MEDICARE ELIGIBLE PARTICIPANTS AND MEDICARE ELIGIBLE DEPENDENTS
Participants who meet the retiree eligibility requirements of the Plan and who are Medicare eligible will automatically be enrolled upon obtaining the age of sixty-five within the United HealthCare Medicare Advantage Plan with Plan D and supplemental pharmaceutical coverage through SavRx.
The key two words in the paragraph above is "eligibility requirements". Please take a moment to review those within your Summary Plan Description Book.
If you are already familiar with what a Medicare Advantage Plan is, please skip to the fourth paragraph. However, if you are unaware of what a Medicare Advantage Plan is, in a nutshell, they are Plans that are approved by Medicare and administered by private companies (usually insurance companies). They provide all of your original Medicare Part A (hospital) and Part B (medical) benefits and may include Medicare Part D (prescription drug) benefits, along with some additional benefits, too.
Be advised that Medicare Advantage programs have provider networks, but you are not limited to utilizing network providers. As long as your provider accepts Medicare, then they will be reimbursed up to the full amount of the Medicare allowance for any covered services provided.
As an added bonus, participants do not have to file claims under these programs—under a Medicare Advantage Plan the treating medical professional submits the claim to the insurer and the insurer that is providing the coverage (in this case United HealthCare) pays the provider the full Medicare benefit and if applicable, whatever additional benefits they offer.
BENEFITS PRROVIDED BY THIS PLAN'S MEDICARE ADVANTAGE PROGRAM
Unless stated otherwise, the benefits that you would be entitled to receive are those that are explained within the Medicare Advantage Plan Guide 2022. This document was mailed to you in the month of October of 2021 and/or before your retirement. If you have misplaced your handbook and wish to request another, and/or want more information about this program or just have questions, you can:
- Access United HealthCare's virtual educational center at: www.uhcvirtualretiree.com/ra or,
- Call: 1-844-481-8820
- Call Labor First on the dedicated phone number of 219.220.4037 or Toll Free at 844.617.5747 (TTY 711) Monday-Friday, 8am-5pm CST.
WHO IS "LABOR FIRST"?
Labor First is an extra and important resource for Medicare eligible retirees.They specialize in ongoing member service of retiree health and drug programs. Labor First has a team of dedicated advocates specifically assigned to the retirees of IBEW Local 697 and are ready to assist you with any plan needs. This includes, but is not limited to:
- Pharmacy/Provider Outreach
- Prior Authorizations
- Card Replacements
- Mail Order Assistance
- Drug Look Up
- Vacation Overrides
- Personal information changes
- Billing questions
We encourage you to reach out to Labor First if you need assistance or are experiencing issues with your United Healthcare Medicare Advantage Plan or Prescription Drug Plan. Labor First can be reached on your dedicated phone number at 219.220.4037 or Toll Free at 844.617.5747 (TTY 711) Monday-Friday, 8am-5pm CST.
ADDITIONAL BENEFITS PROVIDED BY THE PLAN
- Dental benefits – Retirees and any eligible dependents dental benefit will be limited to $1000.00 per family per calendar year. The Plan will pay eighty percent (80%) of the charged amounts for allowable dental expenses up to the maximum annual and family allowance.
- Vision benefits – With the exception that retired participants may opt for a pair of safety glasses in lieu of regular frames once every twenty-four (24) months, retirees have the exact same benefits as those of an active participant.
MEDICARE ELIGIBLE PARTICIPANTS AND MEDICARE ELIGIBLE DEPENDENTS WILL NOT BE ENTITLED TO THE FOLLOWING BENEFITS
- Any short-term disability benefits.
- The Lake County Indiana, NECA – I.B.E.W. Health and Benefit Plan Fitness Membership Stipend.
- The Plans Grand Rounds benefit.
- The Plans Teladoc benefit.
- Retired participants who lose their eligibility under the Plan will not be allowed to re-enroll at a later time.
- If you or your dependents are not enrolled in both Medicare Parts A and B when first eligible, your eligibility for benefits with the Lake County Indiana, NECA – I.B.E.W. Health and Benefit Plan will be terminated.
- If you or your eligible dependents gain or lose insurance from a separate insurer you must inform the Plan of that fact right away. Participants that are negligent in notifying the Plan may permanently lose their eligibility to receive Plan benefits.