Page 43 - GROUP 1 2022 Arl. Villas Benefit Guide Revised

Medicare Part D Notice: Prescription

Drug Coverage and Medicare

This notice has information about your current prescription drug When will you pay a higher premium (penalty) to join a
coverage with Revelations Health Care Group and your options Medicare Drug Plan? You should also know that if you drop or
under Medicare's prescription drug coverage. This information lose your current coverage with Revelations Health Care Group
can help you decide whether or not you want to join a Medicare medical plan and don't join a Medicare drug plan within 63
drug plan. If you are considering joining, you should compare your continuous days after your current coverage ends, you may pay
current coverage, including which drugs are covered at what cost, a higher premium (a penalty) to join a Medicare drug plan later.
with the coverage and costs of the plans offering Medicare prescrip- If you go 63 continuous days or longer without creditable
tion drug coverage in your area. Information about where you can prescription drug coverage, your monthly premium may go up
get help to make decisions about your prescription drug coverage is by at least 1% of the Medicare base beneficiary premium per
at the end of this notice. month for every month that you did not have that coverage.
For example, if you go nineteen months without creditable

Please note: If you are not Medicare eligible, and none of your
coverage, your premium may consistently be at least 19% high-
covered family members are Medicare eligible, no action is required
er than the Medicare base beneficiary premium. You may have
on your part.
to pay this higher premium (a penalty) as long as you have
There are two important things you need to know about your Medicare prescription drug coverage. In addition, you may
current coverage and Medicare's prescription drug coverage: have to wait until the following October to join.
• Medicare prescription drug coverage became available in 2006 For more information about this notice or your current
to everyone with Medicare. You can get this coverage if you join a Prescription Drug Coverage: Contact your HR department for
Medicare Prescription Drug Plan or join a Medicare Advantage Plan further information. NOTE: You may receive this notice at

(like an HMO or PPO) that offers prescription drug coverage. All other times in the future such as before the next period you
Medicare drug plans provide at least a standard level of coverage can enroll in Medicare prescription drug coverage, and if this
set by Medicare. Some plans may also offer more coverage for a coverage changes. You also may request a copy.
higher monthly premium.
For more information about your options under Medicare
• Revelations Health Care Group has determined that the Prescription Drug Coverage: More detailed information about
prescription drug coverage offered by Revelations Health Care Medicare plans that offer prescription drug coverage is in the
Group medical plan is, on average for all plan participants, expected "Medicare & You" handbook. You'll get a copy of the handbook
to pay out as much as standard Medicare prescription drug in the mail every year from Medicare. You may also be
coverage pays and is therefore considered Creditable Coverage. contacted directly by Medicare drug plans.
Because your existing coverage is Creditable Coverage, you can keep
For more information about Medicare prescription drug
this coverage and not pay a higher premium (a penalty) if you later
coverage:
decide to join a Medicare drug plan.
• Visit www.medicare.gov.
When can you join a Medicare Drug Plan? You can join a Medicare
drug plan when you first become eligible for Medicare and each • Call your State Health Insurance Assistance Program (see the
year from October 15 through December 7. However, if you lose inside back cover of your copy of the "Medicare & You"
your current creditable prescription drug coverage, through no fault handbook for their telephone number) for personalized help.
of your own, you will also be eligible for a two (2) month Special
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call
Enrollment Period (SEP) to join a Medicare drug plan.
1-877-486-2048.
What happens to your current coverage if you decide to join a
If you have limited income and resources, extra help paying for

Medicare Drug Plan? If you decide to join a Medicare drug plan,
Medicare prescription drug coverage is available. For
your current Revelations Health Care Group medical coverage will information about this extra help, visit Social Security on the
not be affected. Participants may keep this coverage if they elect web at www.socialsecurity.gov, or call them at 1-800-772-1213
Part D and this plan will coordinate with Part D coverage. If you de- (TTY 1-800-325-0778).
cide to join a Medicare drug plan and drop your current Revelations
Health Care Group medical plan coverage, be aware that you and
your dependents will NOT be able to get this coverage back.
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