To obtain this information, refer to the Schedule of Medical Benefits in the Summary Plan Description (SPD)/Plan Document.
Information about Medicare Part D Prescription Drug Plans for People with Medicare
If you and/or your Dependent(s) are entitled to Medicare Part A or enrolled in Medicare Part B, you are also eligible for Medicare Part D Prescription Drug benefits. It has been determined that the prescription drug coverage included in the Indemnity Medical Plan and the HMO are “creditable”. “Creditable” means that the value of this Plan’s prescription drug benefit is, on average for all Plan Participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay. Because this Plan’s prescription drug coverage is as good as Medicare, you do not need to enroll in a Medicare Prescription Drug Plan in order to avoid a late penalty under Medicare. You may, in the future, enroll in a Medicare Prescription Drug Plan during Medicare’s annual enrollment period (October 15th through December 7th of each year). You can keep your current medical and prescription drug coverage with this Plan and you do not have to enroll in Medicare Part D. If however you keep this Plan coverage and also enroll in a Medicare Part D prescription drug plan you will have dual prescription drug coverage and this Plan will coordinate its drug payments with Medicare. See the Coordination of Benefit chapter for more details on how the Plan coordinates with Medicare. If you enroll in a Medicare prescription drug plan you will need to pay the Medicare Part D premium out of your own pocket. Medicare-eligible people can enroll in a Medicare prescription drug plan at one of the following 3 times:
- when they first become eligible for Medicare; or
- during Medicare’s annual election period (from October 15th through December 7th); or
- for beneficiaries leaving employer/union group health coverage, you may be eligible for a Special Enrollment Period in which to sign up for a Medicare prescription drug plan.
If you do not have creditable prescription drug coverage and you do not enroll in a Medicare prescription drug plan you may have a late enrollment fee on the premium you pay for Medicare coverage if and when you do enroll. For more information about creditable coverage or Medicare Part D coverage see the Plan’s Notice of Creditable Coverage (a copy is available from the Trust Fund Office. See also: www.medicare.gov for personalized help or call 1-800-MEDICARE (1-800-633-4227). If you or a Medicare eligible Dependent are enrolled in the HMO and you enroll in a Medicare prescription drug plan, you will automatically be disenrolled from the HMO. If you do this, you will either have to pay an additional cost for your HMO medical coverage or file an appeal with the HMO to be re-enrolled in the HMO and disenrolled from your Medicare Drug Plan.
Whom to Contact
|Prescription Drug Plan (for Active/Retired Participants and eligible Dependents enrolled in the Blue Cross Network (PPO) or the Blue Cross Advantage Network (APPO)
500 Eagles Landing Drive
Lakeland, FL 33810
|Prescription Drug Plan (for Active/Retired Participants and eligible Dependents enrolled in the Kaiser (HMO) or the Kaiser/Smart Choices (HMO))
||Kaiser Permanente (Group #602697)
Northern California Region
1950 Franklin Street
Oakland, CA 94612