Recent changes in Medicare procedures for MSNs

SRSRA Advisory on Medicare Prescription Drug Plans

U. S. Government Medicare Web Site

How to File a Medicare Claim Yourself

View Medicare Summary Notices (MSNs) on the Internet

Carolina Center for Medical Excellence (Medicare Assistance)

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Recent Changes in Medicare procedures for MSNs

A Medicare representative has stated that Medicare will now only send Medicare Summary Notices to participants on a quarterly schedule provided there were claims processed in the participant's account during that quarter. Previously Medicare had sent notices to participants about every 30 days when there had been activity in their account.

As a result of this change, participants may receive an Explanation Of Benefits from Blue Cross on a claim before receiving their quarterly Medicare Summary Notice. Retirees should carefully review their Medicare and Blue Cross statements until they become familiar with this change in the notification procedure.

As a result of these cost saving administrative changes, retirees may find it more difficult to track their medical expenses. If a retiree needs information about a medical claim they should not hesitate to contact Customer Service at Medicare.   The Medicare Helpline telephone number is 1‑800‑633‑4227

Please note that you can also view your MSNs online at the Medicare.gov link listed below on this page.

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MEDICARE PRESCRIPTION DRUG COVERAGE OPTION

(Note: this is the same info that is displayed on the "Medical Benefits" web page. It is presented here to be sure you find it.)

     If you are over 65 and on Medicare, you certainly have been receiving solicitations to sign up for Medicare prescription drug coverage. The following information is taken directly from the August, 2005, SRSRA Newsletter, and describes our best advice on what to do about this new option.

"SRSRA recommends keeping your current WSRC/BSRI prescription drug coverage coverage. Do not elect the Medicare Prescription Drug Program."

"But before you act either way, please read further in this article."

"The SRSRA is monitoring developments related to the new Part D, Medicare Prescription Drug Coverage, option. We are recommending the nominal best choice when comparing the current Retiree WSRC/BSRI Health Choice Medical Plan to the new Medicare Part D Prescription Drug Coverage. The SRSRA thinks that it is very important to reach all retirees faced with this important choice, both SRSRA members and non-members alike. We encourage SRSRA members to become well informed about Medicare Part D as compared to the WSRC/BSRI Health Choice Medical Plan and to share that information with all retirees."

That assessment is still valid today (as of Dec. 2007).

Facts:

     • You decide if you want to join a Medicare prescription drug plan

     • Signup will be from November 15, 2005, through May 15, 2006.  A subsequent signup began in Nov. 2007.

     • Medicare will help pay for employer retiree drug coverage that meets Medicare's standards for their retirees with Medicare

     • Medicare will charge you a premium for Part D coverage if you elect Part D coverage

     • The Site BCBS prescription drug plan is better than any of the Medicare prescription drug plans for all but exceptional cases. The figure below shows the out-of-pocket cost for prescription drugs for three options:

(1) No insurance
(2) SRS-BCBS plan
(3) Medicare Part D coverage

The figure below clearly shows that the out-of-pocket cost for prescription drugs is lowest for the SRS-BCBS plan.

Choose to either:

     • keep your current drug plan. If you choose to join a Medicare prescription drug plan later (after May 15, 2006) your monthly Part D premium won’t be higher (no surcharge), or

     • drop your current drug plan and join a Medicare prescription drug plan, but you may not be able to get your WSRC/BSRI drug plan back.

     You may want to begin looking at your current retiree health insurance coverage and see what prescription drugs aren't covered or what part of the costs you pay yourself. Medicare is working with employers to help you keep your current drug coverage. Medicare has a handy downloadable chart (PDF) to record ongoing prescription medications that you currently use. (Click here for chart.)

     Medicare will help pay for employer retiree drug coverage that meets Medicare's standards for their retirees who are on Medicare by giving the employer incentives to retain their program.

     In a recent meeting with WSRC Benefits personnel, your SRSRA Benefits Committee members learned that the Site plans to mail all retirees information they need concerning prescription drug benefits under the current WSRC/BSRI Health Benefit and how it may relate to the new Medicare Part D.

     Additionally, WSRC/BSRI has already sent you a notice stating that our Prescription Drug coverage under the WSRC Team Health Choice Plan already meets Medicare’s standards for retirees on Medicare. YOU SHOULD KEEP THAT LETTER FOREVER!

      [IMPT. NOTE:You can download a copy of that vital letter here.]



     On-line tools that you may want to use are at:

          Your Medicare Prescription Drug Coverage Options

          Prescription Drug Coverage Frequently Asked Questions

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