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 3819 WSSC requires that its retirees enroll for Medicare part B when eligible. Most people become eligible at age 65 but you could be- come eligible sooner if disabled. You should receive information from the Social Security Administration when you become eligi- ble for Medicare Part B, however, if you do not, it is your responsibility to contact them. Failure to enroll in Medicare Part B could compromise your eligibility for WSSC medical and prescription benefits and/or subject you to permanent premium penalties. Once you are enrolled in Medicare Parts A & B, you must send a copy of your Medicare ID card to the WSSC HR Department so that we can ensure that you are enrolled in the proper medical and prescription plans. UnitedHealthcare members are then moved into the UnitedHealthcare Medicare Supplement Plan and the SilverScript Prescription Drug Plan (PDP). Please refer to pages 21–23 to learn more about SilverScript. Kaiser members transition into the Kaiser Medicare Plus plan, but they must also complete the Kaiser Medicare Plus application and return it directly to Kaiser. You should not enroll in an individual Medicare Part D program if you are enrolled in one of the WSSC health insurance plans, because Medicare does not allow you to enroll in two Part D plans. Enrolling in an individual plan could compromise your eligibility for WSSC sponsored medical and prescription coverage. Medicare-Eligible Retirees and Dependents Medicare is a national health insurance program covering individuals age 65 and older, younger people with disabilities and people with end stage renal disease (kidney failure). Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals (including critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals), inpatient care in a skilled nursing facility (not custodial or long-term care), hospice care services, home health care services, and inpatient care in a Religious Nonmedical Health Care Institution. Certain conditions must be met to get these benefits. Medicare Part B (Medical Insurance) helps cover medically necessary services like physician services, outpatient care, home health care services, and other medical services. Medicare Part B also covers some preventive services. Medicare Part D offers coverage for prescription drugs. Medicare doesn’t cover everything. If you need services that Medicare doesn’t cover, you will have to pay out of pocket un- less you have other insurance (such as a Medicare Supplement Plan) to cover the costs. Even if Medicare covers a service or item, you generally have to pay deductibles, coinsurance, and copayments. To find out if Medicare covers a service you need, visit www.medicare.gov and select “Find Out What Medicare Covers,” or call 1-800-MEDICARE (1-800-633-4227). Once you’re enrolled in Medicare Parts A& B, your coverage will be changed to the Medicare Supplement Plan. The Medicare Supplement Plan is designed to work in conjunction with your Medicare plan to supplement benefits that Medicare does not offer. When you change to a Medicare Supplement plan offered through WSSC, you are still considered a member of that health plan and may still be governed by the health plans rules on physician and hospital selection, referrals to a specialist, and places where you can receive diagnostic testing or have prescriptions filled. Listed below are some services that are not covered or paid in full by Medicare Part A and/or Part B but would be covered or paid in full by your Medicare Supplement plan. Medicare Summary Medicare Parts A & B Medicare Supplement Plan Deductible on your first hospital admission for each benefit period Daily copayment on hospital days 61-90 Daily coinsurance for days 21-100 in each benefit period for skilled nursing care Deductible for medical services covered under Part B Routine eye exams or eyeglasses Hearing aids or routine hearing loss exams Pays for the hospital deductible Pays for the hospital copayment Pays the daily coinsurance for skilled nursing care Pays the deductible Covers routine eye exams and offer discounts on eyeglass frames & lenses Most of the Medicare Supplement plans offer a hearing exam as part of the annual physical. Hearing aids are not covered