Prescription Drug Coverage and Medicare

PRESCRIPTION DRUG COVERAGE AND MEDICARE                     

OWU RETIREE MEDICARE SUPPLEMENT PLAN

Please read and keep this notice handy. It has information about your current prescription drug coverage with Ohio Wesleyan University and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan.

If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage appears at the end of this notice.

There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:

1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Ohio Wesleyan University has determined that the prescription drug coverage offered by your health plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.  

When Can You Join A Medicare Drug Plan?                                                                                   

 You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15-December 7. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?         

When you or your dependent becomes Medicare Part D eligible, you may:

• Retain your existing coverage and choose not to enroll in a Part D plan, or                                           
•  Enroll in a Part D plan as a supplement to your coverage through Ohio Wesleyan University.             

Your current coverage pays for other health expenses in addition to prescription drugs. If you enroll in a Medicare prescription drug plan, you and your eligible dependents will still be eligible to receive all your current health and prescription drug benefits. If you do not drop your coverage through Ohio Wesleyan University and do not enroll in a Medicare prescription drug plan, your current coverage will continue to pay for other health expenses in addition to prescription drugs, and you will still be able to receive all your current medical and prescription drug benefits. If you do not drop your coverage through Ohio Wesleyan University but you also enroll in a Medicare prescription drug plan, the Ohio Wesleyan University group health plan will coordinate benefits with the Medicare prescription drug plan. If you drop your current coverage through Ohio Wesleyan University including your medical coverage, and enroll in a Medicare prescription drug plan, be aware that you and your eligible dependents will not be able to enroll in the Ohio Wesleyan University group health plan until the next open enrollment period or you experience an event that would qualify you for reenrollment. Please contact us for more information about what happens to your coverage if you enroll in a Medicare prescription drug plan.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?                        You should also know that if you drop or lose your current coverage with Ohio Wesleyan University and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.

NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Ohio Wesleyan University changes. You also may request a copy of this notice at any time.

Detailed information about Medicare plans that offer prescription drug coverage is available in the “Medicare & You” handbook. Medicare will send you a copy of the handbook every year. You may also be contacted directly by Medicare drug plans.

For more information about Medicare prescription drug coverage:                                                               ∙ Visit www.medicare.gov                                                                                                                             

 ∙ Call your State Health Insurance Assistance Program (See “Medicare & You” booklet for number.)                                                                                                                                                                        

   ∙ Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

PRESCRIPTION DRUG COVERAGE AND MEDICARE                  

ANTHEM BLUE ACCESS PPO

Please read this notice carefully and keep it handy. It has information about your current prescription drug coverage with OWU and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan.

If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage appears at the end of this notice.

There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:

1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.                                                                                                                                                         
2. Ohio Wesleyan University has determined that the prescription drug coverage offered by your health plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

 When Can You Join A Medicare Drug Plan?                                                                                        

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15-December 7. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?           

When you or your dependent becomes Medicare Part D eligible, you may:                                                  

• Retain your existing coverage and choose not to enroll in a Part D plan, or                                             
•  Enroll in a Part D plan as a supplement to your coverage through Ohio Wesleyan University.

Your current coverage pays for other health expenses in addition to prescription drugs. If you enroll in a Medicare prescription drug plan, you and your eligible dependents will still be eligible to receive all your current health and prescription drug benefits. If you do not drop your coverage through Ohio Wesleyan University and do not enroll in a Medicare prescription drug plan, your current coverage will continue to pay for other health expenses in addition to prescription drugs, and you will still be able to receive all your current medical and prescription drug benefits. If you do not drop your coverage through Ohio Wesleyan University but you also enroll in a Medicare prescription drug plan, the Ohio Wesleyan University group health plan will coordinate benefits with the Medicare prescription drug plan. If you drop your current coverage through Ohio Wesleyan University including your medical coverage, and enroll in a Medicare prescription drug plan, be aware that you and your eligible dependents will not be able to enroll in the Ohio Wesleyan University group health plan until the next open enrollment period or you experience an event that would qualify you for reenrollment. Please contact us for more information about what happens to your coverage if you enroll in a Medicare prescription drug plan.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?                        

 You should also know that if you drop or lose your current coverage with Ohio Wesleyan University and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.

NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Ohio Wesleyan University changes. You also may request a copy of this notice at any time.

Detailed information about Medicare plans that offer prescription drug coverage is available in the “Medicare & You” handbook. Medicare will send you a copy of the handbook every year. You may also be contacted directly by Medicare drug plans.

For more information about Medicare prescription drug coverage visit:                                                                  www.medicare.gov                                                                                                                            

 ∙ Call your State Health Insurance Assistance Program (See “Medicare & You” booklet for number.)    

 ∙ Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.