1. 1 Medicare & You For city of Phoenix Retirees Presented by city of Phoenix Personnel Department Benefits Office

2. 2 Introduction Presenters  Kathy Bird, Benefits Analyst II  Carol Dodd, Benefits Analyst II Topics  All the Medicare Parts (A, B, C & D)  How Medicare works with the city’s retiree coverage

3. 3 Purpose and Goals Basic information about Medicare How the city’s retiree coverage works with Medicare. Representatives from CIGNA and BlueCross/BlueShield available after the meeting.

4. 4 Medicare & You You are eligible for Medicare on the 1 st day of the month in which you are turning 65. Example: 65 th Birthday – March 23, 2010 Medicare eligible - March 1, 2010 You are also eligible for Medicare if you have qualified for Social Security Disability Income (SSDI) for the previous two years. Medicare enrollment is automatic when disabled.

5. 5 Medicare Part A

6. 6 Your Choices at 65 Basic Medicare Part A Part B Part D Medicare Part C Part A Part B Part D + additional coverage City Retiree Medical Coverage Part A Part B + coverage comparable to active employee coverage

7. 7 Medicare Part A Helps cover inpatient care in a hospital You’re automatically enrolled at age 65  $1,068 annual deductible (increases to $1,100 in 2010)  Can be co-insurance  Also covers skilled nursing care, hospice, and home health care, to a point, if eligible Skilled Nursing facility limited to 20 days

8. 8 Medicare Part B

9. 9 Medicare Part B Helps pay for outpatient medical care A monthly premium ($96.40 in 2009; $110.50 in 2010) and an annual deductible are required. 80% of the Medicare approved amount is covered  If a physician or hospital does not accept Medicare, you are also liable for the charges above the Medicare approved amount (to a limit). These are called “excess charges.” Does not cover most preventive care, vision or hearing expenses.

10. 10 Medicare Part B: Do I have to enroll? Whether you have the city’s retiree medical coverage or you enroll in a Medicare Part C Advantage plan through private carrier, you must enroll in Medicare Part B! YES!

11. 11 Your Medicare Card

12. 12 Medicare Part B What if I’m eligible, but I didn’t enroll? If you don’t enroll during your initial enrollment period, you have another chance each year to sign up during a “general enrollment period” from January 1 through March 31. Your coverage begins the following July. However, your monthly premium increases 10% for each 12-month period you were eligible for, but did not enroll in, Part B.

13. 13 Medicare Part B What if I’m still working at 65? If you are 65 or older and covered under a group health plan, you can delay enrolling in Medicare Part B without penalty. The rules allow you to:  Enroll in Medicare Part B any time while you are covered under the group health plan based on current employment; or  Enroll in Medicare Part B during the eight-month period that begins with the month your group health coverage ends, or the month employment ends—whichever comes first.

14. 14 Medicare Part C: Private Insurance Option

15. 15 Medicare Part C Private Insurance Option If you have Medicare Parts A and B, you can join a Medicare Advantage plan. Medicare Advantage Plans provide additional coverage and may include prescription drug coverage.  If your Medicare Advantage Plan does not include pharmacy coverage, you need to enroll in Medicare Part D. Offers additional benefits such as hearing, vision and dental services, and health and wellness programs.

16. 16 Medicare Part C Private Insurance Option You can enroll in a Medicare Advantage plan during their annual election period from November 15 – December 31. Plan designs: HMO, PPO, Private Fee For Service Carriers: CIGNA, Humana, SecureHorizons, SCAN, Health Net, Aetna, and more. Sign over your Medicare benefits and (usually) pay an additional premium each month. Check each Medicare Advantage plan as some do not charge a monthly premium.

17. 17 Medicare Part C Questions you should ask Is there an additional premium (above and beyond the Medicare Part B premium)? Are referrals needed? Is there a network of providers? Are your providers included? What is the prescription drug coverage? Are your medications covered? What are the deductibles and co-pays? Will the plan cover you out-of-state? How does coverage and cost compare to the city’s retiree medical coverage?

18. 18 Medicare Part C Use the Plan Compare Tool at www.medicare.gov Here you can compare a variety of plan options and see who has the lowest out of pocket costs.

19. 19 Medicare Part D

20. 20 Medicare Part D Prescription Drug Coverage Helps cover the cost of prescription drugs. May be offered on a stand-alone basis or in conjunction with a Medicare Advantage plan. Do not sign up for a Medicare Part D plan if you have the city’s retiree medical coverage!

21. 21 Medicare Part D Prescription Drug Coverage Major Out-of-Pocket Costs with Medicare Part D Annual Deductible =$310.00 25% of the next $2,830 =$707.50 100% of the next$3,610 After that:$2.50/generic, $6.30/brand or 5% whichever is greater

22. 22 Medicare Part D Prescription Drug Coverage Rx Cost You Pay Medicare Pays The first $310$310.00$0 The next $2,830$707.50$2,122.50 The next $3,610$3,610.00$0 Totals$4,627.50$2,122.50 Then: $2.50/generic, $6.30/brand or 5% whichever is more

23. 23 Important Dates for Medicare November 15 – December 31 Annual Enrollment Period  This is when you can enroll in or change your Medicare Advantage plan and/or Medicare Part D plan.  Changes are effective January 1

24. 24 Important Dates for Medicare January 1 – March 31 Open Enrollment Period  This is when you can enroll in Medicare Part B if you are a late enrollee. Coverage would begin July 1 st.  Penalties may apply.

25. 25 Medicare and City Retiree Medical Coverage

26. 26 Medicare Part D & City Coverage If you want to remain in the city’s medical coverage, do NOT enroll in Medicare Part D. When you are enrolled in Medicare Part A and B, your prescriptions continue to be covered through CVS/Caremark.  You can use most pharmacies such as CVS, Walgreens, Fry’s, Safeway, Wal-Mart, etc.  Mail order available

27. 27 With City Coverage … NO MEDICARE PART D

28. 28 Medicare & City Coverage Costs Medicare Part B premium is deducted from your Social Security check. You will see a reduction in the cost of your city retiree medical premium reflected in your pension check.

29. 29 Medicare & City Coverage Single Coverage, No Medicare Part B Single Coverage, With Medicare Part B CIGNA HMO$513.00/month$438.85/month BCBS HMO$467.27/month$399.32/month BCBS PPO$472.91/month$404.16/month Signing up for Medicare Part B reduces your monthly premium for city medical coverage. Here’s one example:

30. 30 Medicare & City Coverage How does Medicare coordinate with CIGNA or BCBS? You receive a Medicare Summary Notice (MSN) every 3 months from Noridian. Retain the Medicare Summary Notices received for up to 2 years. Your healthcare provider also receives this notice.

31. 31 Medicare & City Coverage Most Medicare providers don’t charge co-pays. If you receive a bill from a provider, please contact CIGNA or BlueCross/BlueShield. Remember, there are CIGNA, BCBS and CVS/Caremark reps on-site in the Benefits Office to assist you.

32. 32 Medicare & City Coverage CIGNA may send out a “Request for More Information” document. They are looking for the Medicare MSN. They can set up a “crossover” for claims. BlueCrossBlueShield (BCBS) sets up a “crossover” for claims to transfer from Medicare to the providers.

33. 33 Medicare & City Coverage Can I re-enroll in the city’s plan? Yes. If you want to re-enroll with the city at a future time, you may do so during the city’s Open Enrollment or upon loss of other group coverage or during Medicare’s Annual Enrollment Period. If you choose to waive and enroll in a Medicare product, this is not group coverage. You will need to provide proof of continuous, comparable coverage, including prescription drug coverage.

34. 34 Retiree Dental Coverage

35. 35 Announcing Retiree Dental Choice! Dental HMO Monthly Cost Retiree$18.36 Retiree +1$33.17 Family$58.46 Dental PPO Monthly Cost Retiree$34.08 Retiree +1$75.72 Family$110.75 The monthly cost will be deducted from your pension check each month. Informational fliers can be picked up in the back of the room!

36. 36 General Information Same network of dentists as the employee Dental PPO and the employee Dental HMO plans. Must be enrolled for at least 12 months. Dental plan year will become the same as the medical plan year.

37. 37 Important Retiree Dental PPO Information Tier 3 coverage (i.e., crowns, bridges, dentures, root canals) requires a 12-month waiting period. This waiting period is waived IF YOU ENROLL as of March 1, 2010.

38. 38 Important Retiree Dental Dates Information packets will be mailed in early January Open Enrollment: January 11 – January 29 Coverage begins March 1, 2010

39. 39 Medicare & You Questions?