Mohawk Valley Community College

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Presentation transcript:

Mohawk Valley Community College 2018 Medicare Retiree Plan

What are the parts of Medicare? Original Fee-for-Service Medicare Part A – Hospital coverage Part B – Medical coverage $109 for most $134 new Medicare Advantage Plans Part C – Offered through private health insurance plans Medicare Prescription Drug Plans Part D – Offered through private health insurance plans The Medicare Blue PPO plan is Part C and includes Part D of Medicare.

How Medicare Advantage Plans Work Hospitals Doctors RX/Other YOU

Medicare Advantage PPO-National Service Area Medicare Blue PPO 2018 Service Area Medicare Advantage PPO-National Service Area

Medicare Blue PPO Primary Care $20 Specialist $20 Urgent Care $20 Worldwide MRI, CAT, PET $20 X-Rays $20 Ambulatory Surgery $50 Ambulance $65 Chiropractic Care $20 Podiatrist $20 Kidney dialysis Covered in full

Medicare Blue PPO Preventative Care Diagnostic tests/lab Covered in full Routine Physical Covered in full Immunizations Covered in full Mammography Covered in full PAP/Pelvic Covered in full Bone Mass Covered in full Prostate Exam Covered in full Routine Eye Exam $20 Routine Hearing Exam $20

Medicare Blue PPO Extras Emergency Room $65 - Worldwide Inpatient Hospitalization $500 3 max/No Limit Home Health Care Covered in full Cardiac Rehab $20 PT, OT, ST $20 Out of Pocket Max $2500 In Network (Medical expenses) Extras Eyewear Allowance $100 annually Hearing Aid Allowance $300 every 3 years

Part D – Rx Coverage Initial Coverage: Tier 1 - $5 Tier 2 - $20 No Coverage Gap (Donut Hole) Catastrophic Coverage: $3.35 for generics, $8.35 for brand name drugs or 5% coinsurance (whichever is greater) upon reaching $5000 on annual OOP costs.

SILVER & FIT® $25 annual fee National network = 15,000+ facilities Membership at fitness facility $25 annual fee National network = 15,000+ facilities Optional Home Fitness Program $10 annual fee Out-of-Network option $150 annual allowance Great Support Comprehensive website Quarterly newsletter Dedicated Customer Service

Supplement C PCP $0 Specialist $0 Urgent Care $0 Diagnostic tests/lab Covered in full Home Health Care Covered in full Kidney Dialysis Covered in full Routine Physical Wellness exam Immunizations Covered in full Mammography Covered in full - 24 months PAP/Pelvic Covered in full - 24 months Bone Mass Covered in full - 24 months Prostate Exam Covered in full - 24 months

Supplement C X-Rays $0 Ambulatory Surgery $0 Ambulance $0 Rehabilitation $0 Chiropractic $0 Inpatient Hospitalization $0 Routine Eye Exam Not covered Eyewear Allowance Not covered Hearing Exam Not covered Hearing Aid Allowance Not covered Out of Pocket Max No out of pocket max

Simply P - Part D-Coverage 3 Tier Drug Rider 1st Tier-$5 for a 30 day supply 2nd Tier-$15 for a 30 day supply 3rd Tier-$30 for a 30 day supply NO GAP /DONUT HOLE *3 copays for 90 day fill you may pick up a 90 day supply of your medications at any participating pharmacy. Catastrophic Coverage: $5,000 $3.35 for generics, $8.35 for brand name drugs or 5% coinsurance.

Changes & Reminders For 2018 Expect a new ID card in December Expanded PPO Network Tele-Medicine now covered with PCP copay (MD-live)

Questions and answers