-Amber Wallace ECSD-Maryjane Carpenter ECSD-Jake Sheehan."— Presentation transcript:

1 Welcome Presenters: MVP-Joe Durse MVP-Amber Wallace ECSD-Maryjane Carpenter ECSD-Jake Sheehan

2 Today’s Presentation AGENDA:  Outline of key dates, background and goals  Overview of MVP Health Care  Question and answer session with MVP & ECSD YOU WILL LEAVE WITH:  MVP Health Care Medicare Advanatge Plan Guide  Side-by-side on Website March 12th

3 Background The Elmira City School District’s agreement with POMCO expires June 30, The District must provide a health care plan that is Affordable Care Act compliant. The District has been working with SMOLA Consulting to help provide the best options for health care plans. The District’s law firm, Sayles and Evans, has reviewed the transition.

4 Our Goals  To provide our retirees with the best possible health plan coverage.  To execute a smooth and seamless transition for retirees to their new health care plan.  To support all retirees throughout the transition and to continue that support after the transition.

5 MVP Health Care  The Elmira City School District would like to welcome JOE DURSE from MVP Health Care.  MVP is ranked in the top three Medicare plans in NYS

6 Eligibility & Enrollment Must be enrolled in Medicare Parts A and B. GoldAnywhere PPO members must reside in the MVP service area for 6 months of the year. USA Care PPO residency in US or Puerto Rico. A network of more than 19,000 providers, no specialist referrals required!

7 FranklinOrleans Chittenden Lamoille Caledonia Essex Washington Addison Orange Windsor Rutland Benn. Windham 2015 GoldAnywhere PPO Service Rockland NiagaraOrleans Erie Onondaga Jefferson Chautauqua Steuben Cayuga Orange MonroeWayne Genesee St. Lawrence Allegany Wyoming Cattaraugus Ontario Seneca Livingston Schuyler Chemung Cortland Oswego Lewis Madison Chenango Delaware Franklin Sullivan Essex Clinton Albany Schoharie Greene Wash. Rensselaer Saratoga Warren Schenectady Columbia Ulster Dutchess Putnam Fulton Montgomery Herkimer Hamilton Oneida Tioga Broome Tompkins Yates Otsego Grand Isle Westchester *Medicare eligible retirees residing outside of the service area will be enrolled in USA Care PPO*

8 Medicare pays MVP a subsidy each month. MVP takes the place of Medicare. Medical care and prescription drugs will be covered by MVP. Use MVP ID card for services. Put the Medicare card away in a safe place. Easy to use virtually no claim forms. Fulfills Medicare Part D requirement Upon enrollment into another Medicare Advantage or Part D drug plan, Medicare will automatically dis-enroll you from your Elmira CSD Medicare Advantage plan and enroll you in your new plan. HOW A MEDICARE ADVANTAGE PLAN WORKS:

9 ONE CARD FOR EVERYTHING Use the MVP ID card for all medical services and purchasing prescriptions. The pharmacy will change your coverage to MVP.

10 No Annual Deductible – from day one members are only responsible for applicable copays for medical services and prescription drugs, MVP pays the rest. $4,000 Annual Out-of-Pocket Protection – If met, plan pays 100% for covered benefits. Excludes monthly Premium, prescription drug costs, acupuncture, eyewear, and hearing aid expenses. No balance billing – providers can not bill MVP Medicare Advantage Plan members for costs above and beyond plan copays. MVP Travels With You Worldwide OUT OF POCKET PROCTECTION

11 11 GoldAnywhere PPO (live in MVP service area) Covered Service In-NetworkOut-of- Network Primary Care Office Visits (PCP)$10 Copay$25 Copay Specialist Doctor Office Visits$15 Copay$25 Copay Inpatient HospitalCovered in full20% Ambulance$35 Copay Emergency Visits – Worldwide (waived if admitted) $65 Copay Urgent Care Visits$15 Copay Ambulatory Surgery OutpatientCovered in full20% Lab ServicesCovered in full20% Skilled Nursing Facility – Days 1-100Covered in full20% Home Health CareCovered in full20% Outpatient X-Ray$15 Copay$25 Copay PT,OT & ST$15 Copay$25 Copay Routine Annual Eye & Hearing Exams$15 Copay$25 Copay ©2014 MVP Health Care, Inc.

12 12 USA Care PPO (live outside MVP service area) Covered ServiceIn-Network Primary Care Office Visits (PCP)$10 Copay Specialist Doctor Office Visits$15 Copay Inpatient HospitalCovered in full Ambulance$35 Copay Emergency Visits – Worldwide (waived if admitted) $65 Copay Urgent Care Visits$15 Copay Ambulatory Surgery OutpatientCovered in full Lab ServicesCovered in full Skilled Nursing Facility – Days 1-100Covered in full Home Health CareCovered in full Outpatient X-Ray$15 Copay PT,OT & ST$15 Copay Routine Annual Eye & Hearing Exams$15 Copay ©2014 MVP Health Care, Inc.

13 13 Preventive Care Covered ServiceIn-NetworkOut-of-Network Periodic Health Assessment (Well Visit) Covered in full$25 Copay MammographyCovered in Full Pap Test / Pelvic Exams Colorectal Screening Bone Mass Measurement Prostate Screening Flu, Pneumonia Vaccines ©2014 MVP Health Care, Inc.

14 Additional Benefits Hearing Aid Allowance - $600 every 36 months Eye Wear Allowance - $100 every two calendar years Dental Allowance - $300 allowance for any dental service Acupuncture – 50% of the cost and receive up to 10 visits per calendar year CVS ExtraCare Health Card - provides a 20% discount on more than 2,200 CVS branded health related products 14

15 15©2012 MVP Health Care, Inc. 15 PRESCRIPTIONS

16 16 MVP Offers You Select Generic Drugs and Vaccines At NO COST ! $0 ©2014 MVP Health Care, Inc. Includes coverage for the shingles vaccine and other select vaccines at no cost!

17 17 Part D Prescription Drug Coverage * No Deductible * No Donut Hole Retail (30 day Supply) CVS Caremark Mail Order-2x Copay (90 day Supply) $0 Copay - Tier 1 - Preferred Generic $5 Copay - Tier 2 - Non-Preferred Generic $5 Copay - Tier 3 - Preferred Brands $5 Copay - Tier 4 - Non-Preferred Brands $5 Copay - Tier 5 - Specialty > $600 $0 Copay - Tier 6 - Vaccines $0 Copay - Tier 1 - Preferred Generic $10 Copay - Tier 2 - Non-Preferred Generic $10 Copay - Tier 3 - Preferred Brands $10 Copay - Tier 4 - Non-Preferred Brands $10 Copay - Tier 5 - Specialty > $600 $0 Copay - Tier 6 - Vaccines

18 18©2012 MVP Health Care, Inc. 18 WELLNESS

19 MVP INVESTS IN WELLNESS 19 SilverSneakers ® Fitness Program Join more than 25,000 MVP Medicare members with a No Cost fitness center membership at any SilverSneakers location nationwide. Includes Curves. HealthDollars SM $100 annual allowance for: Wellness or fitness classes, massage, yoga, dance. Safe driving courses Personal emergency response system Even medical ID tags!

20 MVP INVESTS IN YOUR WELLBEING 24 Hour Nurse Advice Line for: Health questions in the middle of the night Answers to “what do I do if” health questions Finding information and resources about prevention, wellness, treatments, chronic conditions. Free Confidential Programs When You Need Extra Support 20

21 21 MVP at Your Service - Personal member content available via secure online member portal View plan information Claims status & history Change mailing address Download member forms Request and print new ID cards Comprehensive provider search View Rx formulary and compare drug costs Complete a personal health assessment, utilize interactive health and wellness tools View provider and hospital quality ratings and reports

22 MVP AT YOUR SERVICE MVP at Your Service Dedicated Medicare Customer Care Center Call with questions on MVP plans prior to January 1, 2015 Provide assistance with Medicare Advantage plan and benefit questions Look up your providers and prescriptions No automated systems, phone trees or numbers to push! Located in Rochester, NY 22

23 Enrolling Question: How and when can I enroll? Answer: Enrollment starts March 23 All forms will be mail to you. These forms can be mailed or dropped off to the District office.  April 17 Enrollment Clinic (9am-12pm)  April 22 Enrollment Clinic (1pm-4 pm)  May 6 Enrollment Clinic (1pm-4 pm)

24 Rates Question: Is my rate going to change? Answer: If you pay a percentage, you will continue to pay a percentage of the current premium. Your premium costs will change based on your plan of choice. If you currently do not contribute to your premium costs, this will not change.

25 Rates Question: Is my rate going to change? PLANPOMCO -Current NY 44 -Current MVP Pre 65 Single$7,221$5,991Not eligible Retiree and Spouse$21,649*$15,666Not eligible Family$21,649$16,578Not eligible 65 and Over Single$6,066$5,991$5,061 Retiree and Spouse$14,371*$15,666$10,123 Family$14,371$16,578$15,183

26 Medicare Part B Reimbursement Question: Will I continue to receive my Medicare Part B reimbursement? Answer: Those who retired under a collective bargaining agreement that provided the Medicare Part B reimbursement as a benefit, will continue to receive it.

27 Current Doctors Question: Will I be able to keep my current Doctors? You LiveYour PlanYour Network NY StateGold AnywhereIs the MVP Health Care network. Outside of NY StateUSA CareAny Medicare participating provider. No out of network costs.

28 Coordination of Benefits Question: Will MVP Health Care coordinate benefits? Answer: No, MVP does not offer the coordination of benefits within the plan.

29 Specific Questions Question: How do I get a specific question answered? Answer: There are few ways to do this.  The first, is to contact MVP Health Care.  The second, is to set up an appointment, signup sheets are in the back of the auditorium.

30 Upcoming Key Dates DATEEVENT March 3MVP Health Care Plan Meeting March 5NY 44 Health Care Plan Meeting March 11District Question and Answer March 23Open Enrollment Begins April 17Enrollment Clinic (9am-12pm) April 22Enrollment Clinic (1pm-4 pm) May 6Enrollment Clinic (1pm-4 pm) May 15Open Enrollment Ends July 1New Plan Starts

31 31 Questions?


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