Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 4432 Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the Washington Suburban Sanitary Commission (WSSC) and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescrip- tion drug coverage: 1.  Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this cover- age if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2.  WSSC has determined that the prescription drug coverage offered by WSSC’s UnitedHealthcare Medical Plans through CVS Caremark RX Services and WSSC’s Kaiser Medical Plan, is on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your 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. n  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 15th through December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. n  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 WSSC coverage will be affected. If you are enrolled in the UnitedHealthcare Medicare Supplement, your prescription coverage is provided to you through CVS Caremark. If you elect a Medicare drug plan and you have CVS Caremark prescription coverage then you will no longer be eligible for prescription coverage under CVS Caremark. If you are enrolled in the Kaiser Medicare Plus Supplement, then you do not have to elect Medicare Part D as it is automatic when enrolled in that plan. If you do decide to join a Medicare drug plan and drop your current WSSC medical coverage, be aware that you and your dependents will not be able to get this coverage back. n  When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with your WSSC’s Medical Plan and don’t join a Medicare drug plan within 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 go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable cov- erage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. Certificate of Creditable Coverage for Medicare Part D Important Notice from WSSC About Your Prescription Drug Coverage and Medicare