Page 12 - 2015 Four Seasons Non-Medical Enrollment Guide
P. 12
Women’s Health and Cancer Important Medicare Notice
Rights Act of 1998 Generally, you, your spouse/domestic partner or other dependent become
eligible for Medicare at age 65; after receiving no less than 24 months of Social
In compliance with the Women’s Security disability beneits, regardless of age; or after being diagnosed with end
Health and Cancer Rights Act of stage renal disease (ESRD), subject to certain exceptions.
1998, the Four Seasons Medical Plan
provides coverage for the following Federal law requires Four Seasons to exchange information with Medicare
medical services in conjunction with a regarding plan participants who may be eligible for Medicare. To the extent
mastectomy: allowed by federal law, Four Seasons will always process your claim as secondary
z Reconstruction of the breast to Medicare—regardless of whether you have enrolled in Medicare. Therefore,
you are responsible for applying for Medicare, which includes hospital coverage
on which the mastectomy was
performed under Medicare Part A and outpatient medical coverage through Medicare
Part B. While enrollment in Part A is automatic for most individuals (some minor
z Surgery and reconstruction of exceptions apply), enrollment for Part B is not automatic.
the other breast to produce a
symmetrical appearance, and You must contact the Social Security ofice at 1(800) 772-1213 to apply for
z Prosthesis and treatment of Medicare Part B. It is not done through Four Seasons.
physical complications in all If you and/or your spouse/partner/dependents do not enroll in Medicare
stages of mastectomy, including Part B, the level of your beneits will be signiicantly reduced. For example, to
lymphedemas the extent allowed by federal law, your Four Seasons coverage always pays
beneits assuming Medicare paid its portion irst. Thus, if you do not timely enroll in
These services will be provided in a Medicare, you will not receive any Medicare beneits for those claims.
manner determined in consultation
with the attending physician and If you do not enroll in Medicare Part B as soon as you are eligible, Medicare may
patient. Coverage is subject to the charge you a penalty for late enrollment when you do enroll. This penalty will
plan’s applicable deductibles and apply for as long as you are enrolled in Medicare Part B. Therefore, you should
coinsurance amounts that apply to enroll in Medicare Part B as soon as you are eligible.
other beneits under the plan.
Expanded Women’s HIPAA Privacy Notice
Preventive Care Services The Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy
Health plans must now cover an and security rules protect your health information that is created or received by
the Four Seasons Medical, Dental, Vision, and EAP Plans. These health plans are
expanded list of women’s preventive required to publish a HIPAA Privacy Notice that explains the HIPAA privacy rules.
care services with no deductible or You may obtain a copy of the updated HIPAA Privacy Notice on the My Four
coinsurance as long as services are Seasons Beneits Center website (https://fsbeneits.fourseasons.com) by clicking
received in-network. Four Seasons on the Forms and Materials tab. If you prefer, you may have a copy of the notice
already covers many of these, mailed to your home address by calling the My Four Seasons Beneits Center at 1
including well women visits. There (866) 672-0435 (toll free), Monday through Friday from 8 a.m. to 8 p.m. EST.
are a few new items that will now
be covered in full, including generic
and brand name (if a generic is No HIPAA Certificates Issued After 2014
not available or if the brand name Due to changes made by the Affordable Care Act, the Four Seasons Health
Colour Elements is medically necessary), FDA- Plan will no longer issue HIPAA certiicates of creditable coverage after
approved contraceptives and December 31, 2014. The Affordable Care Act allows you to obtain medical
breastfeeding support, supplies and coverage without any exclusions for pre-existing conditions. Therefore, these
counseling. certiicates are no longer required.
Logo & Logo Variations
My Four Seasons BENEFITS My Four Seasons 12
BENEFITS
Icon Image Elements Font Elements
Tandelle
Century Gothic
Rights Act of 1998 Generally, you, your spouse/domestic partner or other dependent become
eligible for Medicare at age 65; after receiving no less than 24 months of Social
In compliance with the Women’s Security disability beneits, regardless of age; or after being diagnosed with end
Health and Cancer Rights Act of stage renal disease (ESRD), subject to certain exceptions.
1998, the Four Seasons Medical Plan
provides coverage for the following Federal law requires Four Seasons to exchange information with Medicare
medical services in conjunction with a regarding plan participants who may be eligible for Medicare. To the extent
mastectomy: allowed by federal law, Four Seasons will always process your claim as secondary
z Reconstruction of the breast to Medicare—regardless of whether you have enrolled in Medicare. Therefore,
you are responsible for applying for Medicare, which includes hospital coverage
on which the mastectomy was
performed under Medicare Part A and outpatient medical coverage through Medicare
Part B. While enrollment in Part A is automatic for most individuals (some minor
z Surgery and reconstruction of exceptions apply), enrollment for Part B is not automatic.
the other breast to produce a
symmetrical appearance, and You must contact the Social Security ofice at 1(800) 772-1213 to apply for
z Prosthesis and treatment of Medicare Part B. It is not done through Four Seasons.
physical complications in all If you and/or your spouse/partner/dependents do not enroll in Medicare
stages of mastectomy, including Part B, the level of your beneits will be signiicantly reduced. For example, to
lymphedemas the extent allowed by federal law, your Four Seasons coverage always pays
beneits assuming Medicare paid its portion irst. Thus, if you do not timely enroll in
These services will be provided in a Medicare, you will not receive any Medicare beneits for those claims.
manner determined in consultation
with the attending physician and If you do not enroll in Medicare Part B as soon as you are eligible, Medicare may
patient. Coverage is subject to the charge you a penalty for late enrollment when you do enroll. This penalty will
plan’s applicable deductibles and apply for as long as you are enrolled in Medicare Part B. Therefore, you should
coinsurance amounts that apply to enroll in Medicare Part B as soon as you are eligible.
other beneits under the plan.
Expanded Women’s HIPAA Privacy Notice
Preventive Care Services The Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy
Health plans must now cover an and security rules protect your health information that is created or received by
the Four Seasons Medical, Dental, Vision, and EAP Plans. These health plans are
expanded list of women’s preventive required to publish a HIPAA Privacy Notice that explains the HIPAA privacy rules.
care services with no deductible or You may obtain a copy of the updated HIPAA Privacy Notice on the My Four
coinsurance as long as services are Seasons Beneits Center website (https://fsbeneits.fourseasons.com) by clicking
received in-network. Four Seasons on the Forms and Materials tab. If you prefer, you may have a copy of the notice
already covers many of these, mailed to your home address by calling the My Four Seasons Beneits Center at 1
including well women visits. There (866) 672-0435 (toll free), Monday through Friday from 8 a.m. to 8 p.m. EST.
are a few new items that will now
be covered in full, including generic
and brand name (if a generic is No HIPAA Certificates Issued After 2014
not available or if the brand name Due to changes made by the Affordable Care Act, the Four Seasons Health
Colour Elements is medically necessary), FDA- Plan will no longer issue HIPAA certiicates of creditable coverage after
approved contraceptives and December 31, 2014. The Affordable Care Act allows you to obtain medical
breastfeeding support, supplies and coverage without any exclusions for pre-existing conditions. Therefore, these
counseling. certiicates are no longer required.
Logo & Logo Variations
My Four Seasons BENEFITS My Four Seasons 12
BENEFITS
Icon Image Elements Font Elements
Tandelle
Century Gothic
