Changes for retirees

State announces changes to prescription drug plans for retirees, pensioners

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2:03 p.m., Dec. 7, 2012--Effective Jan. 1, 2013, the state of Delaware’s group health insurance prescription plan for Medicare-eligible University of Delaware retirees and pensioners will change to an enhanced Medicare Part D Retiree Prescription plan administered by Express Scripts, formerly known as Medco.

Special Medicfill, the state’s Medicare supplement plan, will continue to be administered by Highmark Blue Cross Blue Shield Delaware.

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These changes apply to all Medicare-eligible University/State of Delaware retirees. This new plan allows the state to provide better coverage than a standard Medicare Part D plan, while also taking advantage of federal programs that provide significant cost savings and allow for reduced premiums.

• The copay structure and retail pharmacy network will remain the same as the current prescription plan, except that Veterans Administration pharmacies will no longer be in the network.

This chart in PDF format shows the new retiree rates and UD/state contribution. (State pensioners who retired with less than 20 years of pension-creditable service may pay a higher portion.)

• The annual plan year for the Special Medicfill supplement plan and the enhanced Medicare Part D prescription coverage will be from Jan. 1 through Dec. 31 each year. Dental, vision and pre-Medicare health plans will continue as fiscal year plans (July 1 to June 30) with open enrollment in May.

Most people will pay only their portion of the plan’s standard Medicare Part D prescription drug plan premium. However, some people may have to pay an extra amount because of their yearly income.

Individuals who are required to pay an extra amount (referred to as IRMAA) will be notified by letter from Social Security. Those who have questions about this extra amount can contact Social Security at 1-800-772-1213 from 7 a.m.-7 p.m., Monday through Friday. TTY users should call 1-800-325-0778.

Some individuals qualify for extra help to pay for prescription drug premiums and costs. Those who want to see if they qualify can call Medicare at 1-800-MEDICARE (1-800-633-4227) any time (TTY users should call 1-877-486-2048); the Social Security Office at 1-800-772-1213 between 7 a.m.-7 p.m., Monday through Friday (TTY users should call 1-800-325-0778); or the state Medicaid office.

For those who qualify, Medicare will tell the plan how much assistance they will receive, and Express Scripts will send information on the amount for which they are qualified once they are enrolled in the plan.

Current Special Medicfill participants received a mailing from the UD Office of Human Resources; information about the plan, and new prescription ID cards, were mailed to participants by Express Scripts.

Additional information, including a Benefit Overview, is published on the Statewide Benefits website.

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