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If you’re feeling stressed about your Medicare coverage – relax, we’ve got your back.
Here’s how it works.
Original Medicare is a federal health insurance program for eligible adults age 65 and older or those under 65 with a medical disability who qualify. It has four parts – Part A, Part B, Part C and Part D.
Parts A and B pay for different health care costs.
Part C is unique because it combines the coverage of Parts A and B; it’s known as Medicare Advantage.
Part D is additional prescription drug coverage, often included in Medicare Advantage plans; it’s also available as a stand-alone plan.
There’s also a Medicare state-approved offering, known as Medicare supplement insurance. Medicare supplement helps cover the costs that aren’t covered by Original Medicare as well as your share of the costs for Medicare services.
Medicare Part A acts as hospital insurance. Part A helps pay for inpatient care in hospitals, hospice care, home health care and care provided in a skilled nursing facility
Medicare Part B provides medical insurance. Part B helps cover doctor visits, procedures that
don’t require an overnight hospital stay and some preventive care services, such as flu shots. Most
people pay a monthly premium for Part B, which is based on their income. The monthly premium for Part B is typically taken out of your Social Security benefit.
Part C: Medicare Advantage
Medicare Part C, known as Medicare Advantage, integrates Medicare Part A and Part B, and
often Part D, with additional medical benefits not covered by Original Medicare. Medicare
Advantage plans are available through private health insurers and provides extras, such as:
Routine vision and dental care
Hearing aids and eyewear
Resources for managing chronic conditions
Wellness and fitness programs
Preventive services and annual wellness exams at no additional cost
Part D: Prescription Drug Coverage Medicare Part D helps cover your cost for prescription drugs if
you have Original Medicare. Part D plans are managed by private Medicare-approved insurers. You must enroll in a private plan, such as those offered by Blue Cross, to receive Part D drug coverage. A Part D drug plan can be added to your Medicare benefits as a stand-alone plan if you’ve chosen Original Medicare and a Medicare Supplement plan. Another cost-effective way to buy Part D drug benefits is to get them through a Medicare Advantage plan with hospital and medical coverage.
Medicare supplement, also called Medigap
Medicare supplement plans help bridge the gap between what Original Medicare covers and the total cost of medical services. They cover all or a portion of Medicare deductibles and coinsurances; plans are accepted nationwide. As long as you pay your premium, a Medicare
supplement policy is guaranteed renewable.
Please review the Enrollment Book for detailed information on Medicare options!
We have established Group Medical plans for Retirees in the Auto Industry eligible for Medicare, regardless of their age, that have worked for any Auto Company for at least 5 years and can provide documentation of their eligibility. Unlike the Pre-65 plans we offer, it is not necessary that the former employers have their plan trusteed by the Pension Benefits Guaranty Corporation (PBGC) in order to qualify for Medicare group plans established by Cone Retiree Healthcare Group through the Auto Industry as well as the Dental and Vision plans.
Retiree Eligibility for Medicare Plans
Eligible retirees have the ability to enroll in the plans of the Trust. You will find we have healthcare options available to ALL US Auto Retirees through these plans.
Medicare-eligible retirees, spouses, domestic partners, survivors and their families who have worked at least 5 years for one of the companies eligible to participate in the Trust.
Spouse - Your legally married spouse, including a declared common-law spouse.* Only one spouse or same gender domestic partner may be covered at any time. *Where recognized by the state.
Domestic Partner - The individual who lives in the same household and shares the common resources of life in a close, personal, intimate relationship with a retiree if, under state law, the individual would not be prevented from marrying the retiree due to age, consanguinity, or prior undissolved marriage to another. An eligible domestic partner must be of the same gender as the retiree. Only one spouse or same-gender domestic partner may be covered at any time.
Annual Enrollment Periods
The Annual Enrollment begins October 15 – December 31 each year. We recommend you enroll as soon as possible after October 15 to ensure you receive your insurance cards in a timely manner. Don’t confuse the Trust’s open enrollment period with the Individual Market’s open enrollment period which is from October 15th to December 7th. Because this Trust is a Group plan, we are able to extend the annual open enrollment period until December 31st of each year.
Enrollment for New Retirees or Retirees becoming Medicare Eligible
If you are retiring or becoming Medicare eligible, your enrollment period to enroll in a Medicare plan will follow the same timeline that you would follow if you were enrolling in the individual market. Your Pre-65 insurance will typically end on the last day of the month prior to your 65th birthday. You will have up to 3 months prior to your 65th birthday and 3 months following your 65th birthday to enroll in a Medicare plan. If you do not enroll in a Medicare plan during that time period, you may be subject to permanent penalties from Medicare for not enrolling in a timely manner, so make sure you take the proper steps to get enrolled in the time allowed.
What Can I Change During Open Enrollment?
Return to Original Medicare from an existing Medicare Advantage (MA) plan if you are currently enrolled in a Medicare Advantage Plan.
Enroll in Medicare Plan D (prescription drug plan) or move to another coverage level in the Trust.
Drop your Plan D coverage if you plan to get your prescription drug coverage through a private insurance provider.
Switch from one Medicare Advantage plan to another plan.
Make changes to your Dental or Vision options available to the eligible plan participants.
Important Reminders for Medicare Eligible Retirees Enrolled in Group Plans Retirees that turn 65 and continue on group coverage with their spouse or through another company, are not required to enroll in Medicare until spousal coverage terminates or the Retiree leaves group coverage through another plan without incurring a penalty assessment.
Medicare Eligibility Change
Under Age 65 - Your spouse/domestic partners are all eligible for any Medicare Plans offered through the Trust as long as you are Medicare eligible and are enrolled in Medicare Part A and Part B. The Secondary Medical Plans are available to Medicare eligible plan participants over the age of 65 only.
Medicare-eligible (over the age of 65) - If you are enrolling in the Medicare medical and prescription drug plans offered through the Trust, each plan participant has the ability to enroll in benefits coverage tailored to their specific needs. It is not necessary for the retiree and the spouse to be enrolled in the same benefit plan.
The Board of the Trust is pleased to announce the continuation of the additional benefits you will receive at NO COST for eligible participants in 2024, when enrolling in a Secondary Retiree Medical Plan or a Medicare Advantage Plan through the Auto Trust.
NO COST TO THE ELIGIBLE PARTICIPANT:
· FREE Silver&Fit for the eligible participants of one of The Hartford Medicare Plans or Silver Sneakers for each member participating in the Blue Cross Blue Shield Medicare Advantage Plans!
· Enhanced Benefits at No additional Cost when enrolling in the Retiree Medical Plans offered through the Trust!
What Benefits Are Offered Through Your Trust Plans?
Contained within this section you will find the rates for the various Medical, Dental, and Vision plans that are available to you. We offer cafeteria style benefits, you have the ability to select each of our healthcare options as standalone plans (Retiree Medical Plans, Medicare Advantage Plans and Dental/Vision plans). We also offer a Medicare Advantage Plan that includes a Prescription Drug Plan.
In addition, *Dental and Vision must be selected together when choosing these products without Medical or Prescription drug coverage options. They are only offered as bundled coverage.
The BCBSM Medicare Advantage Plans and The Hartford Retiree Medicare Plans are both non-network plans, you have access to any Medicare-eligible provider. To find a doctor or hospital participating in Medicare and who accepts or does not accept Medicare assignments visit http://medicare.gov.
You’ll get great coverage with the confidence you expect from Blue Cross — confidence you can trust whether you feel great or when you need medical care.
Health Insurance Plan Information
Medicare Advantage Plans
What is a Medicare Advantage Plan
(also called Medicare Part C)?
How They Work...
Are They Right For You?
MEDICARE ADVANTAGE PPO PLANS
You must continue to be enrolled, aging up or qualify to enroll in Part A and Part B of Medicare to be eligible to enroll in a Medicare Advantage plan. In addition, since the BCBS Medicare Advantage PPO plans offered are group Medicare plans, you have the ability to enroll now or at another time during the year when you experience a life event. When moving to a group plan you don’t have to wait for the “Medicare Annual Enrollment Window”.
How Medicare Advantage Plans Work
Medicare Part A helps cover an inpatient stay at the hospital, skilled nursing facility or rehabilitation facility. Here are just a few of the costs that are covered through Part A:
• A semi-private hospital room
• Drugs, medical supplies, medical equipment, lab tests, X-rays and radiation treatment as an inpatient
• Operating room and recovery room services
• Some blood transfusions in a hospital or skilled nursing facility
• Rehabilitation services, such as physical therapy through home health care
Medicare Part B goes hand-in-hand with Part A. It covers the cost of doctor visits – including an annual wellness exam — and other medical services. You can count on it for expenses, such as:
• Visits to your doctor and outpatient medical services
• Emergency services
• Clinical laboratory services, such as blood and urine tests
• Preventive care, including flu shots and preventive screenings, such as mammograms, colorectal and prostate cancer screenings
When enrolled in the Medicare Advantage plan, you’ll still need to pay your Part B premium.
Medicare Part C is when private insurance companies contract with the Federal government to administer Original Medicare benefits this is called a Medicare Advantage plan. Medicare Advantage plans combine all Original Medicare benefits, rights and protections with extra benefits. Our Medicare Advantage PPO plan includes benefits you won’t get from Original Medicare including:
• Blue Cross® Coordinated Care
• In-home wellness visit
• 24-Hour Nurse Line
• SilverSneakers® Fitness program
Medicare Part D is prescription drug coverage.
The plans are all-in-one Medicare Advantage plans, that combine Medicare Part A and Part B with additional benefits. Blue Cross Blue Shield has a contract with Medicare to administer your health care benefits. Medicare Advantage plans focus on health, not just health care, and can help you attain and maintain better health through coverage for preventive services, as well as care support and disease management programs.
The Trust offers 3 Blue Cross Blue Shield Medicare Advantage PPO plans with a Blue Cross Blue Shield Prescription Drug plan. We do not require you to enroll in a “bundled” plan with both a medical and prescription drug plan. We allow you to decide what medical and prescription drug plans best meet your needs.
The Blue Cross Blue Shield Medicare Advantage plans provide three options for your medical needs with extra benefits to consider that are not available in The Hartford plans we have available. The chart below will show you the benefit differences between the BCBS Medicare Advantage Plans and The Hartford Plans available. BCBS provides great options for prescription drug plans, the choice is yours, to select a medical and prescription drug plan through this Trust, or elect a medical plan through another provider.
The BCBS Medicare Advantage PPO plans offered do not have a defined geographic service area and you can visit any physician and/or hospital where Medicare services are offered.
Your annual costs will vary depending on the premiums, copayments, coinsurance and benefits of the plan you select. There are 3 plans offered through the trust.
Medicare Advantage PPO plans may have copayments or cost sharing amounts on Medicare covered services that differ from the cost sharing amounts in Original Medicare.
Your plan covers an annual physical exam and an annual wellness visit at no cost.
• Annual physical exam
Your doctor physically checks your overall health and discusses any symptoms or concerns you currently have.
• Annual wellness visit
Based on your health and risk factors, your doctor creates or updates your personalized prevention plan to help prevent disease or disability (a physical exam isn’t performed).
We have plans for everyone.
If a large network of doctors and hospitals is important to you, we’ve got it.
If you want a plan that doesn’t require referrals, we’ve got it.
If a low premium is one of your priorities, we’ve got that too.
The Centers for Medicare and Medicaid Services (CMS) regulate the Medicare Advantage plans and determine the rules by which the contracted insurance carriers, such as BCBS, are required to follow. Your out-of-pocket costs for benefits or services you receive vary by Medicare Advantage plan. The three BCBS Medicare Advantage PPO plans the Trust offer are (1) BCBS / Diamond Plan PPO with a BCBS Medicare Prescription Drug Plan, (2) BCBS / Emerald Plan PPO with a BCBS Medicare Prescription Drug Plan or (3) BCBS / Ruby Plan PPO with a BCBS Medicare Prescription Drug Plan.
With Medicare Plus Blue PPO you can visit any health care provider you’d like without a referral. With your PPO plan, you can choose any doctor or hospital that accepts Medicare. You’ll get nationwide coverage and low out-of-pocket costs. Our plans offer tons of sweet extras, so you save money and stay healthy.
Choose the Right Plan for You!
BCBS Medicare Advantage Plan Rates
Diamond and Emerald Plan
Monthly Rates for Medicare Advantage
Plan with High RX Plan
Ruby Plan Monthly Rates for Medicare Advantage
Plan with Ruby RX Plan
Please review details on the benefits for each medicare advantage plan
BCBS Medicare Advantage vs Hartford
Designed for seniors
Whether indoors or outdoors, beginner or experienced, we have fitness classes fit for everyone. All SilverSneakers classes are led by our supportive instructors.
No additional cost to you
If you have SilverSneakers included in your Medicare Advantage Plan, you get all of the location access, SilverSneakers classes, on-demand videos, and perks of membership at no additional cost.
More classes. More places.
Whether you live too far away from a gym or prefer the comfort of a familiar place, join others with instructor-led SilverSneakers FLEX classes. From community centers to nearby parks - you’ll have access to over 80 different types of classes like outdoor walking groups and nutrition workshops.
The freedom to choose
Weights, treadmills, stationary bikes, and so much more - whether you're starting to exercise or keeping up with your proven workout, you'll have access to equipment you need.
A fitness app designed for you
Access fitness programs on the go, track and schedule activities, find locations, and get your member ID with SilverSneakers GO.
On-Demand video workouts
Prefer exercising at home? Use your SilverSneakers membership to log in to our on-demand video library of classes, workouts, and how-to videos..
It’s never too late to start living a longer, healthier life. Take advantage of all SilverSneakers has to offer.
The Hartford Retiree Medical Plans
What is a Medicare Supplement Plan
(also called Medigap)?
The Hartford MEDICAL PLANS / BCBSM RX PLANS
· The Hartford offers 2 Retiree Medical Plans
Premium Choice (mirrors the “F” Plan) and Premium (mirrors the “G” Plan)
Many people new to Medicare are surprised to find that Medicare covers only 80% of your Part B expenses. The other 20% can be devastating to you financially if a serious illness arises. You can choose one of The Hartford Medical Retiree Plans that are Medicare Supplement to help pay some or all of that 20% for you, among other things. Supplemental insurance for seniors with Medicare essentially buys you peace of mind by eliminating that cost-sharing responsibility.
The Trust offers two (2) options of Retiree Medical Plans through The Hartford, and two (2) Blue Cross Blue Shield Medicare Prescription Drug plan options (PDPs) in all states where the plans are offered. You decide which, if any of these plans, best meet your needs. We do not require you to enroll in a “bundled” plan with both a medical and prescription drug plan. We allow you to decide what medical and prescription drug plans best meet your needs, understanding that “one size does not fit all ”.
While The Hartford provides two options for your medical needs and BCBSM provides great options for prescription drug plans, the choice is yours, to select a medical and prescription drug plan through this Trust, or elect a medical plan through another provider.
The Hartford Retiree Medical plans work with original Medicare to pay for some or all of the remaining balances for Medicare approved services after Medicare’s payment.
There is one supplemental insurance plan that covers ALL OF the gaps, leaving you with nothing out of pocket, Premium Plus (Plan F). There are others where you agree to do some cost-sharing and in return you get a lower monthly premium. If you prefer something like this, in the middle, you could look at the Premium (Plan G) where you pay a few things yourself, in exchange for lower premiums.
Another important benefit for Auto Retirees enrolling in BCBSM Medicare Advantage Plans and The Hartford Medicare Retiree Plans through the Auto VEBA Trust is the coverage for travel, you will pay a $250 deductible and then 20% up to a $50,000 maximum lifetime benefit.
TRAVEL BENEFITS INCLUDED IN SECONDARY MEDICAL PLANS
THE HARTFORD RETIREE MEDICAL PLAN COST
-PREMIUM CHOICE (F PLAN) AND PREMIUM PLAN (G PLAN)
Retirees are eligible to join these The Hartford Retiree Medicare plans at anytime. These group plans offered are age banded. These Plans are always open for enrollment, unlike an individual plan, which has an open enrollment window.
The Enrollment form is for all States, with the exception of Florida.
PLEASE CONTACT BENISTAR CALL CENTER IF YOU ARE ENRO:LLING AND LIVE IN FLORIDA.
CONTACT BENISTAR TO HELP DETERMINE PRICING FOR FLORIDA.
THE HARTFORD GROUP RETIREE MEDICARE PLANS
Paid by Trust
Paid by Trust
Both Forms provided to your right are required to enroll in one of The Hartford Medicare Plans.
Welcome to the enhanced Silver&Fit® Healthy Aging and Exercise program where members will discover a better life balance in a program with flexibility, personalized support, and the following features tailored to meet their unique needs:
Extra Benefit offered through The Hartford Medicare Plans
One on One Silver&Fit Healthy
Standalone Prescription Drug Plans
Admin Fee already included (plan administration, billing and claims)
The prescription drug plan offered by the Auto Trust is through BCBS. The BCBS RX Plans are managed by OptumRX.
Members may enroll in stand-alone prescription drug coverage with BCBS in either the High or Low plan.
•Your formulary is a list of drugs covered by your plan.
•Out-of-pocket cost is applied based on drug tiers and pharmacy type:
Tier 1= Preferred generic drugs
Tier 2= Generic
Tier 3= Preferred brand drugs
Tier 4= Non-preferred drugs
Tier 5= Specialty drugs
Your plan doesn’t have a coverage gap as with other Part D prescription plans. This means you continue to pay your plan’s copay until you reach the catastrophic phase, where your out-of-pocket cost may be lower but never more than your group plan copay.
You have access to more than 62,000 pharmacies nationwide. including more than 23,000 preferred pharmacies.
Standalone Prescription Drug Rates
High RX Plan
Low RX Plan
How Is the Medicare Part D Benefit Changing in 2024?
In 2024, costs in the catastrophic phase will change: the 5% coinsurance requirement for Part D enrollees will be eliminated and Part D plans will pay 20% of total drug costs in this phase instead of 15%.
The 5% coinsurance requirement for Part D enrollees in the catastrophic phase will be eliminated.
In 2024, once Part D enrollees without low-income subsidies (LIS) have drug spending high enough to qualify for catastrophic coverage, they will no longer be required to pay 5% of their drug costs, which in effect means that out-of-pocket spending for Part D enrollees will be capped. In 2024, the catastrophic threshold will be set at $8,000. This amount includes what Part D enrollees spend out of pocket plus the value of the manufacturer price discount on brands in the coverage gap phase. At this amount, Part D enrollees who take only brand-name drugs in 2024 will have spent about $3,300 out of their own pockets and will then face no additional costs for their medications.
To understand the impact of this change, it helps to consider what Part D enrollees without LIS currently pay for high-cost medications. For example, for the five drugs with the highest per capita Part D expenditures in 2021 used by more than 10,000 Part D enrollees – Revlimid, Pomalyst, Imbruvica, Jakafi, and Ibrance, all cancer treatments – annual out-of-pocket costs per drug in 2023 range from over $11,000 to nearly $15,000, and out-of-pocket costs for each drug in the catastrophic phase alone range from around $8,000 to nearly $12,000 (see methods for details) (Figure 2). (These estimates exclude the cost of other drugs that users of these drugs might be taking.) Eliminating the 5% coinsurance requirement in the catastrophic phase in 2024 means that Part D enrollees without LIS who use these or other high-cost medications covered by Part D will see thousands of dollars in savings.
Part D plans will pay a somewhat larger share of total drug costs above the catastrophic threshold
With the elimination of the 5% coinsurance requirement for Part D enrollees in the catastrophic coverage phase, Part D plans will be required to pay 20% of total drug costs in this phase in 2024, up from 15% in 2023 and prior years.
What Other Changes Are Being Made to Part D?
Starting in 2024, people with Medicare who have incomes up to 150% of poverty and resources at or below the limits for partial low-income subsidy benefits will be eligible for full benefits under the Part D Low-Income Subsidy (LIS) Program. The law eliminates the partial LIS benefit currently in place for individuals with incomes between 135% and 150% of poverty.
Also starting in 2024, the calculation of the base beneficiary premium will be adjusted, as needed, to limit increases in the base premium to no more than 6% from the prior year. (Premiums for individual Part D plan premiums and annual plan-level premium increases will continue to vary, however.)
Prescription Drug (Part D) Coverage is Important even for those not currently using Drugs!
Please remember, everyone on Medicare must be enrolled in a Part D Prescription Drug plan when you become eligible for Medicare, or you will be subject to a penalty that will affect your premium for the rest of your life, if you fail to enroll in a timely manner. It does not matter if you do not use drugs or you purchase your drugs at a local pharmacy such as Wal-Mart and you only require generics. You must be enrolled in a Part D plan to meet Medicare requirements when you become Medicare eligible.
Enrolling in the Supplemental Medical Plans and Prescription Drug Plans
To enroll in a Supplemental Medical plan and/or a Prescription Drug Plan, please complete, sign and date the Enrollment forms and return them to Benistar at the address on the form.
Enrollment Form indicating your selections
•Premium Choice Plan(Plan F), or Premium Plan(Plan G)
•BCBS PDP High, BCBS PDP Low or neither
•Blue Dental/Blue Cross Blue Shield Dental
•Blue Vision (VSP)
A copy of any document(s) providing your employment in the Auto industry for at least five (5) years or your retirement from the Auto Industry.
Dental & Vision Plans
Network Access Information
With Blue Dental PPO Plus, members can choose any licensed dentist anywhere . However, they'll save the most money when they choose a dentist who is a member of the Blue Dental PPO network.
Blue Dental PPO Network
Blue Dental members have unmatched access to PPO dentists through the Blue Dental PPO network, which offers more than 260,000 dentist locations nationwide. PPO dentists agree to accept our approved amount as full payment for covered services - members pay only their applicable coinsurance and deductible amounts. Members also receive discounts on noncovered services when they use PPO dentists (in states where permitted by law). To find a PPO dentist near you, please visit mibluedentist.com or call 1-888-826-8152.
1 Blue Dental uses the Dental Network of America (DNoA) Preferred Network for its dental plans.
2 A dentist location is any place a member can see a dentist to receive high-quality dental care. For example, one dentist practicing in two offices would be two dentist locations.
Blue Par SelectSM Arrangement
Most non-PPO dentists accept our Blue Par Select arrangement, which means they participate with the Blues on a "per claim" basis. Members should ask their dentists if they participate with BCBS before every treatment. Blue Par Select dentists accept our approved amount as full payment for covered services - members pay only applicable coinsurance and deductibles . To find a dentist who may participate with BCBS, please visit mibluedentist.com.
Note: Members who go to nonparticipating dentists are responsible for any difference between our approved amount and the dentist's charge.
POST 65 DENTAL AND VISION RATES
Vision Benefit Information
Blue Vision benefits are provided by Vision Service Plan (VSP), the largest provider of vision care in the nation. VSP is an independent company providing vision benefit services for Blues members. To find a VSP doctor, call 1-800-877-7195 or log on to the VSP Web site at vsp.com.
Note: Members may choose between prescription glasses (lenses and frame) or contact lenses, but not both.
POST 65 DENTAL AND VISION RATES
S5584 (PDP Only) - BCBS
Prescription BlueSM is a PDP plan with a Medicare contract. Enrollment in Prescription Blue depends on contract renewal.
H9572 & S5584 (PPO/PDP) - BCBS
Medicare Plus BlueSM and Prescription BlueSM are PPO and PDP plans with Medicare contracts. Enrollment in Medicare Plus Blue and Prescription Blue depends on contract renewal.
DENTAL BCBSM through BCBSM
VISION Vision Service Plan (VSP)
Call Us Today!
Medicare Plus BlueSM and Prescription BlueSM are PPO and PDP plans with Medicare contracts. Enrollment in Medicare Plus Blue and Prescription Blue depends on contract renewal.
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“Out-of-network/non- contracted providers are under no obligation to treat Medicare Plus Blue PPO BCBSM Diamond, Medicare Plus Blue PPO BCBSM Emerald and Medicare Plus Blue PPO BCBSM Ruby members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.”
Auto Retiree VEBA Trust
PPO: 19937 (600-604)