Page 38 - NYMets_2018_Benefits_Guide

legal disclosures

IMPORTANT NOTICE FROM YOUR EMPLOYER ABOUT YOUR When Can You Join a Medicare Drug Plan?
PRESCRIPTION DRUG COVERAGE AND MEDICARE
You can join a Medicare drug plan when you first become
Creditable Coverage for Choice Plus, Choice and Premier Plans eligible for Medicare and each year from October 15 through
Please read this notice carefully and keep it where you December 7th.
can find it. This notice has information about your current However, if you lose your current creditable prescription
prescription drug coverage with your employer and about drug coverage, through no fault of your own, you will also be
your options under Medicare’s prescription drug coverage. eligible for a two-month Special Enrollment Period (SEP) to
This information can help you decide whether or not you want join a Medicare drug plan.
to join a Medicare drug plan. If you are considering joining, What Happens to Your Current Coverage if You Decide to
you should compare your current coverage, including which Join a Medicare Drug Plan?
drugs are covered at what cost, with the coverage and costs
of the plans offering Medicare prescription drug coverage in If you decide to join a Medicare drug plan, your Medical
your area. Information about where you can get help to make Plan coverage will be affected. Your current coverage pays
decisions about your prescription drug coverage is at the end for other health expenses in addition to prescription drugs.
of this notice. If you enroll in a Medicare prescription drug plan, you and
your eligible dependents will still be eligible to receive all of
As a plan participant, it is your responsibility to provide a
copy of this electronic disclosure to your Medicare-eligible your current health and prescription drug benefits under the
dependents covered under the group health plan. You are Medical Plan, subject to the remaining terms of the Medical
entitled to request and obtain a paper version of this document Plan. However, if you enroll in a Medicare prescription drug
from the Benefits Team outlined at the end of this notice. plan, the Medical Plan will coordinate with Medicare Part D
coverage, if permitted by applicable law.
There are two important things you need to know about your
current coverage and Medicare’s prescription drug coverage: This means that:
Ÿ for Medicare eligible retirees and their Medicare eligible
1. Medicare prescription drug coverage became available dependents, Medicare Part D coverage pays primary and
in 2006 to everyone with Medicare. You can get this the Medical Plan pays secondary.
coverage if you join a Medicare Prescription Drug Plan
or join a Medicare Advantage Plan (like an HMO or PPO) Ÿ for Medicare eligible active employees and their Medicare
that offers prescription drug coverage. All Medicare drug eligible dependents, the Medical Plan pays primary and
plans provide at least a standard level of coverage set by Medicare Part D coverage pays secondary.
Medicare. Some plans may also offer more coverage for a If you enroll in a Medicare prescription drug plan, you will
higher monthly premium.
need to pay the Medicare Part D premium out of your own
2. The Medical Plan Sponsor has determined that the pocket.
1
prescription drug coverage offered by the Medical Plan is, You may not drop prescription drug coverage under the
on average for all plan participants, expected to pay out Medical Plan and keep other coverage under the Medical
as much as standard Medicare prescription drug coverage Plan. This is because prescription drug coverage is part of the
pays and is considered Creditable Coverage. Because your entire Medical Plan.
existing coverage is Creditable Coverage, you can keep
this coverage and not pay a higher premium (a penalty) if
you later decide to join a Medicare drug plan.

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