Helping You Prepare For Your Upcoming Medicare Enrollment · yourself for eligible medical,...

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Helping You Prepare

For Your Upcoming

Medicare

Enrollment

September 11, 2019


Discussion Topics

© 2019 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.

Medicare — Plan Types

Who We Are

2

1

Via Benefits Enrollment Process

Health Reimbursement Arrangement (HRA)

Action Items and Timeline

Questions and Answers

3

4

5

6


Who We Are



Experience that counts


#1 The first and

largest private

Medicare

company

120+ Insurance

providers

1.9M retirees from

hundreds of

employers

15th Year of

service

9 10 Retirees

reported they

would work

with Via

Benefits again

out

of

4

Approved by the National Council of Aging for Excellence in Medicare brokerage services


Our Service Centers

Operating Hours: Monday – Friday, 7:00 a.m. – 8:00 p.m. CT


Salt Lake City

Phoenix

Dallas

1-855-229-3283


Medicare

— Plan Types



Plans and insurers

7 © 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.

Dental and Vision Plans Available

Medicare Advantage

(Part C)

Medicare Supplement

(Medigap)

Prescription Drug

(Part D)

PLANS

INSURERS


+

+

Your Future Coverage


Original Medicare

Parts A & B

MAPD

Medicare Advantage

with Prescription Drug

coverage (Part C)

Medigap

+ Prescription Drug Plans

(Part D)

Optional Coverage

Dental & Vision

Plans

OR

Additional Coverage

How Medicare Coverage Works CMS


Your Future Supplemental Coverage Options

MAPD Plans


MAPD Medicare Advantage

with Prescription Drug

coverage (Part C)

HMO

Health

Maintenance

Organization

PPO

Preferred

Provider

Organization


Your Future Supplemental Coverage Options

Medigap Plans


Medigap

Prescription

Drug Plans

(Part D)

+


Medicare Supplement Insurance (Medigap) Lettered Policies

Medicare Supplement Insurance (Medigap) Policies

Benefits A B D G K L M N

Medicare Part A

coinsurance and hospital

costs 100% 100% 100% 100% 100% 100% 100% 100%

Medicare Part B

coinsurance or copayment 100% 100% 100% 100% 50% 75% 100% 100%

Blood (first 3 pints) 100% 100% 100% 100% 50% 75% 100% 100%

Part A hospice care

coinsurance or copayment 100% 100% 100% 100% 50% 75% 100% 100%

Skilled nursing facility

care coinsurance 100% 100% 50% 75% 100% 100%

Part A deductible 100% 100% 100% 50% 75% 50% 100%

Part B deductible

Part B excess charges 100%

Foreign travel emergency

(up to plan limits) 80% 80% 80% 80%

Source: CMS

Out-of-Pocket

limit in 2019

$5,560 $2,780

Medicare

First-Eligible

Before 2020

ONLY

C F

100% 100%

100% 100%

100% 100%

100% 100%

100% 100%

100% 100%

100% 100%

100%

80% 80%


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Changes to Medigap Plans – MACRA & 2020

The MACRA Law impacted the Part B deductible,

removing the Part B deductible coverage benefit in

Medigap plans starting with NEWLY-eligible

Medicare recipients as of 1/1/2020.

For these individuals, Plan G becomes the most

comprehensive Medigap plan instead of Plan F

(and Plan D is the same as a Plan C, without the

Part B deductible benefit).

How This Affects You

Part A effective date on or before December 31st, 2019

• Able to enroll in Medigap Plan F or C • Part B deductible coverage benefit.

Part A effective date on or after January 1st, 2020

• Able to enroll in all available Medigap Plans except plan F or C • All plans will require you to pay Part B deductible.

©2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only. 13 willistowerswatson.com

Prescription Drugs — 5 Tiers of Co-Pays

Tier 2 – Non-preferred generic

Tier 1 – Preferred generic

Tier 3 – Preferred brand

Tier 4 – Non-preferred brand

Tier 5 – Specialty drugs or injectables


Medicare Prescription Drug Coverage 2020


$3.60 for Generics

$8.95 for Brand Name

5% whichever is

greater

Catastrophic Coverage (only 4% will reach)

Coverage Gap (only 25% will reach)

Initial Coverage

Deductible

25% for Brand Name

25% for Generics

Beneficiary Pays

$0 - $435

$4020

$6350

Total Cost

Full retail until

deductible is met

Copays for your plan

coverage – 25%


Local Examples for

Cook County

60611

[breath]


Plans for Cook County

Plan Type

Number of

Plans

Offered

[74]

2019

Monthly

Premium

Insurers

[subject to change]

Medicare

Advantage 27 $0 - $177 AARP-UHC, Aetna,

BCBS-IL, Cigna HealthSpring,

Humana, WellCare

Medicare

Supplement

(Medigap) 27 $77 - $294

AARP-UHC, First Health,

Humana, Humana Connect,

Mutual of Omaha, WPS

Part D 20 $15 - $131

AARP-UHC, Aetna,

BCBS-IL, Coventry,

Express Scripts, Humana,

SilverScript, WellCare


Ancillary Plans

Plan Type

Number of

Plans

Offered

2019

Monthly

Premium

Insurers

[subject to change]

Vision 3 $14 - $17 Humana,

Vision Service Plan

(VSP)

Dental 8 $24 - $59

Ameritas, Guardian,

Humana,

MetLife Dental,

Renaissance Dental


Medicare Advantage

Benefit 2019 Cost

Premium $0

Network HMO

Deductible $0

Doctor Copay $0

Specialist Copay $25

Hospital Days 1 - 7 $175 per day

Emergency Room $120

Rx – Deductible

Retail Co-Pay Tiers (30 days)

$0

$0 / $5 / $47 / $100 / 33%

Mail Order Co-Pay Tiers

(90 days) $0 / $0 / $131 / $290 / 33%

2020 plans and rates will be available in October


Medigap Plan F + Prescription Drug Plan Based on a 75 year old male

Benefit 2019 Cost

Premium $264 ($237 Medical + $27 PDP)

Network Not Applicable

Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx – Deductible


$0

$9 / $19 / $46 / 49% / 33%


(90 days) $0 / $48 / $115 / 49% / 33%



Medigap Plan G + Prescription Drug Plan Based on a 75 year old male

Benefit 2019 Cost

Premium $214 ($187 Medical + $27 PDP)

Network Not Applicable

Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx – Deductible


$0

$9 / $19 / $46 / 49% / 33%


(90 days) $0 / $48 / $115 / 49% / 33%


Pay Part B

Deductible


Via Benefits

Process

© 2019 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson cl ient use only.


How We Can Help


Consultative Process

Simplified Selection

Effortless Enrollment

Ongoing Advocacy


Licensed/Certified/Appointed

Average age 43

Objective and unbiased (non-commissioned)

100% domestic workforce

Benefit Advisors


Benefit advisors are available:

Monday through Friday, 7:00 a.m. until 8:00 p.m. CT


Online Support Tools


Prescription Profiler

My.ViaBenefits.com/loyola

Load in your prescriptions — Shorten your time on the phone with us!


Online Support Tools


Help Me Choose Comparison Tool


24/7 access to your information


Enrollment process


100% of calls are recorded

Benefit Advisors Benefit Advisors

can discuss

coverage options

with anyone

1

Application

Customer

Service Rep Telephonic

enrollment

2


Personal guidance

Navigation

Enrollment

Prescription changes

Affordability concerns

Late enrollment

Annual plan review

Your ongoing advocate


The plans you select continue

on year-to-year. No need to

re-enroll in the fall unless you

want to make a plan change.


Health

Reimbursement

Arrangement (HRA)



Health Reimbursement Arrangement


used to reimburse you for eligible health care expenses — you pay first and then get reimbursed

Tax-free account

If you are eligible

Loyola will make a lump sum contribution to a Health Reimbursement Arrangement (HRA)

You may use

HRA funding to reimburse yourself for eligible medical, prescription drug, dental and vision premiums (even PartB premiums), as well as eligible out-of-pocket healthcare expenses

Your HRA funding will be available:

The first of the month after you retire

Unused funds DO roll over.




You may be reimbursed up to the amount available in your HRA!

How the HRA works

YOU Insurance

Provider

Premium

Reimburse (Check or Direct Deposit)

Receipt of Payment




Automatic Monthly Premium Reimbursement

Up to the amount available in your HRA

YOU Your Bank

Reimburse

Insurance Provider

Set Up Automatic Withdrawal

Receipt of Payment

Premium




Manual Reimbursement

Up to the amount available in your HRA

YOU

Insurance or Other

Provider


Qualify for Your HRA


Funding Guide

Enroll in a medical plan

through Via Benefits before

your enrollment period ends

(the last month before you retire)

to have access to your funding


Next Steps



What you need to do when retiring

You will need your:

Schedule your enrollment call – get in the queue!

Contact Via Benefits at 1-855-229-3283

Medicare card (not required to schedule an appointment,

but required for enrollment)

Prescription list

Doctors’ information

Hospital information

©2019 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson cl ient use only. 38 willistowerswatson.com

Call Now … We’re Ready

1-855-229-3283


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Helping You Prepare For Your Upcoming Medicare Enrollment · yourself for eligible medical,...

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Transcript of Helping You Prepare For Your Upcoming Medicare Enrollment · yourself for eligible medical,...