RCBP and Medicare
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RCBP and Medicare
Our retiree focused health plan offers enhanced benefits and programs for RCBP High Option retirees who have Medicare Parts A and B as their primary coverage.
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All right folks, let’s get started. So today we will go over Medicare, the different parts of Medicare. We’ll review the Aetna Medicare Advantage PPO plan for our RCBP members. We’ll take a look at those benefits at a glance. We’ll take a look at the new SilverScript Employer Prescription Drug Plan, as well as the wellness and support programs that do come with this plan. How to opt in to this plan. And then we’ll have time for questions at the end. When talking about retirement, it’s important to talk about Medicare. If you already have Medicare, then this slide does not apply to you, but you can enroll in Medicare without penalty at two times.
The first is during your initial election period or your IEP. Your IEP occurs three months before the month of, and three months after your 65th birthday. If you’re still working, when you turn 65, you do not need to enroll. You will get a special election period or SEP. Your SEP goes into effect when you retire and does last eight months. If you enroll outside of one of these periods, you must enroll during the Medicare general enrollment period, between January 1 and March 31 each year, and you might be subject to late enrollment penalties.
It’s important to note, when I do go over the different parts of Medicare that we are not taking into consideration your FEHB coverage when discussing original Medicare, we’re just talking if you just had Medicare. So Medicare Part A is part of original Medicare and provides hospital insurance. Part A is free for those who have paid Medicare taxes while working, already receive Social Security benefits or have a spouse with Medicare covered employment. If you don’t qualify to get Part A for free, then you can purchase it for a premium of $499 for the year of 2023. This coverage is going to help cover the cost of services, like inpatient hospital, skilled nursing, home healthcare and hospice. Part A can have substantial out-of-pocket costs, such as an annual deductible and co-payments, depending on the duration of your care.
And then Medicare Part B is also a part of original Medicare and provides medical insurance. Part B has a standard monthly premium of $174.70 for 2024. However, this amount can be higher depending on your annual income. Part B also has a late enrollment penalty that will increase your monthly premium by 10% for every 12 months you do not enroll after your initial election. If your income is above a certain limit, you may be required to pay the income related monthly adjustment amount or IRMA, to the government, which is an additional charge on top of your standard premium.
Medicare Part C or Medicare Advantage is an optional part that is available from private insurance companies. These plans combine part A and part B with additional benefits. Some Medicare Part C plans also include Part D benefits and premiums can start as low as $0. You must have a part A and a part B plan to get a Part C plan. These plans are becoming an option now through the FEHB, but I’ll get into that a little bit more later.
Medicare Part D is an additional coverage for prescription drugs and is also available for purchase for a monthly premium from private insurance companies. Beginning in 2024, these type of plans will be available through several FEHB plan options, and you only would have to pay for your FEHB plan premium. OPM has required the benefit to be the same as or better than the current plan benefits. So your FEHB plan will notify you if your plan will include your part D coverage. Part D can also be included in Medicare Advantage plans, as well. All RCBP members who are retired and have Medicare A and or Part B will automatically be enrolled into the SilverScript prescription drug plan for RCBP at no additional cost. This plan does not have any deductibles or donut holes.
While most plans offered through FEHB do require cost sharing, cost sharing means you might have to pay deductible and co-insurance, co-payments when you visit healthcare providers, and we know this could add up. So with combining both RCBP and the Aetna FEHB presence, along with the cost savings of Medicare Advantage plan with prescription coverage, then you get the Aetna Medicare Advantage Plan designed for RCBP members. This plan is $0 cost sharing for deductibles, co-payments, and co-insurance. So you would enroll in the Aetna Medicare Advantage Plan to get these enhanced benefits. This plan also comes with $900 a year in Medicare Part B premium reduction credit. So that is $75 automatically applied to lowering your Medicare Part B premium. It also gets added programs such as SilverSneakers and healthy home visits. There’s lower prescription copays, as low as $0 from preferred pharmacies and $2 for standard pharmacies, unlimited chiropractic, physical, occupational, and speech therapy visits and nationwide doctors. So with this plan, you can use any doctor who’s eligible to receive Medicare payment.
Here are the benefits at a glance. So the red column is just the RCBP high option with Medicare, so Medicare A and B as your primary, and then RCBP high option as your secondary. It’s still $0 deductible. The out-of-pocket maximum is $5,000 per person, and that’s combined medical and prescription, $0 co-insurance, except for prescription drugs and $0 for chiropractic services. There is a 90 visit maximum per person, per calendar a year for the physical, occupational and speech therapy. Then with the Aetna Medicare Advantage for our RCBP members, you’ll receive that $900 Medicare Part B premium reduction credit with $0 copay and $0 co-insurance, except for prescription drugs. And then that prescription drug maximum is lower with the Aetna Medicare Advantage Plan, it is $2,000 per person. So once you pay $2,000 towards your prescription drugs, per person, then the rest of your prescription drugs for that calendar year are covered at 100%. Then you also get $0 copay for chiropractic and $0 copay for physical, occupational, and speech therapy visits, as well as unlimited visits. So you do get some of these enhanced benefits.
And then here we have an example of the new SilverScript employer prescription drug plan for RCBP members. So for all RCBP members who have Medicare A and or B, prescription drug coverage will be changing for 2024. It will be this new silver or gray column right here, compared to the other prescription drug benefits that do come with the Aetna Medicare Advantage for RCBP members. And then when you do enroll in the Aetna Medicare Advantage Plan, you do have access to programs like Teladoc Telehealth services, which can provide you with online access to a provider. You can use them on the phone, through their mobile app or on the line and there’s over 700 US board certified state licensed healthcare professionals.
There’s also a hearing aid reimbursement from members that need help to pay for the tools that they need to engage and communicate in the world around them. The reimbursement is $2,500 every 36 months. There’s also a Resources for Living program, which is a life consultant. With just one call, you can get contacted to a life consultant who can help you find things like, finding a contractor to do work around the house, researching senior housing or adult daycare, and gathering a list of activities at thousands of location nationwide. There’s a non-emergency transportation program that ensures retirees make it to or from their doctor or hospital appointment safely, without having to rely on friends or family.
So at no extra cost, Aetna will provide 24, one-way trips within 60 miles of the starting point. Then after a hospital stay, Aetna does offer a meal benefit program through the relationship with Nation’s Market. This program offers home delivered meals at no additional cost. It’s 14 pre-cooked meals, two per day, for seven days. And then also, SilverSneakers comes with this plan. At no extra cost. You get a SilverSneakers membership, which can get you access to thousands of locations nationwide or gyms, as well as online classes that are also available to you.
To complete your enrollment in the Aetna Medicare Advantage Plan for RCBP members, you can go to AetnaRetireeHealth.com/RCBP, if you’re already an RCBP member, or you can call Aetna’s Retiree Solution Service Center and you’ll be asked to provide your Aetna Medicare A and B effective dates and your Medicare number. So let’s take a look at the highlights of this plan. The Aetna Medicare Advantage Plan comes with low premiums and low out-of-pocket costs. $900 in Medicare Part B premium reduction per year for eligible members. Eligible members just means you’re retired and have Medicare A and B. You get routine vision coverage and hearing aid reimbursement, unlimited chiropractic visits, prescription copays as low as $0 from a preferred pharmacy, added programs to keep you healthy, such as SilverSneakers and nationwide providers and no referrals.
So if you do have follow-up questions, I encourage you to go to rcbphealth.com/retiree, here, you can connect with our team. You can live chat, oh, excuse me, not live chat, you can visit live webinars online. You can view on demand webinars, so prerecorded webinars and videos. Online, you can also find the enrollment links. You can find the up-to-date information for 2024. There’s an online provider directory, FAQs, and again, that 2024 brochure, or you can always call your member services team at 1-800-638-8432.
Ready to opt in to Aetna Medicare Advantage?
Aetna Medicare Advantage member services representatives can help. Call us at 1-866-241-0262 (TTY: 711), Monday through Friday, 8 AM to 8 PM ET.
Get to know the Aetna Medicare Advantage plan
RCBP and Medicare: A guide for RCBP retiree health and prescription drug plans. As an Aetna Medicare Advantage for RCBP High Option plan member, you have a suite of programs and services available at no extra cost to you. Download the brochure to learn more.
Aetna Medicare Advantage for
RCBP High Option
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Aetna Medicare is an HMO, PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Out-of-network / non-contracted providers are under no obligation to treat Aetna 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. The formulary, provider and/ or pharmacy network may change at any time. You will receive notice when necessary. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 10-14 days. You can call the number on your ID card if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.