Page 31 - Heritage Oaks_Benefit Guide 7-1-2020_Revised 09-25-2020

Medicare Part D Notice: Prescription

Drug Coverage and Medicare

This notice has information about your current prescription drug cover- tion drug plan provisions/options that Medicare eligible individuals
age with Heritage Oaks and your options under Medicare's prescription may have available to them when they become eligible for Medicare
drug coverage. This information can help you decide whether or not Part D.]
you want to join a Medicare drug plan. If you are considering joining,
you should compare your current coverage, including which drugs are If you decide to join a Medicare drug plan and drop your current
covered at what cost, with the coverage and costs of the plans offering Heritage Oaks medical plan coverage, be aware that you and your de-
Medicare prescription drug coverage in your area. Information about pendents will NOT be able to get this coverage back.
where you can get help to make decisions about your prescription drug
coverage is at the end of this notice. When will you pay a higher premium (penalty) to join a Medicare
Please note: If you are not Medicare eligible, and none of your covered Drug Plan? You should also know that if you drop or lose your current
family members are Medicare eligible, no action is required on your coverage with medical plan and don't join a Medicare drug plan within
part. 63 continuous days after your current coverage ends, you may pay a
higher premium (a penalty) to join a Medicare drug plan later. If you
There are Three important things you need to know about your cur- go 63 continuous days or longer without creditable prescription drug
rent coverage and Medicare's prescription drug coverage: coverage, your monthly premium may go up by at least 1% of the Med-
icare base beneficiary premium per month for every month that you
1.Medicare prescription drug coverage became available in 2006 to did not have that coverage. For example, if you go nineteen months
everyone with Medicare. You can get this coverage if you join a Med- without creditable coverage, your premium may consistently be at
icare Prescription Drug Plan or join a Medicare Advantage Plan (like least 19% higher than the Medicare base beneficiary premium. You
an HMO or PPO) that offers prescription drug coverage. All Medicare may have to pay this higher premium (a penalty) as long as you have
drug plans provide at least a standard level of coverage set by Medi- Medicare prescription drug coverage. In addition, you may have to
care. Some plans may also offer more coverage for a higher monthly wait until the following October to join.
premium.
2.Heritage Oaks has determined that the prescription drug coverage For more information about this notice or your current Prescription
offered by the Heritage Oaks is, on average for all plan participants, Drug Coverage: Contact your HR department for further information.
NOT expected to pay out as much as standard Medicare prescription NOTE: You may receive this notice at other times in the future such as
drug coverage pays. Therefore, your coverage is considered Non- before the next period you can enroll in Medicare prescription drug
Creditable Coverage. This is important because, most likely, you will coverage, and if this coverage changes. You also may request a copy.
get more help with your drug costs if you join a Medicare drug plan,
than if you only have prescription drug coverage from the [Insert For more information about your options under Medicare Prescrip-
Name of Plan]. This also is important because it may mean that you tion Drug Coverage: More detailed information about Medicare plans
may pay a higher premium (a penalty) if you do not join a Medicare that offer prescription drug coverage is in the "Medicare & You" hand-
drug plan when you first become eligible. book. You'll get a copy of the handbook in the mail every year from
3.You can keep your current coverage from Revelations Healthcare Medicare. You may also be contacted directly by Medicare drug plans.
Group. However, because your coverage is non-creditable, you have • Visit www.medicare.gov.
decisions to make about Medicare prescription drug coverage that • For personalized help, you can call 1-800-MEDICARE (1-800-633-
may affect how much you pay for that coverage, depending on if and 4227). TTY users should call 1-877-486-2048.
when you join a drug plan. When you make your decision, you should
compare your current coverage, including what drugs are covered, If you have limited income and resources, extra help paying for
with the coverage and cost of the plans offering Medicare prescrip- Medicare prescription drug coverage is available. For information
tion drug coverage in your area. Read this notice carefully it explains about this extra help, please visit Social Security on the web at
your options. www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-
325-0778).
When can you join a Medicare Drug Plan? You can join a Medicare drug
plan when you first become eligible for Medicare and each year from
October 15 through December 7. However, if you decide to drop your
current coverage, you will also be eligible for a two (2) month Special
Enrollment Period (SEP) to join a Medicare drug plan however you also
may pay a higher premium (a penalty) because you did not have credita-
ble coverage under Heritage Oaks plan.

What happens to your current coverage if you decide to join a
Medicare Drug Plan? If you decide to join a Medicare drug plan, your
current Heritage Oaks coverage will [or will not] be affected. [See pag-
es 9 - 11 of the CMS Disclosure of Creditable Coverage To Medicare
Part D Eligible Individuals Guidance (available at http://
www.cms.hhs.gov/CreditableCoverage/), which outlines the prescrip-

31