IMPORTANT NOTICE REGARDING YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE
NOTICE OF CREDITABLE COVERAGE
Dear Medicare Eligible Participant and Medicare Eligible Spouse/Dependent:
The annual enrollment period for Medicare’s prescription drug coverage – Medicare Part D-- is from November 15 through December 31, 2008. Therefore, it is time for you to consider whether you want to make any changes in your current prescription drug plan coverage.
During the upcoming enrollment period, you have the opportunity to enroll in a Medicare Part D plan, or to keep your AFTRA Health Plan coverage provided you pay your premiums on a timely basis and, if you are an active participant, provided you remain eligible for coverage under the AFTRA Health Plan.
It is important to note that if you choose to enroll in a Medicare prescription drug plan, the AFTRA Health Plan’s Senior Citizen Program will not provide secondary prescription drug coverage. However, it will continue to provide your other hospital and medical benefits in accordance with the Plan. Therefore, if you qualify for the Senior Citizen Program and want prescription drug coverage under the Senior Citizen Program, you must not enroll in a Part D plan. If you are currently enrolled in a Part D Plan, in order for you to be covered under the Senior Citizen Program prescription drug coverage, you must terminate your enrollment in your Part D Plan by contacting your current plan or by calling 1-800-MEDICARE.
Read this notice carefully before you make your decision, and keep this notice where you can find it. This notice contains information about the Medicare prescription drug coverage and the current prescription drug coverage offered under the AFTRA Health Plan. It tells you where to find more information about the Medicare program and the options that are available to you.
Medicare Part D Prescription Drug Plan
Medicare prescription drug coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plans that offer prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. (Some plans might also offer more coverage for a higher monthly premium.) It is important for you to understand that the AFTRA Health Plan has determined that its prescription drug coverage provides “Creditable Coverage”. That means the AFTRA Plan is, on average for all plan participants, expected to pay out as much as, or even more than, the standard Medicare prescription drug coverage will pay. Therefore, if you are satisfied with the AFTRA Health Plan coverage, you may choose not to enroll in a Medicare prescription drug plan at this time.
People can enroll in a Medicare prescription drug plan when they first become eligible and during this year’s annual open enrollment period from November 15, 2008 through December 31, 2008. If you decide to enroll in Medicare prescription drug coverage at a later date, you may do so during the Medicare Part D annual open enrollment period each November 15 through December 31. But remember, as stated above, the AFTRA Health Plan Senior Citizen Program will not provide prescription drug coverage if you enroll in a Medicare drug plan.
Before You Make Your Decision
Before you make your decision, you should compare your current coverage and premiums under the AFTRA Health Plan, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area.
Remember, your current AFTRA Health Plan coverage pays for health expenses, in addition to prescription drugs, some of which may not be covered by Medicare. If you are covered under the AFTRA Health Plan’s Senior Citizen Program and choose to enroll in a Medicare Part D Plan, you will no longer have prescription drug coverage through the AFTRA Plan effective January 1, 2009. Medicare will provide your sole prescription drug coverage although you will maintain the AFTRA Plan medical and hospital coverage. Please note that the premium under the AFTRA Health Plan will not be reduced to reflect the termination of the prescription drug coverage.
If you are covered under the AFTRA Health Plan for active participants, that Plan, by law, will always pay before Medicare. Therefore, if you want to elect a Medicare Part D Plan in addition to the AFTRA Plan, you will have to pay the Part D plan premium in addition to the AFTRA Heath Plan premium, though it is unlikely that there will be any benefits payable by the Medicare Plan because it will always be secondary to the AFTRA Plan. As an alternative, you can drop the entire AFTRA Plan and be covered only by Medicare.
If you are an active participant and elect to drop your coverage under the AFTRA Health Plan, you will be able to re-enroll in the AFTRA Plan as of your next eligibility period, provided you once again meet the earnings requirements and pay the required premium. If you choose to drop your coverage under the Senior Citizen Program, you will be eligible to re-enroll at the beginning of the quarter following the anniversary of when you first enrolled in the Program provided you pay the required premium. If you lose or decide to drop your AFTRA Health Plan coverage, you will be eligible for a 60-day Special Enrollment Period to enroll in a Part D plan.
You should also know that if you drop coverage or lose eligibility under the AFTRA Health Plan and don’t enroll within 63 days in Medicare prescription drug coverage after your AFTRA Health Plan coverage ends, you may be required to pay more to enroll in Medicare prescription drug coverage later on.
For example, if, after December 31, 2008, your AFTRA Health Plan coverage ends and you have a 63-day or longer gap without prescription drug coverage that is at least as good as Medicare’s, you will pay more to enroll in Medicare prescription drug coverage. Your monthly premium for Medicare Part D coverage will go up at least 1% per month for every month after December 31, 2008 that you did not have that coverage. For example, if you do not have coverage for 19 months, your premium will always be at least 19% (1% x 19 months) higher than what most other people would pay. And, you will have to pay this higher premium for as long as you have Medicare prescription drug coverage. Finally, you may have to wait until the following November to enroll in another Medicare Part D plan, and your Part D coverage under the program will not be effective until January 1 of the next year.
More Information Available
More detailed information about Medicare plans that offer prescription drug coverage will be available in the “Medicare & You 2009” handbook. You will receive a new edition of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. More information about Medicare prescription drug plans can be found on the following Web sites:
If you have additional questions about this notice or your current AFTRA Health Plan prescription drug coverage, you can call the Fund office Participant Services Department at 1-800-562-4690. You can also visit our Web site at http://www.aftrahr.com/. You will receive this notice each year prior to the annual enrollment period, or if the AFTRA Health Plan’s prescription drug coverage changes. You may also request a copy of this notice at any time.
Save This Notice
After December 31, 2008, if you enroll in one of the plans approved by Medicare which offers prescription drug coverage, and your AFTRA Health Plan coverage is still in effect or ended less than 63 days before your enrollment in the Medicare prescription drug coverage, you may need to provide a copy of this notice to show that you are not required to pay a higher premium amount.
Special Note:
While we have attempted to provide you with some basic answers about Medicare Part D, this brief document is not a full description of the Medicare Part D program. You should review this notice, as well as other Medicare Part D information, very carefully and consider how it will affect your particular circumstances. No one at the Fund office can advise you as to what decision to make. Whether to enroll in a Medicare Part D program and which program is best for you is your decision.
The AFTRA H&R Trustees may modify or eliminate (without prior notice to you) any benefits and the eligibility requirements for benefits, including the Senior Citizen coverage, provided by the AFTRA Health Plan as described in this notice. The premiums for the AFTRA Health Plan may also change from time to time. The AFTRA H&R Trustees have the authority and discretion to interpret the plan of benefits and make final determinations regarding them. No benefits are guaranteed.
November 2008
Dear Medicare Eligible Participant and Medicare Eligible Spouse/Dependent:
The annual enrollment period for Medicare’s prescription drug coverage – Medicare Part D-- is from November 15 through December 31, 2008. Therefore, it is time for you to consider whether you want to make any changes in your current prescription drug plan coverage.
During the upcoming enrollment period, you have the opportunity to enroll in a Medicare Part D plan, or to keep your AFTRA Health Plan coverage provided you pay your premiums on a timely basis and, if you are an active participant, provided you remain eligible for coverage under the AFTRA Health Plan.
It is important to note that if you choose to enroll in a Medicare prescription drug plan, the AFTRA Health Plan’s Senior Citizen Program will not provide secondary prescription drug coverage. However, it will continue to provide your other hospital and medical benefits in accordance with the Plan. Therefore, if you qualify for the Senior Citizen Program and want prescription drug coverage under the Senior Citizen Program, you must not enroll in a Part D plan. If you are currently enrolled in a Part D Plan, in order for you to be covered under the Senior Citizen Program prescription drug coverage, you must terminate your enrollment in your Part D Plan by contacting your current plan or by calling 1-800-MEDICARE.
Read this notice carefully before you make your decision, and keep this notice where you can find it. This notice contains information about the Medicare prescription drug coverage and the current prescription drug coverage offered under the AFTRA Health Plan. It tells you where to find more information about the Medicare program and the options that are available to you.
Medicare Part D Prescription Drug Plan
Medicare prescription drug coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plans that offer prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. (Some plans might also offer more coverage for a higher monthly premium.) It is important for you to understand that the AFTRA Health Plan has determined that its prescription drug coverage provides “Creditable Coverage”. That means the AFTRA Plan is, on average for all plan participants, expected to pay out as much as, or even more than, the standard Medicare prescription drug coverage will pay. Therefore, if you are satisfied with the AFTRA Health Plan coverage, you may choose not to enroll in a Medicare prescription drug plan at this time.
People can enroll in a Medicare prescription drug plan when they first become eligible and during this year’s annual open enrollment period from November 15, 2008 through December 31, 2008. If you decide to enroll in Medicare prescription drug coverage at a later date, you may do so during the Medicare Part D annual open enrollment period each November 15 through December 31. But remember, as stated above, the AFTRA Health Plan Senior Citizen Program will not provide prescription drug coverage if you enroll in a Medicare drug plan.
Before You Make Your Decision
Before you make your decision, you should compare your current coverage and premiums under the AFTRA Health Plan, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area.
Remember, your current AFTRA Health Plan coverage pays for health expenses, in addition to prescription drugs, some of which may not be covered by Medicare. If you are covered under the AFTRA Health Plan’s Senior Citizen Program and choose to enroll in a Medicare Part D Plan, you will no longer have prescription drug coverage through the AFTRA Plan effective January 1, 2009. Medicare will provide your sole prescription drug coverage although you will maintain the AFTRA Plan medical and hospital coverage. Please note that the premium under the AFTRA Health Plan will not be reduced to reflect the termination of the prescription drug coverage.
If you are covered under the AFTRA Health Plan for active participants, that Plan, by law, will always pay before Medicare. Therefore, if you want to elect a Medicare Part D Plan in addition to the AFTRA Plan, you will have to pay the Part D plan premium in addition to the AFTRA Heath Plan premium, though it is unlikely that there will be any benefits payable by the Medicare Plan because it will always be secondary to the AFTRA Plan. As an alternative, you can drop the entire AFTRA Plan and be covered only by Medicare.
If you are an active participant and elect to drop your coverage under the AFTRA Health Plan, you will be able to re-enroll in the AFTRA Plan as of your next eligibility period, provided you once again meet the earnings requirements and pay the required premium. If you choose to drop your coverage under the Senior Citizen Program, you will be eligible to re-enroll at the beginning of the quarter following the anniversary of when you first enrolled in the Program provided you pay the required premium. If you lose or decide to drop your AFTRA Health Plan coverage, you will be eligible for a 60-day Special Enrollment Period to enroll in a Part D plan.
You should also know that if you drop coverage or lose eligibility under the AFTRA Health Plan and don’t enroll within 63 days in Medicare prescription drug coverage after your AFTRA Health Plan coverage ends, you may be required to pay more to enroll in Medicare prescription drug coverage later on.
For example, if, after December 31, 2008, your AFTRA Health Plan coverage ends and you have a 63-day or longer gap without prescription drug coverage that is at least as good as Medicare’s, you will pay more to enroll in Medicare prescription drug coverage. Your monthly premium for Medicare Part D coverage will go up at least 1% per month for every month after December 31, 2008 that you did not have that coverage. For example, if you do not have coverage for 19 months, your premium will always be at least 19% (1% x 19 months) higher than what most other people would pay. And, you will have to pay this higher premium for as long as you have Medicare prescription drug coverage. Finally, you may have to wait until the following November to enroll in another Medicare Part D plan, and your Part D coverage under the program will not be effective until January 1 of the next year.
More Information Available
More detailed information about Medicare plans that offer prescription drug coverage will be available in the “Medicare & You 2009” handbook. You will receive a new edition of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. More information about Medicare prescription drug plans can be found on the following Web sites:
- www.medicare.gov for personalized help;
- www.aarp.org
- www.medicarerights.org
- www.cms.hhs.gov
- Call your State Health Insurance Assistance Program (their telephone number will be found in the “Medicare & You” handbook);
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have additional questions about this notice or your current AFTRA Health Plan prescription drug coverage, you can call the Fund office Participant Services Department at 1-800-562-4690. You can also visit our Web site at http://www.aftrahr.com/. You will receive this notice each year prior to the annual enrollment period, or if the AFTRA Health Plan’s prescription drug coverage changes. You may also request a copy of this notice at any time.
Save This Notice
After December 31, 2008, if you enroll in one of the plans approved by Medicare which offers prescription drug coverage, and your AFTRA Health Plan coverage is still in effect or ended less than 63 days before your enrollment in the Medicare prescription drug coverage, you may need to provide a copy of this notice to show that you are not required to pay a higher premium amount.
Special Note:
While we have attempted to provide you with some basic answers about Medicare Part D, this brief document is not a full description of the Medicare Part D program. You should review this notice, as well as other Medicare Part D information, very carefully and consider how it will affect your particular circumstances. No one at the Fund office can advise you as to what decision to make. Whether to enroll in a Medicare Part D program and which program is best for you is your decision.
The AFTRA H&R Trustees may modify or eliminate (without prior notice to you) any benefits and the eligibility requirements for benefits, including the Senior Citizen coverage, provided by the AFTRA Health Plan as described in this notice. The premiums for the AFTRA Health Plan may also change from time to time. The AFTRA H&R Trustees have the authority and discretion to interpret the plan of benefits and make final determinations regarding them. No benefits are guaranteed.
November 2008
