Page 35 - 2023 Stamford Benefit Guide
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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 Stamford ManagementCo LLC and your options under   Medicare Drug Plan?  You should also know that if you drop or
        Medicare's  prescription  drug coverage.    This  information  can  help   lose your current coverage with Stamford ManagementCo LLC
        you decide whether or not you want to join a Medicare drug plan.  If   medical  plan  and  don't  join  a    Medicare  drug  plan  within  63
        you are considering joining, you should compare your  current cov-  continuous days after your current coverage ends, you may pay
        erage, including which drugs are covered at what cost, with the cov-  a higher premium (a penalty) to join a Medicare drug plan later.
        erage  and  costs  of  the  plans  offering  Medicare  prescription  drug   If  you  go  63  continuous  days  or  longer  without  creditable
        coverage in your area. Information about where you can get help to   prescription drug coverage, your monthly premium may go up
        make decisions about your prescription drug coverage is at the end   by at least 1% of the Medicare base beneficiary premium per
        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%
        covered family members are Medicare eligible, no action is required
                                                                  higher than the Medicare base beneficiary premium. You may
        on your part.
                                                                  have 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 have
        current coverage and Medicare's prescription drug coverage:   to wait until the following October to join.
        •  Medicare prescription drug coverage became available in 2006 to   For  more  information  about  this  notice  or  your  current
        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,  325-773-3671.   NOTE:   You  may  receive


        (like  an  HMO  or  PPO)  that  offers  prescription  drug  coverage.  All    this notice at other times in the future such as before the next
        Medicare drug plans provide at least a standard level of coverage   period you can enroll in Medicare prescription drug coverage,
        set by Medicare.  Some plans may also offer more coverage for a   and if this coverage changes.  You also may request a copy.
        higher monthly premium.
                                                                  For  more  information  about  your  options  under  Medicare
        •  Stamford ManagementCo LLC has determined that the  prescrip-  Prescription  Drug  Coverage: More detailed information about
        tion drug coverage offered by Stamford Management Co LLC medi-  Medicare plans that offer prescription drug coverage is in the
        cal plan is, on average for all plan participants, expected to pay out   "Medicare & You" handbook.  You'll get a copy of the handbook
        as much as standard Medicare prescription drug coverage pays and   in  the  mail  every  year  from  Medicare.  You  may  also  be
        is  therefore  UNITED  HEALTHCARE  is  considered  Creditable  Cover-  contacted directly by Medicare drug plans.
        age.  Because your existing coverage is Creditable Coverage, you can
                                                                  For  more  information  about  Medicare  prescription  drug
        keep this coverage and not pay a  higher premium  (a penalty)  if you
                                                                  coverage:
        later 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 Austin Healthcare and Rehabilitation medical coverage
                                                                  information  about  this  extra  help,  visit  Social  Security  on  the
        will  not  be  affected.  Participants  may  keep  this  coverage  if  they   web at www.socialsecurity.gov, or call them at 1-800-772-1213
        elect Part D and this plan will coordinate with Part D coverage. If   (TTY  1-800-325-0778).
        you  decide  to  join  a    Medicare  drug  plan  and  drop  your  current
        Austin  Healthcare  medical  plan  coverage,  be  aware  that  you  and
        your dependents will NOT be able to get this coverage back.
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