AlaskaCare Prescription Drug Coverage & Medicare
Important Notice from AlaskaCare About
Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with AlaskaCare and prescription drug coverage available for people with Medicare. It also explains the options you have under Medicare prescription drug coverage and can help you decide whether or not you want to enroll. At the end of this notice is information about where you can get help to make decisions about your prescription drug coverage.
- 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 may also offer more coverage for a higher premium. If you purchase Medicare prescription drug coverage, your AlaskaCare plan will become your supplemental prescription drug plan.
- The State of Alaska has determined that the prescription drug coverage offered by the AlaskaCare plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay and is considered creditable coverage.
Because your existing coverage is on average at least as good as standard Medicare prescription drug coverage, you can keep your AlaskaCare coverage and not pay extra if you later decide to enroll in Medicare prescription drug coverage.
Individuals can enroll in a Medicare prescription drug plan when they first become eligible for Medicare and each year from November 15 through December 31. Beneficiaries leaving employer coverage may be eligible for a Special Enrollment Period to sign up for a Medicare prescription drug plan.
You should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area.
Please contact us for more information about what happens to your coverage if you enroll in a Medicare prescription drug plan. Medicare prescription drug coverage, if elected, would become your primary coverage for prescription drugs and your AlaskaCare prescription drug plan would become the secondary coverage. There is no additional premium cost for prescription drug coverage for those who elect to remain covered by AlaskaCare.
Benefits Provided by your AlaskaCare Prescription Drug Plan (employee plan)
|All drugs||Up to 30-day supply||31-90 day supply||Mail Order 90 day supply|
|Minimum||$ 13||$ 21|
Benefits Provided by your AlaskaCare Prescription Drug Plan (retiree plan)
|Up to 90-day or 100-Unit supply|
|Brand Mail Order||$0|
|Generic Mail Order||$0|
Prescription Drug Benefits Provided by Medicare Part D Plan
The Medicare Part D prescription drug benefit uses a drug formulary to determine which drugs are covered and at what rate they are paid. The additional premium cost for prescription drug coverage under Medicare Part D is estimated to be $37 per month.
|Benefit Stages||Drug Charges||Percent Covered||Your Out-of-Pocket Cost||Your Cumulative Cost|
|Annual Deductible||Up to $310||0%||$310||$310|
|Initial Coverage Limitation||$310.01 to $2,830||75%||$630||$940|
|Coverage Gap||$2,830.01 to $6,440||0%||$3,610||$4,550|
|Catastrophic Coverage||6,440.01 to ∞||95%||Greater of 5% or $2.50 generic and $6.30 brand||Varies depending on the amount of drugs you purchase|
You should also know that if you drop or lose your coverage with AlaskaCare and don’t enroll in Medicare prescription drug coverage after your current coverage ends, you may pay more (a penalty) to enroll in Medicare prescription drug coverage later. If you go 63 days or longer without comparable prescription drug coverage to Medicare’s prescription drug coverage, your monthly premium will go up at least 1% per month for every month that you did not have that coverage. For example, if you go nineteen months without coverage, your premium will always be at least 19% higher than what many other people pay. You’ll have to pay this higher premium as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to enroll.
For more information about this notice or your current prescription drug coverage…
Contact the Division of Retirement and Benefits for further information at (907) 465-4460 or toll free at (800) 821-2251. NOTE: You will receive this notice annually and at other times in the future such as before the next period you can enroll in Medicare prescription drug coverage, and if this coverage through AlaskaCare changes. You also may request a copy.
For more information about your options under Medicare prescription drug coverage. . .
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug plans:
- Visit www.medicare.gov,
- Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number) for personalized help,
- Call (800) 633-4227 (Medicare). TTY users should call (877) 486-2048.
For people with limited income and resources, extra help paying for a Medicare prescription drug plan is available. Information about this extra help is available from the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.socialsecurity.gov, or call them at (800) 772-1213 (TTY (800) 325-0778).
Remember: If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show that you are not required to pay a higher premium amount.
- (800) 821-2251
Alaska Division of Retirement and Benefits
- P.O. Box 110203, Juneau, AK 99811-0203
- Direct (907) 465-4460 TDD (907) 465-2805
- Email email@example.com