Page 15 - 2016 WFF Guide 1
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15
S pecial E nrollment P eriod E x ceptions to the L ate E nrollment P enalty F or M ore I nformation
There are “ special enrollment period s” that allow you to ad d M ed icare P art D cov erage A bout Y our O ptions U nd er
months or even years after you irst became eligible to do so, without a penalty. For M ed icare P rescription D rug
ex ample, if after your M ed icare P art D initial enrollment period you lose or d ecid e C ov erage
to leav e employer- sponsored or union- sponsored health cov erage that includ es
“ cred itable” prescription d rug cov erage, you w ill be eligible to j oin a M ed icare d rug M ore d etailed information about
plan at that time. M ed icare plans that offer prescription
d rug cov erage is in the “ M ed icare &
I n ad d ition, if you otherw ise lose other cred itable prescription d rug cov erage ( such Y ou” hand book . Y ou’ ll get a copy of the
as und er an ind iv id ual policy) through no fault of your ow n, you w ill be able to j oin a hand book in the mail ev ery year from
M ed icare d rug plan, again w ithout penalty. These special enrollment period s end tw o M ed icare. Y ou may also be contacted
months after the month in w hich your other cov erage end s. d irectly by M ed icare d rug plans.
C ompare C ov erage F or more information about M ed icare
Y ou should compare your current cov erage, includ ing w hich d rugs are cov ered at prescription d rug cov erage:
w hat cost, w ith the cov erage and costs of the plans offering M ed icare prescription V isit w w w .med icare.gov
d rug cov erage in your area. S ee the P lan’ s summary plan d escription for a summary C all your S tate H ealth I nsurance
of the P lan’ s prescription d rug cov erage. I f you d on’ t hav e a copy, you can get one by A ssistance P rogram ( see the insid e
contacting us at the telephone number or ad d ress listed below . back cov er of your copy of the
“ M ed icare & Y ou” hand book for their
C oord inating O ther C ov erage W ith M ed icare P art D telephone number) for personaliz ed
help
G enerally speak ing, if you d ecid e to j oin a M ed icare d rug plan w hile cov ered und er
the C ompany P lan d ue to your employment ( or someone else’ s employment, such C all 8 0 0 .M E D I C A R E ( 8 0 0 .6 3 3 .4 2 2 7 ) ;
TTY users should call 8 7 7 .4 8 6 .2 0 4 8
as a spouse or parent) ; your cov erage und er the C ompany P lan w ill not be affected .
For most persons covered under the Plan, the Plan will pay prescription drug beneits I f you hav e limited income and
irst, and Medicare will determine its payments second. For more information about resources, ex tra help paying for M ed icare
this issue of what program pays irst and what program pays second, see the Plan’s prescription d rug cov erage is av ailable.
summary plan d escription or contact M ed icare at the telephone number or w eb F or information about this ex tra help,
ad d ress listed below . v isit S ocial S ecurity on the w eb at
w w w .socialsecurity.gov , or call them
I f you d o d ecid e to j oin a M ed icare d rug plan and d rop your C ompany prescription at 8 0 0 .7 7 2 .1 2 1 3 ( TTY 8 0 0 .3 2 5 .0 7 7 8 ) .
d rug cov erage, be aw are that you and your d epend ents may not be able to get this
cov erage back . To regain cov erage you w ould hav e to re- enroll in the P lan, pursuant
to the P lan’ s eligibility and enrollment rules. Y ou should rev iew the P lan’ s summary
plan d escription to d etermine if and w hen you are allow ed to ad d cov erage.
F or M ore I nformation A bout This N otice or Y our C urrent
P rescription D rug C ov erage
C ontact the person listed below for further information, or call 3 1 4 .5 8 4 .6 6 2 9 . N O TE :
Y ou’ ll get this notice each year. Y ou w ill also get it before the nex t period you can j oin
a M ed icare d rug plan, and if this cov erage through the C ompany changes. Y ou also
may req uest a copy.
2016 Open Enrollment
S pecial E nrollment P eriod E x ceptions to the L ate E nrollment P enalty F or M ore I nformation
There are “ special enrollment period s” that allow you to ad d M ed icare P art D cov erage A bout Y our O ptions U nd er
months or even years after you irst became eligible to do so, without a penalty. For M ed icare P rescription D rug
ex ample, if after your M ed icare P art D initial enrollment period you lose or d ecid e C ov erage
to leav e employer- sponsored or union- sponsored health cov erage that includ es
“ cred itable” prescription d rug cov erage, you w ill be eligible to j oin a M ed icare d rug M ore d etailed information about
plan at that time. M ed icare plans that offer prescription
d rug cov erage is in the “ M ed icare &
I n ad d ition, if you otherw ise lose other cred itable prescription d rug cov erage ( such Y ou” hand book . Y ou’ ll get a copy of the
as und er an ind iv id ual policy) through no fault of your ow n, you w ill be able to j oin a hand book in the mail ev ery year from
M ed icare d rug plan, again w ithout penalty. These special enrollment period s end tw o M ed icare. Y ou may also be contacted
months after the month in w hich your other cov erage end s. d irectly by M ed icare d rug plans.
C ompare C ov erage F or more information about M ed icare
Y ou should compare your current cov erage, includ ing w hich d rugs are cov ered at prescription d rug cov erage:
w hat cost, w ith the cov erage and costs of the plans offering M ed icare prescription V isit w w w .med icare.gov
d rug cov erage in your area. S ee the P lan’ s summary plan d escription for a summary C all your S tate H ealth I nsurance
of the P lan’ s prescription d rug cov erage. I f you d on’ t hav e a copy, you can get one by A ssistance P rogram ( see the insid e
contacting us at the telephone number or ad d ress listed below . back cov er of your copy of the
“ M ed icare & Y ou” hand book for their
C oord inating O ther C ov erage W ith M ed icare P art D telephone number) for personaliz ed
help
G enerally speak ing, if you d ecid e to j oin a M ed icare d rug plan w hile cov ered und er
the C ompany P lan d ue to your employment ( or someone else’ s employment, such C all 8 0 0 .M E D I C A R E ( 8 0 0 .6 3 3 .4 2 2 7 ) ;
TTY users should call 8 7 7 .4 8 6 .2 0 4 8
as a spouse or parent) ; your cov erage und er the C ompany P lan w ill not be affected .
For most persons covered under the Plan, the Plan will pay prescription drug beneits I f you hav e limited income and
irst, and Medicare will determine its payments second. For more information about resources, ex tra help paying for M ed icare
this issue of what program pays irst and what program pays second, see the Plan’s prescription d rug cov erage is av ailable.
summary plan d escription or contact M ed icare at the telephone number or w eb F or information about this ex tra help,
ad d ress listed below . v isit S ocial S ecurity on the w eb at
w w w .socialsecurity.gov , or call them
I f you d o d ecid e to j oin a M ed icare d rug plan and d rop your C ompany prescription at 8 0 0 .7 7 2 .1 2 1 3 ( TTY 8 0 0 .3 2 5 .0 7 7 8 ) .
d rug cov erage, be aw are that you and your d epend ents may not be able to get this
cov erage back . To regain cov erage you w ould hav e to re- enroll in the P lan, pursuant
to the P lan’ s eligibility and enrollment rules. Y ou should rev iew the P lan’ s summary
plan d escription to d etermine if and w hen you are allow ed to ad d cov erage.
F or M ore I nformation A bout This N otice or Y our C urrent
P rescription D rug C ov erage
C ontact the person listed below for further information, or call 3 1 4 .5 8 4 .6 6 2 9 . N O TE :
Y ou’ ll get this notice each year. Y ou w ill also get it before the nex t period you can j oin
a M ed icare d rug plan, and if this cov erage through the C ompany changes. Y ou also
may req uest a copy.
2016 Open Enrollment
