Page 31 - Revelations Group 2 - 2021 Greenbrier Benefit Guide (R2)
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Medicare Part D Notice: Prescription


           Drug Coverage and Medicare




        This  notice  has  information  about  your  current  prescription  drug    through no fault of your own, you will also be eligible for a two (2)
        coverage with Revelations Health Care Group and your options under        month Special  Enrollment Period (SEP) to join a Medicare drug plan.
        Medicare's prescription drug coverage.  This information can help you
                                                               What  happens  to  your  current  coverage  if  you  decide  to  join  a
        decide whether or not you want to join a Medicare drug plan.  If you
                                                               Medicare Drug Plan?  If you decide to join a Medicare drug plan, your
        are considering joining, you should compare your current coverage,
                                                               current  Revelations  Health  Care  Group  medical  coverage  will  not  be
        including  which  drugs  are  covered  at  what  cost,  with  the  coverage
                                                               affected. Participants may keep this coverage if they elect Part D and
        and costs of the plans offering Medicare prescription drug coverage in
                                                               this plan will coordinate with Part D coverage. If you decide to join a
        your  area.  Information  about  where  you  can  get  help  to  make
                                                               Medicare  drug  plan  and  drop  your  current  Revelations  Health  Care
        decisions about your prescription drug coverage is at the end of this
                                                               Group medical plan coverage, be aware that you and your dependents
        notice.
                                                               will NOT be able to get this coverage back.

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