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R R/zhRB!Bh!?R"k D&'iKa Aza?hR I!B!=T)u!4Bz6HM ^FRI'ӥ)JR/#KdQZ!Ղ(,]HBQzr_D!5)JRRJSZFХ.zA@R/BjA~&/BՏV6=nJR*Q_>.R]!4RHBҔ^+ԣ'ϢJ_ "zXߦ)J_]: BEE(!>kKލ_EBz)tF/ӟB OD&Bmi}J]^Z_u֗HBk}0/!OD֔HAdA/!)4Ma BBBD&JR2dɓ:BOSD' =/Q("!~VKO222 AAAz@ H  *Ғ *       #~P _H]G JRE)JR)JR)tRE)tRE+(&Q(FR)JR)tҔ.Z_])~_5c ?E)K֔ZI/_Mtz!&jO~wD6].zR7(RğFg\o$k"kRȓ,/ҖL0D7YtA!!hN}7] O"ǰ{ zsg ڛ&c҉!-!AiDcIueNOqȜAm&E1J&"z!4LDik1i? }&^iF} hZR4(B 5M.?ЧJ`oL{Z>Mwg#nEtyZM`B D_\tU#*$%I)NM htMK"zVIN ,z! UL{2v# 蠞^!5_^'D>s.# =\ap`WM FO:CKFKO<_"MD4>0C'3r!1"iE-.җVD J H2WL}"EQS B jKEk>f(0T5t30OI" Ah`=$^Z6N]a>M:W4OHRiRHB*S,@iEkǯW @= X֡aDa}p>uxYQleo=@ZryGkY!Ek0Vo(@ 1E  S<http://atyourservice.ucop.edu/<http://atyourservice.ucop.edu/l www.medicare.gov0http://www.medicare.gov/z.http://www.medicare.gov0http://www.medicare.gov/f4http://ucsfhr.ucsf.edu/hcf4http://ucsfhr.ucsf.edu/hcfl www.medicare.gov0http://www.medicare.gov// 00DArialNew RomanPP ؖF0ؖ"DTahomaew RomanPP ؖF0ؖ" DWingdingsRomanPP ؖF0ؖ0DTimes New RomanPP ؖF0ؖ C .  @n?" dd@  @@``   l5  B  >!"#'()*0134598  = B ry^G]M M[ \]^_` qr x} ~ \ 0  . ?b$rd%`sA5$R$ u0 |`  0AA 3@8 H]Pʚ;Y(7ʚ;g4;d;d00F0ppp@ <4dddd@0P <4BdBd@0P <4!d!d@0P g48d8dF0Dpp p0___PPT10 f___PPT9H@X(? -O =\@Medicare Enrollment and Your UC Sponsored Medical Plan Coverage ; UCSF HR/Benefits Health Care Facilitator Program, 2009&<8bHLets take a look at Medicare 'What is Medicare?Medicare is a Federal Medical Insurance Program for: People 65 years of age and older regardless of their income or medical history In 1972 Medicare was expanded to include the following groups: Some people with disabilities under age 65 End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) In 2000, individuals with Lou Gehrig s Disease (amyotrophic lateral sclerosis) could enroll at time of diagnosis (rather than having to satisfy the 24-month waiting period l5ZZZZZ5~cMedicare Coverage Part A Hospital Coverage Part B Medical Coverage Part C Medicare Advantage Program Part D Out-Patient Prescription Drug Coverage  began in 20067  7fGaps in Medicare Coverage3If you had only Medicare insurance you would experience large gaps in coverage requiring significant out-of-pocket expenses Your UC medical plan coverage coordinates with Medicare to reduce these gaps and decrease your out-of-pocket expenses See www.medicare.gov for information on coverage and exclusionsD@ @",c0$Delaying Medicare Part B enrollment %%(Medicare allows you to delay Part B enrollment as long as you are covered by an Employer Group Health Plan (EGHP) either as an employee or the dependent of an employee You will have a special enrollment period to enroll in Medicare if you are older than 65 when your EGHP ends and you will not be subject to the late enrollment penalty SS will provide you with a form requiring documentation of EGHP enrollment and terminationZcI>Lets take a look at UC Medicare Enrollment Policy for Retirees ?6( ( 3fUC s Medicare Enrollment Requirements for Retirees  4*( ( 4  UC requires that you/your dependents enroll in Medicare Part B when you/your dependents become eligible for premium free, Medicare Part A ** You/your dependents are transferred into the  Medicare-coordinated version of the plan You/your dependents do not need to enroll in a non-UC sponsored Medicare Part D plan Your plan will enroll you in Medicare Part D ** Adult Dependent Relatives that become eligible for Medicare Part A may not continue their UC sponsored medical coverage.ZYZUZ.Z} " Zl YU-}   dUC s Medicare Enrollment Requirements for Retirees 3*( (2  Retirees and their dependents risk de-enrollment from UC sponsored medical coverage if they& . Do not enroll in Medicare Part B when eligible for premium free Medicare Part A Enroll in a non-UC sponsored Medicare Part D plan Are HMO members who do not assign/lock Medicare to the plan and/or uses Medicare outside of the plan d_Z ZZ Z_#Why UC Mandates Medicare Enrollment$$( $  MRetirees over age 65 without Medicare cost at least twice as much to insure as those with Medicare Enrollment in Medicare partially reduces the cost of the plan, which keeps the UC premiums affordable for all Allows UC to continue to fund health benefits for retirees Many employers are dropping or reducing retiree health coveragepcZ ZnZ Z;Z@Z;@ N  aG!Exceptions to UC Medicare Mandate""(!  JRetirees that didn t pay Medicare taxes may not be eligible for premium free Medicare Part A UC does not require retirees ineligible for premium free Medicare Part A, to enroll in Part B. These retirees may continue with their current non-Medicare medical plan. Please note: You may qualify for premium free Medicare Part A through a spouse, former spouse or prior work history. Contact Social Security, 1-800-772-1213^_K^ 8K6!!Exceptions to UC Medicare Mandate""( "  UC does not require you to enroll in Medicare Part B if: You reside outside the United States you must enroll in Medicare if you return You may incur a penalty from Medicare when you re-enroll You are still working at UCSF and have health coverage as an employee (never retired from UC) You have UC sponsored health coverage through your spouse or domestic partner who is still working at UC.P  P%PdP P^PPiP. %d      'Lets take a look at Medicare Enrollment x^Medicare EnrollmentTo enroll in Medicare or determine if you are eligible, contact Social Security 1-800-772-1213 Remember if you don t qualify on your own, you may qualify through a current or former spouse If you don t qualify now but continue to work you may qualify in the future You are required to enroll at age 65 unless covered by an employer group health plan (EGHP) or pay a penalty for late enrollment ,ZP-vTips for Enrolling in MedicareIf you are retired, when you reach age 65, you should apply for Medicare three months before your reach age 65. If you are receiving SS benefits at the time, you will automatically be enrolled in both Part A and Part B and a Medicare card will be sent to you about 3 months before your birthday. If you are not receiving SS benefits you will need to initiate enrollment into Medicare yourself.Zw7Coordinating Medicare with your Retiree Health Coverage88(Approximately 3 months prior to your 65th birthday UC will send you the following documents (if you are retired): UC Medicare Declaration Form Universal Medicare Advantage Form (to be completed by those in an HMO plan: Health Net, Kaiser, WHA) UCOP will transfer your medical plan enrollment to the Medicare version of the plan once they receive your documents and adjust your plan premiums as indicated Your family members enrolled as dependents who are not eligible for Medicare will remain in the basic non-Medicare version of the plan rPPPP PPP' I  x( Period of Darkness There is usually a three week period of transition from a non-Medicare plan to the Medicare version of the plan During this time period it can appear that your coverage has been terminated. It hasn t! If you experience problems obtaining medical care or accessing your pharmacy benefits during this time, call your Health Care Facilitator@S) dJTLets take a look at UC Sponsored Health Plans and how they Coordinate with Medicare UU(1Information based on coverage for plan year, 2009:" Medicare vs. Non-Medicare Plans !(, !  All the UC medical plans have a separate  Medicare -coordinated version When you become eligible for Medicare you coordinate your current medical plan with Medicare. The Medicare-coordinated version of a plan may differ in: Plan benefits/drug formulary Costs Service area Network providers Enrollment/de-enrollment process.ZcZc E  <Medicare Coordination with HMO plans (Advantage Plans), 2009==(If you are enrolled in an Health Maintenance Organization plan (HMO) -- Health Net, Kaiser, or WHA -- Medicare Parts A, B and D must be  assigned/locked into the plan You cannot use Medicare outside the plan You will need to complete a MAPD form assigning Medicare to your plan If you change plans you will need to  unlock Medicare from your plan ~)EF`  C(1Medicare Coordination with Blue Cross Plans, 200822(High Option Supplement to Medicare Blue Cross PPO (Preferred Provider Organization) Blue Cross Plus POS (Point of Service Plan) Includes in-network (HMO), and out-of-network coverage Must live in the CA service area Blue Cross Core XXX1Medicare Coordination with Blue Cross Plans, 200822(>You may see any Medicare provider* Find doctors using the Participating Physician Directory online at: http://www.medicare.gov Medicare pays as primary Each plan has an annual deductible* - Once the deductible is met, Blue Cross coordinates their payment after Medicare pays, to cover a percentage of your expenses P#P\PP#\c0g~xMedicare Coordination with Blue Cross Plans  Medicare Terms==( Provider Accepts Assignment Provider will accept Medicare contracted rates for services Provider Does not Accept Assignment Provider can charge up to 15% above Medicare contracted rates Provider Opts Out of Medicare or Does Not Have a Medicare Contract Claims from a provider that has opted out of Medicare or from a provider without a Medicare certificate number will not be paid by Medicare and will not be paid by your UC sponsored health plan ZZ=Z$Z>ZZCZZZZ =$>C )Lets take a look at Health Coverage Costs {1How much will my medical plan cost when I retire?22(0If you began work at UC prior to 1/1/90 and did not have a break in covered service for more than 120 days, you will receive 100% of UC s maximum contribution toward the medical monthly premium. You will still pay the employee/retiree portion of the cost If you began work on or after 1/1/90 you will be subject to graduated eligibility. You will receive a percentage of UC s maximum contribution. Your percentage corresponds to your years of UC service credit. In addition, you will still pay the employee/retiree portion of the cost0P PP,|Part B ReimbursementHReimbursement for Part B may apply if UC s contribution for a plan is greater than the gross premium Maximum individual reimbursement currently is $96.40 per person&{#Things to Consider in a Health Plan$$(Your total annual health plan costs: Services that are and are not covered Medicare and UC Health Plan Premiums Deductibles and Co-insurance Include both medical, prescription drugs and behavioral health Factor in your Out-of-Pocket Maximum (OOPM) protection If your co-pays, co-insurance and deductibles paid equal your OOPM, additional care in the plan year for covered expenses is paid at 100% - review the plan for excluded items %h?7 %h?7  Additional Issues to Consider lX Additional Considerations Changing Plans& ..--(*Open Enrollment (OE) When you retire you will continue to have the option to change plans during November Open Enrollment, the change will be effective the first of the following January Move Out of the Service Area/Out of the US If you move out of your plan s service area you will have a  Period of Initial eligibility to switch plans outside of Open Enrollment Process: Call UCOP customer service, alert them of your new address. The rep will mail you a form so you can select a new plan. If the form is returned to UCOP by the 15th of the month, typically the change is effective the first of the following month UCOP Customer Service 1-800-888-8267 PP+PP%PP P+3 R%  ?% (Plan options if you move outside California Blue Cross PPO, High Option Supplement to Medicare, and Core Plan options if you move outside the U.S. for longer than 6 months Blue Cross PPO and Core Will switch to Non-Medicare version of plan Higher premiums, different coverage levels j,=CX! =CX  >$(Additional Considerations Changing Plans))(Use the Medical Plan Wizard to find the medical plans available in your service area You will need a zip code Tool on At Your Service Website Always call the plan for the most current information because service areas are subject to change&UUA'Tips for Planning Ahead(NRead Open Enrollment materials each year to track changes in coverage Stay informed of general developments in Medicare and medical insurance Use your UC online resources for retirees UC  At Your Service Website http://atyourservice.ucop.edu/ UCSF HCF Website http://ucsfhr.ucsf.edu/hcf PP PPPP Sc0fc0 $rXTips for Planning Ahead( Use your Medicare resources www.medicare.gov - Medicare General Information  1-800-633-4227 Social Security  1-800-772-1213 Health Insurance Counseling and Advocacy Program (HICAP)  1-800-434-0222 Still have questions? UC Retiree, Health and Welfare - 1-800-888-8267 Contact Your Health Plan UCSF Health Care Facilitator (HCF) Pgrm  (415) 514-3324 sforstat@hr.ucsf.edu ZZA" Zk0 " dZ0 " dZZZZ0 " dZ0 " dZc0-pThe End THANK YOU FOR PARTICIPATING! Additional information about Medicare is available on the Health Care Facilitator website at: www.ucsfhr.ucsf.edu/hcf . /l79<B     4  0` 3f` ]fff3` W.f36d` ff3fffe̙` 3f3` kuos` f___ff̙` /!fff3̙` f3f` f3f` ff3f>?" dd@,? " xd@  d  " x@ d`vP n?" dd@   @@``PR    @ ` `p>> vn h(  h h 63 " `   T Click to edit Master title style! !$ h 0DB " `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S h 6G #" `^ `  @* h 6TR #" `^   B* h 6H\ #" `^ `  B*x h LA޽h ?ocean_pale#" @@ ff3f80___PPT10. P:4  OceanY 0 0 l)(  l l 6j "p  T Click to edit Master title style! ! l 0Tn " `    W#Click to edit Master subtitle style$ $ l \@ABCxDE k'<xx"^ l 6r #" `^   B* l 6} #" `^ `  B* l 6\ #" `^ `  @*x l LA޽h ?ocean_pale#" @@ ff3f80___PPT10. 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H  0޽h ? 3fffff3̙3f̙___PPT10i.JD+D=' 3= @B +[0 rj`(    s *vh  v l<Medicare Coordination with HMO plans (Advantage Plans), 2009==(  s *vh v r You must live in the plan s CA service area Medicare pays a flat fee to the HMO each month - the HMO agrees to accept full responsibility for your care You pay a low monthly premium *You cannot use Medicare outside the plan t, +*,  H  0޽h ? f;v3ff___PPT10i.0`+D=' 3= @B +  0 7/P(    s **vh  v l<Medicare Coordination with HMO plans (Advantage Plans), 2008==(  s *@1h@ v 7 You select a primary care provider (PCP) to coordinate your care though your medical group You pay a small co-pay when you receive services No need to submit claim forms l ZP,$H  0޽h ? f;v3ff___PPT10i.0`+D=' 3= @B + 0 6(  ~  s *1h `   1 x  c $11h` 1 H  0޽h ? f;v3ff___PPT10i.'`'+D=' 3= @B + 0  D(   ~   s *g1h `   1 x   c $h1hP`F 1    6i1(0 R*Exceptions  Blue Cross Plus in-network 2*0lKZ(H   0޽h ? f;v3ff___PPT10i.0|+D=' 3= @B + 0N0 $<(  $~ $ s *`~1h `   1 ~ $ s *81h0 1 H $ 0޽h ? f;v3ff___PPT10i.G0h+D=' 3= @B +0 &` (  ~"  s *\1lp 1 H  0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' 3= @B + 0  0(  x"  c $1h `   1 x  c $1h ` 1 H  0޽h ? 3fffff3̙3f̙___PPT10i.\u05+D=' 3= @B + 0  0(  x"  c $1h `   1 x  c $<1h ` 1 H  0޽h ? 3fffff3̙3f̙___PPT10i.kuPo+D=' 3= @B + 0  <(  ~  s *Pah `    ~  s *dkh  H  0޽h ? f;v3ff___PPT10i. :t+D=' 3= @B +0 &p (  ~"  s *(1lp 1 H  0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' 3= @B + 0 86(  8~" 8 s *1h `   1 x 8 c $T1h@ 1 H 8 0޽h ? 3fffff3̙3f̙___PPT10i.n+D=' 3= @B + 0 (  ~  s *Ģ1h P  1 x  c $1hp   1   <_3D + 0   6،3  `  X(Additional Considerations Changing Plans))(H  0޽h ? 3333y___PPT10Y+D=' 3= @B + 0 6(  ~  s *1h `   1 x  c $1h0WP 1 H  0޽h ? 3333y___PPT10Y+D=' 3= @B + 0 800(     `81gֳgֳ ?h `   1    `1gֳgֳ ?hC"? ` 1 H  0޽h ? ̙33y___PPT10Y+D=' 3= @B + 0 <(  ~  s *`1h `8  1 ~  s *1h.  1 H  0޽h ? f;v3ff___PPT10i.Gp}h+D=' 3= @B + 0  L6(  L~" L s *t!h `    x L c $AhP  H L 0޽h ? 3fffff3̙3f̙___PPT10i.[p k+D=' 3= @B +0 bZ0(  d  c $XK   +N  3 rz+kk )  + d_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ c  H  0.k ? ̙33!0 bZ(  d  c $XK   +N  3 r+kk )  + d_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ c  H  0.k ? ̙33"0 bZ(  d  c $XK   +N  3 r+kk )  + d_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ c  H  0.k ? ̙33D'0 @(     `1 ?VI   +   `+ k k ? M)  + H  0.k ? ̙330 YQ (  X  C XK   uQ  S $7 )  u For individuals who will be or are Medicare eligible when retire and eligible for UC retiree coverage. Medicare overview; UC medicare requirements; Medicare enrollment/coordination~0H  0.k ? 3380___PPT10.REH0   (  X  C XK     S } )   "Brief overviewH  0.k ? 3380___PPT10.0A0  Q(  X  C XK     S  )   S?Many calls from employees who are turning 65 and still working.H  0.k ? 3380___PPT10.$0 ^VP (  d  c $XK   J  3 r,kk )   `True for most companies who provide retiree coverage  UC not exception _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ /  H  0.k ? ̙33^0  p (  X  C XK     S | )    Very important to ensure you speak with SS if you have a unique situation. If qualify based on work history of spouse, they must be 62.H  0.k ? 3380___PPT10. UPw0  '(  X  C XK     S 4 )   )MAPD may be changing.H  0.k ? 3380___PPT10. \(0  .(  X  C XK     S h^ )   0PCP 30 miles of home addressH  0.k ? 3380___PPT10. PL0  \(  X  C XK     S R )   ^JHigh Option  all members in MedicareH  0.k ? 3380___PPT10. p3J0    (   X   C XK      S 8u )   pRetirement not allow for switching plans. CIGNA available to retirees, but not if Medicare eligible. (HRA issue)K&H   0.k ? 3380___PPT10.!<r8y09'13j6 9 c<0> A0zEia@+S̸rx~7E0; ;0ӫi˜& h ;p@z# 1o(@ 1E  S<http://atyourservice.ucop.edu/<http://atyourservOh+'0 px   $Slide 1 sforstatOcean SForstat270Microsoft PowerPoint@@T @@ɖZ@ Ghg  ,V'&" WMFC <8!"#'()*0134598  = B ry^G]M M[ \]^_` qr x} ~ \ 0  . ?b$rd%`sA5$R$ u0 |`  0AA 3@8 vjFʚ;p0ʚ;g4?d?d00F0&ppp@ <4dddd@0P <4BdBd@0P <4!d!d@0P g48d8dF0Dpp p0___PPT10 f___PPT9H@X(? %O =#_@Medicare Enrollment and Your UC Sponsored Medical Plan Coverage ; UCSF HR/Benefits Health Care Facilitator Program, 2009&<8bHLets take a look at Medicare 'What is Medicare?Medicare is a Federal Medical Insurance Program for: People 65 years of age and older regardless of their income or medical history In 1972 Medicare was expanded to include the following groups: Some people with disabilities under age 65 End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) In 2000, individuals with Lou Gehrig s Disease (amyotrophic lateral sclerosis) could enroll at time of diagnosis (rather than having to satisfy the 24-month waiting period l5ZZZZZ5~cMedicare Coverage Part A Hospital Coverage Part B Medical Coverage Part C Medicare Advantage Program Part D Out-Patient Prescription Drug Coverage  began in 2006ZZZZZZZ7Z  7fGaps in Medicare Coverage3If you had only Medicare insurance you would experience large gaps in coverage requiring significant out-of-pocket expenses Your UC medical plan coverage coordinates with Medicare to reduce these gaps and decrease your out-of-pocket expenses See www.medicare.gov for information on coverage and exclusionsD@ @",c0$Delaying Medicare Part B enrollment %%(Medicare allows you to delay Part B enrollment as long as you are covered by an Employer Group Health Plan (EGHP) either as an employee or the dependent of an employee You will have a special enrollment period to enroll in Medicare if you are older than 65 when your EGHP ends and you will not be subject to the late enrollment penalty SS will provide you with a form requiring documentation of EGHP enrollment and terminationJP PP P[PcI>Lets take a look at UC Medicare Enrollment Policy for Retirees ?6( ( 3fUC s Medicare Enrollment Requirements for Retirees  4*( ( 4  UC requires that you/your   !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~o      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~,Root EntrydO) & PicturesCurrent User+8SummaryInformation(ĭPowerPoint Document(DocumentSummaryInformation8 ice.ucop.edu/l www.medicare.gov0http://www.medicare.gov/z.http://www.medicare.gov0http://www.medicare.gov/f4http://ucsfhr.ucsf.edu/hcf4http://ucsfhr.ucsf.edu/hcfl www.medicare.gov0http://www.medicare.gov// 00DArialNew RomanPP ؖF0ؖ"DTahomaew RomanPP ؖF0ؖ" DWingdingsRomanPP ؖF0ؖ0DTimes New RomanPP ؖF0ؖ C .  @n?" dd@  @@``   l5  B  >!"#'()*0134598  = B ry^G]M M[ \]^_` qr x} ~ \ 0  . ?b$rd%`sA5$R$ u0 |`  0AA 3@8 H]Pʚ;Y(7ʚ;g4;d;d00F0ppp@ <4dddd@0P <4BdBd@0P <4!d!d@0P g48d8dF0Dpp p0___PPT10 f___PPT9H@X(? -O =\@Medicare Enrollment and Your UC Sponsored Medical Plan Coverage ; UCSF HR/Benefits Health Care Facilitator Program, 2009&<8bHLets take a look at Medicare 'What is Medicare?Medicare is a Federal Medical Insurance Program for: People 65 years of age and older regardless of their income or medical history In 1972 Medicare was expanded to include the following groups: Some people with disabilities under age 65 End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) In 2000, individuals with Lou Gehrig s Disease (amyotrophic lateral sclerosis) could enroll at time of diagnosis (rather than having to satisfy the 24-month waiting period l5ZZZZZ5~cMedicare Coverage Part A Hospital Coverage Part B Medical Coverage Part C Medicare Advantage Program Part D Out-Patient Prescription Drug Coverage  began in 20067  7fGaps in Medicare Coverage3If you had only Medicare insurance you would experience large gaps in coverage requiring significant out-of-pocket expenses Your UC medical plan coverage coordinates with Medicare to reduce these gaps and decrease your out-of-pocket expenses See www.medicare.gov for information on coverage and exclusionsD@ @",c0$Delaying Medicare Part B enrollment %%(Medicare allows you to delay Part B enrollment as long as you are covered by an Employer Group Health Plan (EGHP) either as an employee or the dependent of an employee You will have a special enrollment period to enroll in Medicare if you are older than 65 when your EGHP ends and you will not be subject to the late enrollment penalty SS will provide you with a form requiring documentation of EGHP enrollment and terminationZcI>Lets take a look at UC Medicare Enrollment Policy for Retirees ?6( ( 3fUC s Medicare Enrollment Requirements for Retirees  4*( ( 4  UC requires that you/your dependents enroll in Medicare Part B when you/your dependents b      !"#$'()*+-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnspqrtuvwxyz|}~ecome eligible for premium free, Medicare Part A ** You/your dependents are transferred into the  Medicare-coordinated version of the plan You/your dependents do not need to enroll in a non-UC sponsored Medicare Part D plan Your plan will enroll you in Medicare Part D ** Adult Dependent Relatives that become eligible for Medicare Part A may not continue their UC sponsored medical coverage.ZYZUZ.Z} " Zl YU-}   dUC s Medicare Enrollment Requirements for Retirees 3*( (2  Retirees and their dependents risk de-enrollment from UC sponsored medical coverage if they& . Do not enroll in Medicare Part B when eligible for premium free Medicare Part A Enroll in a non-UC sponsored Medicare Part D plan Are HMO members who do not assign/lock Medicare to the plan and/or uses Medicare outside of the plan d_Z ZZ Z_#Why UC Mandates Medicare Enrollment$$( $  MRetirees over age 65 without Medicare cost at least twice as much to insure as those with Medicare Enrollment in Medicare partially reduces the cost of the plan, which keeps the UC premiums affordable for all Allows UC to continue to fund health benefits for retirees Many employers are dropping or reducing retiree health coveragepcZ ZnZ Z;Z@Z;@ N  aG!Exceptions to UC Medicare Mandate""(!  JRetirees that didn t pay Medicare taxes may not be eligible for premium free Medicare Part A UC does not require retirees ineligible for premium free Medicare Part A, to enroll in Part B. These retirees may continue with their current non-Medicare medical plan. Please note: You may qualify for premium free Medicare Part A through a spouse, former spouse or prior work history. Contact Social Security, 1-800-772-1213^_K^ 8K6!!Exceptions to UC Medicare Mandate""( "  UC does not require you to enroll in Medicare Part B if: You reside outside the United States you must enroll in Medicare if you return You may incur a penalty from Medicare when you re-enroll You are still working at UCSF and have health coverage as an employee (never retired from UC) You have UC sponsored health coverage through your spouse or domestic partner who is still working at UC.P  P%PdP P^PPiP. %d      'Lets take a look at Medicare Enrollment x^Medicare EnrollmentTo enroll in Medicare or determine if you are eligible, contact Social Security 1-800-772-1213 Remember if you don t qualify on your own, you may qualify through a current or former spouse If you don t qualify now but continue to work you may qualify in the future You are required to enroll at age 65 unless covered by an employer group health plan (EGHP) or pay a penalty for late enrollment ,ZP-vTips for Enrolling in MedicareIf you are retired, when you reach age 65, you should apply for Medicare three months before your reach age 65. If you are receiving SS benefits at the time, you will automatically be enrolled in both Part A and Part B and a Medicare card will be sent to you about 3 months before your birthday. If you are not receiving SS benefits you will need to initiate enrollment into Medicare yourself.Zw7Coordinating Medicare with your Retiree Health Coverage88(Approximately 3 months prior to your 65th birthday UC will send you the following documents (if you are retired): UC Medicare Declaration Form Universal Medicare Advantage Form (to be completed by those in an HMO plan: Health Net, Kaiser, WHA) UCOP will transfer your medical plan enrollment to the Medicare version of the plan once they receive your documents and adjust your plan premiums as indicated Your family members enrolled as dependents who are not eligible for Medicare will remain in the basic non-Medicare version of the plan rPPPP PPP' I  x( Period of Darkness There is usually a three week period of transition from a non-Medicare plan to the Medicare version of the plan During this time period it can appear that your coverage has been terminated. It hasn t! If you experience problems obtaining medical care or accessing your pharmacy benefits during this time, call your Health Care Facilitator@S) dJTLets take a look at UC Sponsored Health Plans and how they Coordinate with Medicare UU(1Information based on coverage for plan year, 2009:" Medicare vs. Non-Medicare Plans !(, !  All the UC medical plans have a separate  Medicare -coordinated version When you become eligible for Medicare you coordinate your current medical plan with Medicare. The Medicare-coordinated version of a plan may differ in: Plan benefits/drug formulary Costs Service area Network providers Enrollment/de-enrollment process.ZcZc E  <Medicare Coordination with HMO plans (Advantage Plans), 2009==(If you are enrolled in an Health Maintenance Organization plan (HMO) -- Health Net, Kaiser, or WHA -- Medicare Parts A, B and D must be  assigned/locked into the plan You cannot use Medicare outside the plan You will need to complete a MAPD form assigning Medicare to your plan If you change plans you will need to  unlock Medicare from your plan ~)EF`  C(1Medicare Coordination with Blue Cross Plans, 200822(High Option Supplement to Medicare Blue Cross PPO (Preferred Provider Organization) Blue Cross Plus POS (Point of Service Plan) Includes in-network (HMO), and out-of-network coverage Must live in the CA service area Blue Cross Core XXX1Medicare Coordination with Blue Cross Plans, 200822(>You may see any Medicare provider* Find doctors using the Participating Physician Directory online at: http://www.medicare.gov Medicare pays as primary Each plan has an annual deductible* - Once the deductible is met, Blue Cross coordinates their payment after Medicare pays, to cover a percentage of your expenses P#P\PP#\c0g~xMedicare Coordination with Blue Cross Plans  Medicare Terms==( Provider Accepts Assignment Provider will accept Medicare contracted rates for services Provider Does not Accept Assignment Provider can charge up to 15% above Medicare contracted rates Provider Opts Out of Medicare or Does Not Have a Medicare Contract Claims from a provider that has opted out of Medicare or from a provider without a Medicare certificate number will not be paid by Medicare and will not be paid by your UC sponsored health plan ZZ=Z$Z>ZZCZZZZ =$>C )Lets take a look at Health Coverage Costs {1How much will my medical plan cost when I retire?22(0If you began work at UC prior to 1/1/90 and did not have a break in covered service for more than 120 days, you will receive 100% of UC s maximum contribution toward the medical monthly premium. You will still pay the employee/retiree portion of the cost If you began work on or after 1/1/90 you will be subject to graduated eligibility. You will receive a percentage of UC s maximum contribution. Your percentage corresponds to your years of UC service credit. In addition, you will still pay the employee/retiree portion of the cost0P PP,|Part B ReimbursementHReimbursement for Part B may apply if UC s contribution for a plan is greater than the gross premium Maximum individual reimbursement currently is $96.40 per person&{#Things to Consider in a Health Plan$$(Your total annual health plan costs: Services that are and are not covered Medicare and UC Health Plan Premiums Deductibles and Co-insurance Include both medical, prescription drugs and behavioral health Factor in your Out-of-Pocket Maximum (OOPM) protection If your co-pays, co-insurance and deductibles paid equal your OOPM, additional care in the plan year for covered expenses is paid at 100% - review the plan for excluded items %h?7 %h?7  Additional Issues to Consider lX Additional Considerations Changing Plans& ..--(*Open Enrollment (OE) When you retire you will continue to have the option to change plans during November Open Enrollment, the change will be effective the first of the following January Move Out of the Service Area/Out of the US If you move out of your plan s service area you will have a  Period of Initial eligibility to switch plans outside of Open Enrollment Process: Call UCOP customer service, alert them of your new address. The rep will mail you a form so you can select a new plan. If the form is returned to UCOP by the 15th of the month, typically the change is effective the first of the following month UCOP Customer Service 1-800-888-8267 PP+PP%PP P+3 R%  ?% (Plan options if you move outside California Blue Cross PPO, High Option Supplement to Medicare, and Core Plan options if you move outside the U.S. for longer than 6 months Blue Cross PPO and Core Will switch to Non-Medicare version of plan Higher premiums, different coverage levels j,=CX! =CX  >$(Additional Considerations Changing Plans))(Use the Medical Plan Wizard to find the medical plans available in your service area You will need a zip code Tool on At Your Service Website Always call the plan for the most current information because service areas are subject to change&UUA'Tips for Planning Ahead(NRead Open Enrollment materials each year to track changes in coverage Stay informed of general developments in Medicare and medical insurance Use your UC online resources for retirees UC  At Your Service Website http://atyourservice.ucop.edu/ UCSF HCF Website http://ucsfhr.ucsf.edu/hcf PP PPPP Sc0fc0 $rXTips for Planning Ahead( Use your Medicare resources www.medicare.gov - Medicare General Information  1-800-633-4227 Social Security  1-800-772-1213 Health Insurance Counseling and Advocacy Program (HICAP)  1-800-434-0222 Still have questions? UC Retiree, Health and Welfare - 1-800-888-8267 Contact Your Health Plan UCSF Health Care Facilitator (HCF) Pgrm  (415) 514-3324 sforstat@hr.ucsf.edu ZZA" Zk0 " dZ0 " dZZZZ0 " dZ0 " dZc0-pThe End THANK YOU FOR PARTICIPATING! Additional information about Medicare is available on the Health Care Facilitator website at: www.ucsfhr.ucsf.edu/hcf . /l79<B     r3!# !71yr(@ 1E  S<http://atyourservice.uc  !"#$%&'()*՜.+,D՜.+,    6On-screen ShowUCSF9$' +ArialTahoma WingdingsTimes New Roman RockwellOceanMicrosoft Graph ChartAMedicare Enrollment and Your UC Sponsored Medical Plan Coverage Medicare BasicsWhat is Medicare?Medicare CoverageGaps in Medicare Coverage%Delaying Medicare Part B enrollment +UC Medicare Enrollment Policy for Retirees4UCs Medicare Enrollment Requirements for Retirees 3UCs Medicare Enrollment Requirements for Retirees$Why UC Mandates Medicare Enrollment"Exceptions to UC Medicare Mandate"Exceptions to UC Medicare MandateMedicare EnrollmentMedicare EnrollmentTips for Enrolling in Medicare8Coordinating Medicare with your Retiree Health CoveragePeriod of Darkness8How UC Sponsored Health Plans Coordinate with Medicare !Medicare vs. Non-Medicare Plans =Medicare Coordination with HMO plans (Advantage Plans), 2009=Medicare Coordination with HMO plans (Advantage Plans), 2009=Medicare Coordination with HMO plans (Advantage Plans), 20092Medicare Coordination with Blue Cross Plans, 20092Medicare Coordination with Blue Cross Plans, 2009=Medicare Coordination with Blue Cross Plans Medicare TermsHealth Coverage Costs2How much will my medical plan cost when I retire?Part B Reimbursement$Things to Consider in a Health PlanAdditional Issues to Consider- Additional Considerations Changing Plans.. )Additional Considerations Changing PlansTips for Planning AheadTips for Planning AheadThe End  Fonts UsedDesign TemplateEmbedded OLE Servers Slide Titles$(PX| _PID_HLINKSVersionAhttp://atyourservice.ucop.edu/http://www.medicare.gov/http://www.medicare.gov/http://ucsfhr.ucsf.edu/hcfhttp://www.medicare.gov/v/ _SForstatSForstatdependents enroll in Medicare Part B when you/your dependents become eligible for premium free, Medicare Part A ** You/your dependents are transferred into the  Medicare-coordinated version of the plan You/your dependents do not need to enroll in a non-UC sponsored Medicare Part D plan Your plan will enroll you in Medicare Part D ** Adult Dependent Relatives that become eligible for Medicare Part A may not continue their UC sponsored medical coverage.ZYZUZ.Z} " Zl YU-}   dUC s Medicare Enrollment Requirements for Retirees 3*( (2  Retirees and their dependents risk de-enrollment from UC sponsored medical coverage if they& . Do not enroll in Medicare Part B when eligible for premium free Medicare Part A Enroll in a non-UC sponsored Medicare Part D plan Are HMO members who do not assign/lock Medicare to the plan and/or uses Medicare outside of the plan d_Z ZZ Z_#Why UC Mandates Medicare Enrollment$$( $  MRetirees over age 65 without Medicare cost at least twice as much to insure as those with Medicare Enrollment in Medicare partially reduces the cost of the plan, which keeps the UC premiums affordable for all Allows UC to continue to fund health benefits for retirees Many employers are dropping or reducing retiree health coveragepcP PnP P;P@P;@ N  aG!Exceptions to UC Medicare Mandate""(!  JRetirees that didn t pay Medicare taxes may not be eligible for premium free Medicare Part A UC does not require retirees ineligible for premium free Medicare Part A, to enroll in Part B. These retirees may continue with their current non-Medicare medical plan. Please note: You may qualify for premium free Medicare Part A through a spouse, former spouse or prior work history. Contact Social Security, 1-800-772-1213^Z_ZKZZ^ 8K6!!Exceptions to UC Medicare Mandate""( "  UC does not require you to enroll in Medicare Part B if: You reside outside the United States you must enroll in Medicare if you return You may incur a penalty from Medicare when you re-enroll You are still working at UCSF and have health coverage as an employee (never retired from UC) You have UC sponsored health coverage through your spouse or domestic partner who is still working at UC.Z  Z%ZdZ Z^ZZiZ. %d      'Lets take a look at Medicare Enrollment x^Medicare EnrollmentTo enroll in Medicare or determine if you are eligible, contact Social Security 1-800-772-1213 Remember if you don t qualify on your own, you may qualify through a current or former spouse If you don t qualify now but continue to work you may qualify in the future You are required to enroll at age 65 unless covered by an employer group health plan (EGHP) or pay a penalty for late enrollment z_Z Z_Z ZLZ ZZP/vTips for Enrolling in MedicareIf you are retired, when you reach age 65, you should apply for Medicare three months before your reach age 65 If you are receiving SS benefits at the time, you will automatically be enrolled in both Part A and Part B and a Medicare card will be sent to you about 3 months before your birthday If you are not receiving SS benefits you will need to initiate enrollment into Medicare yourselfJoZ ZZ ZaZw7Coordinating Medicare with your Retiree Health Coverage88(Approximately 3 months prior to your 65th birthday UC will send you the following documents (if you are retired): UC Medicare Declaration Form Universal Medicare Advantage Form (to be completed by those in an HMO plan: Health Net, Kaiser, WHA) UCOP will transfer your medical plan enrollment to the Medicare version of the plan once they receive your documents and adjust your plan premiums as indicated Your family members enrolled as dependents who are not eligible for Medicare will remain in the basic non-Medicare version of the plan rPPPP PPP' I  x( Period of Darkness There is usually a three week period of transition from a non-Medicare plan to the Medicare version of the plan During this time period it can appear that your coverage has been terminated. It hasn t! If you experience problems obtaining medical care or accessing your pharmacy benefits during this time, call your Health Care FacilitatorvpZ ZYZ ZZ) dJTLets take a look at UC Sponsored Health Plans and how they Coordinate with Medicare UU(1Information based on coverage for plan year, 2009:" Medicare vs. Non-Medicare Plans !(, !  All the UC medical plans have a separate  Medicare -coordinated version When you become eligible for Medicare you coordinate your current medical plan with Medicare The Medicare-coordinated version of a plan may differ in: Plan benefits/drug formulary Costs Service area Network providers Enrollment/de-enrollment processnIZ Z]Z Z:ZcZ:c E  <Medicare Coordination with HMO plans (Advantage Plans), 2009==(If you are enrolled in an Health Maintenance Organization plan (HMO) -- Health Net, Kaiser, or WHA -- Medicare Parts A, B and D must be  assigned/locked into the plan You cannot use Medicare outside the plan You will need to complete a MAPD form assigning Medicare to your plan If you change plans you will need to  unlock Medicare from your plan ~)EF`  C(1Medicare Coordination with Blue Cross Plans, 200822(High Option Supplement to Medicare Blue Cross PPO (Preferred Provider Organization) Blue Cross Plus POS (Point of Service Plan) Includes in-network (HMO), and out-of-network coverage Must live in the CA service area Blue Cross Core XXX1Medicare Coordination with Blue Cross Plans, 200822(>You may see any Medicare provider* Find doctors using the Participating Physician Directory online at: http://www.medicare.gov Medicare pays as primary Each plan has an annual deductible* - Once the deductible is met, Blue Cross coordinates their payment after Medicare pays, to cover a percentage of your expenses P#P\PP#\c0g~xMedicare Coordination with Blue Cross Plans  Medicare Terms==( Provider Accepts Assignment Provider will accept Medicare contracted rates for services Provider Does not Accept Assignment Provider can charge up to 15% above Medicare contracted rates Provider Opts Out of Medicare or Does Not Have a Medicare Contract Claims from a provider that has opted out of Medicare or from a provider without a Medicare certificate number will not be paid by Medicare and will not be paid by your UC sponsored health plan ZZ=Z$Z>ZZCZZZZ =$>C )Lets take a look at Health Coverage Costs {1How much will my medical plan cost when I retire?22(JIf you began work at UC prior to 1/1/90 and did not have a break in covered service for more than 120 days, you will receive 100% of UC s maximum contribution toward the medical monthly premium. You will still pay the employee/retiree portion of the cost If you began work on or after 1/1/90 you will be subject to graduated eligibility. You will receive a percentage of UC s maximum contribution. Your percentage corresponds to your years of UC service credit. In addition, you will still pay the employee/retiree portion of the cost No  salary banding  all retiree rates are equal to the second band ($46, 001 - $92, 000) with the exception of Medicare coordinated plans0P PP>|Part B ReimbursementHReimbursement for Part B may apply if UC s contribution for a plan is greater than the gross premium Maximum individual reimbursement currently is $96.40 per person&{#Things to Consider in a Health Plan$$(Your total annual health plan costs: Services that are and are not covered Medicare and UC Health Plan Premiums Deductibles and Co-insurance Include both medical, prescription drugs and behavioral health Factor in your Out-of-Pocket Maximum (OOPM) protection If your co-pays, co-insurance and deductibles paid equal your OOPM, additional care in the plan year for covered expenses is paid at 100% - review the plan for excluded items %h?7 %h?7  Additional Issues to Consider lX Additional Considerations Changing Plans& ..--(*Open Enrollment (OE) When you retire you will continue to have the option to change plans during November Open Enrollment, the change will be effective the first of the following January Move Out of the Service Area/Out of the US If you move out of your plan s service area you will have a  Period of Initial eligibility to switch plans outside of Open Enrollment Process: Call UCOP customer service, alert them of your new address. The rep will mail you a form so you can select a new plan. If the form is returned to UCOP by the 15th of the month, typically the change is effective the first of the following month UCOP Customer Service 1-800-888-8267 PP+PP%PP P+3 R%  ?% (Plan options if you move outside California Blue Cross PPO, High Option Supplement to Medicare, and Core Plan options if you move outside the U.S. for longer than 6 months Blue Cross PPO and Core Will switch to Non-Medicare version of plan Higher premiums, different coverage levels j,=CX! =CX  >$(Additional Considerations Changing Plans))(Use the Medical Plan Wizard to find the medical plans available in your service area You will need a zip code Tool on At Your Service Website Always call the plan for the most current information because service areas are subject to change&UUA'Tips for Planning Ahead(NRead Open Enrollment materials each year to track changes in coverage Stay informed of general developments in Medicare and medical insurance Use your UC online resources for retirees UC  At Your Service Website http://atyourservice.ucop.edu/ UCSF HCF Website http://ucsfhr.ucsf.edu/hcf PP PPPP Sc0fc0 $rXTips for Planning Ahead( Use your Medicare resources www.medicare.gov - Medicare General Information  1-800-633-4227 Social Security  1-800-772-1213 Health Insurance Counseling and Advocacy Program (HICAP)  1-800-434-0222 Still have questions? UC Retiree, Health and Welfare - 1-800-888-8267 Contact Your Health Plan UCSF Health Care Facilitator (HCF) Pgrm  (415) 514-3324 sforstat@hr.ucsf.edu ZZA" Zk0 " dZ0 " dZZZZ0 " dZ0 " dZc0-pThe End THANK YOU FOR PARTICIPATING! Additional information about Medicare is available on the Health Care Facilitator website at: www.ucsfhr.ucsf.edu/hcf . /l79<B     \  0` 3f` ]fff3` W.f36d` ff3fffe̙` 3f3` kuos` f___ff̙` /!fff3̙` f3f` f3f` ff3f` f3f>?" dd@,? " xd@  d  " x@ d`vP n?" dd@   @@``PR    @ ` `p>> vn h(  h h 63 " `   T Click to edit Master title style! !$ h 0DB " `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S h 6G #" `^ `  @* h 6TR #" `^   B* h 6H\ #" `^ `  B*x h LA޽h ?ocean_pale#" @@ f3f80___PPT10. P:4  OceanY 0 0 l)(  l l 6j "p  T Click to edit Master title style! ! l 0Tn " `    W#Click to edit Master subtitle style$ $ l \@ABCxDE k'<xx"^ l 6r #" `^   B* l 6} #" `^ `  B* l 6\ #" `^ `  @*x l LA޽h ?ocean_pale#" @@ f3f80___PPT10. P:4 0 0(  x"  c $8h `    x  c $h `  H  0޽h ? 3fffff3̙3f̙___PPT10i.4 +D=' '= @B +  0  0(  x"  c $h `    x  c $Щh `  H  0޽h ? 3fffff3̙3f̙___PPT10i.Q+D=' '= @B +  0 <4@ (    3 rH/B/Bh #     3 r/B/BhPP  H  0޽h ? f33y___PPT10Y+D=' '= @B + 0 p*(  px" p c $h `    r p S h  H p 0޽h ? 3fffff3̙3f̙___PPT10i.P+D=' '= @B + 0 <4p(    3 r/B/Bh-.     3 r/B/Bh0  H  0޽h ? f33y___PPT10Y+D=' '= @B +  0 0(  x"  c $Luvh `   v x  c $$vvh / v H  0޽h ? 3fffff3̙3f̙___PPT10i.BL$6+D=' '= @B + 0 p h0(  hx" h c $vh `   v x h c $vh ` v H h 0޽h ? 3fffff3̙3f̙___PPT10i.-gY+D=' '= @B + 0  p0(  px" p c $vh `   v x p c $tvh ` v H p 0޽h ? 3fffff3̙3f̙___PPT10i./g0dv+D=' '= @B +0 |6(  |~" | s *vlp v x | c $vl L v H | 0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' '= @B + 0 <4(    3 rv/B/Bha `   v   3 rv/B/Bh v H  0޽h ? f33y___PPT10Y+D=' '= @B +h 0 wP(    s **vh p  v l<Medicare Coordination with HMO plans (Advantage Plans), 2008==(  s *@1h` v  You select a primary care provider (PCP) to coordinate your care though your medical group You pay a small co-pay when you receive services No need to submit claim forms \Z Z1Z Z!Z ZZ[Q( H  0޽h ? f;v3ff___PPT10i.0`+D=' '= @B + 0  0(  x"  c $1h `   1 x  c $1h ` 1 H  0޽h ? 3fffff3̙3f̙___PPT10i.\u05+D=' '= @B +rtk6{:,C/adK*x"~)%'o4B P{# G71or( 1E @ SEU 1KDؖ`Ґ4}1j$GEbbxo_sfwvﶥdgvgw"mB K|r| }ý noDyFgl &#F@Bs9(،$kwA&=Ǻc{[5mh>X-u6"d;g!u B{϶1_.~#yYַ/#ǐcg+x#Eq}gUt?0oyri{7`UcNٗZڛ$[S$焌)&&gW~x~kU=蟆4F6F2O=vRd\i $=]~п A;yCП5' C?b1 ~ψly/2ޤd#i'}DRrDΕ\\w;>Z^οJO:7urdrOA>qMT~|TI5j wzxo1:}fu)λw )쥱i)bϵŚh<3x4 ^bs=w7Pr~*,X>nIT+|dLKۘfF*`_B(#B9C3Ch܋wp_Mo|43_6_|uE.(,\5}H%?gy` ‚G^ Qb=Ys=&@c k.f$a5vTMp;rU39܎nGDj ۲yD]H xklOew87`"{/9)aSˬ6@(&v#Pk4a*2v4î%%;m㼱yX Vy3Bq3L{Ͽ9>6>_4q_a܄wM~}C#֓΁p?(R[4 摵Zj%Z6_D0ahGb[{;_yKuÃgge^lJ^X_n 7|.@=Vu:,oݖBk`a}p>hxYMlU&?9!nh!ب; KQ(D$M8)A EAh+K)U @1Ap۝}޵767f HDE{ Nu;}]&>{eDŽWdu6R .ې;?Ɖ0Lh"{ݹ.߇6-5{8FA*<}z'D~O@$r^/7#ʼn7:IK1 <56ߤ"1\6>3p-8~[=R0/Arܞ"}kH>K!{{dR_b)_~GɎ퇯 <http://atyourservice.ucop.edu/<http://atyourservice.ucop.edu/l www.medicare.gov0http://www.medicare.gov/z.http://www.medicare.gov0http://www.medicare.gov/f4http://ucsfhr.ucsf.edu/hcf4http://ucsfhr.ucsf.edu/hcfl www.medicare.gov0http://www.medicare.gov/ Chart MSGraph.Chart.80*Microsoft Graph ChartL/ 0|DArialll RomanPP ؖF0ؖ"DTahomal RomanPP ؖF0ؖ" DWingdingsRomanPP ؖF0ؖ0DTimes New RomanPP ؖF0ؖ@DRockwell RomanPP ؖF0ؖ C .  @n?" dd@  @@`` H @  #%9  B  >!"#'()*0134598  = B ry^G]M M[ \]^_` qr x} ~ \ 0  .   Ob$rd%`sA5$R$ u0 |` "$ X֡aD 0AA 3@8 vjFʚ;p0ʚ;g4?d?d00F0&ppp@ <4dddd@0P <4BdBd@0P <4!d!d@0P g48d8dF0Dpp pp0___PPT10 f___PPT9H@X(? %O =s]@Medicare Enrollment and Your UC Sponsored Medical Plan Coverage ; UCSF HR/Benefits Health Care Facilitator Program, 2009&<8bHMedicare Basics 'What is Medicare?Medicare is a Federal Medical Insurance Program for: People 65 years of age and older regardless of their income or medical history In 1972 Medicare was expanded to include the following groups: Some people with disabilities under age 65 End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) In 2000, individuals with Lou Gehrig s Disease (amyotrophic lateral sclerosis) could enroll at time of diagnosis (rather than having to satisfy the 24-month waiting period l5ZZZZZ5~cMedicare Coverage,Part A Hospital Coverage Part B Medical Coverage Part C Medicare Advantage Program Part D Out-Patient Prescription Drug Coverage  established in 2006ZZZZZZZ=Z  =fGaps in Medicare Coverage3If you had only Medicare insurance you would experience large gaps in coverage requiring significant out-of-pocket expenses Your UC medical plan coverage coordinates with Medicare to reduce these gaps and decrease your out-of-pocket expenses See www.medicare.gov for information on coverage and exclusionsD@ @",c0$Delaying Medicare Part B enrollment %%(Medicare allows you to delay Part B enrollment as long as you are covered by an Employer Group Health Plan (EGHP) either as an employee or the dependent of an employee You will have a special enrollment period to enroll in Medicare if you are older than 65 when your EGHP ends and you will not be subject to the late enrollment penalty SS will provide you with a form requiring documentation of EGHP enrollment and terminationJP PP P[PcI*UC Medicare Enrollment Policy for Retirees+"  3fUC s Medicare Enrollment Requirements for Retirees  4*( ( 4  UC requires that you/your dependents enroll in Medicare Part B when you/your dependents become eligible for premium free, Medicare Part A ** You/your dependents are transferred into the  Medicare-coordinated version of the plan You/your dependents do not need to enroll in a non-UC sponsored Medicare Part D plan Your plan will enroll you in Medicare Part D ** Adult Dependent Relatives that become eligible for Medicare Part A may not continue their UC sponsored medical coverage.ZYZUZ.Z} " Zl YU-}   dUC s Medicare Enrollment Requirements for Retirees 3*( (2  Retirees and their dependents risk de-enrollment from UC sponsored medical coverage if they& . Do not enroll in Medicare Part B when eligible for premium free Medicare Part A Enroll in a non-UC sponsored Medicare Part D plan Are HMO members who do not assign/lock Medicare to the plan and/or uses Medicare outside of the plan d_Z ZZ Z_#Why UC Mandates Medicare Enrollment$$$ $  MRetirees over age 65 without Medicare cost at least twice as much to insure as those with Medicare Enrollment in Medicare partially reduces the cost of the plan, which keeps the UC premiums affordable for all Allows UC to continue to fund health benefits for retirees Many employers are dropping or reducing retiree health coveragepcP PnP P;P@P;@ N  aG!Exceptions to UC Medicare Mandate""(!  JRetirees that didn t pay Medicare taxes may not be eligible for premium free Medicare Part A UC does not require retirees ineligible for premium free Medicare Part A, to enroll in Part B. These retirees may continue with their current non-Medicare medical plan. Please note: You may qualify for premium free Medicare Part A through a spouse, former spouse or prior work history. Contact Social Security, 1-800-772-1213^Z_ZKZZ^ 8K6!!Exceptions to UC Medicare Mandate""( "  UC does not require you to enroll in Medicare Part B if: You reside outside the United States you must enroll in Medicare if you return You may incur a penalty from Medicare when you re-enroll You are still working at UCSF and have health coverage as an employee (never retired from UC) You have UC sponsored health coverage through your spouse or domestic partner who is still working at UC.Z  Z%ZdZ Z^ZZiZ. %d      Medicare Enrollment x^Medicare EnrollmentTo enroll in Medicare or determine if you are eligible, contact Social Security 1-800-772-1213 Remember if you don t qualify on your own, you may qualify through a current or former spouse If you don t qualify now but continue to work you may qualify in the future You are required to enroll at age 65 unless covered by an employer group health plan (EGHP) or pay a penalty for late enrollment z_Z Z_Z ZLZ ZZP/vTips for Enrolling in MedicareIf you are retired, when you reach age 65, you should apply for Medicare three months before your reach age 65 If you are receiving SS benefits at the time, you will automatically be enrolled in both Part A and Part B and a Medicare card will be sent to you about 3 months before your birthday If you are not receiving SS benefits you will need to initiate enrollment into Medicare yourselfJoZ ZZ ZaZw7Coordinating Medicare with your Retiree Health Coverage88(Approximately 3 months prior to your 65th birthday UC will send you the following documents (if you are retired): UC Medicare Declaration Form Universal Medicare Advantage Form (to be completed by those in an HMO plan: Health Net, Kaiser, WHA) UCOP will transfer your medical plan enrollment to the Medicare version of the plan once they receive your documents and adjust your plan premiums as indicated Your family members enrolled as dependents who are not eligible for Medicare will remain in the basic non-Medicare version of the plan rPPPP PPP' I  x( Period of Darkness There is usually a three week period of transition from a non-Medicare plan to the Medicare version of the plan During this time period it can appear that your coverage has been terminated. It hasn t! If you experience problems obtaining medical care or accessing your pharmacy benefits during this time, call your Health Care FacilitatorvpZ ZYZ ZZ) dJ7How UC Sponsored Health Plans Coordinate with Medicare 88(1Information based on coverage for plan year, 2009:" Medicare vs. Non-Medicare Plans !(, !  All the UC medical plans have a separate  Medicare -coordinated version When you become eligible for Medicare you coordinate your current medical plan with Medicare The Medicare-coordinated version of a plan may differ in: Plan benefits/drug formulary Costs Service area Network providers Enrollment/de-enrollment processnIZ Z]Z Z:ZcZ:c E  <Medicare Coordination with HMO plans (Advantage Plans), 2009==(If you are enrolled in an Health Maintenance Organization plan (HMO) -- Health Net, Kaiser, or WHA -- Medicare Parts A, B and D must be  assigned/locked into the plan You cannot use Medicare outside the plan You will need to complete a MAPD form assigning Medicare to your plan If you change plans you will need to  unlock Medicare from your plan ZZ)EF`  C(1Medicare Coordination with Blue Cross Plans, 200922(High Option Supplement to Medicare Blue Cross PPO (Preferred Provider Organization) Blue Cross Plus POS (Point of Service Plan) Includes in-network (HMO), and out-of-network coverage Must live in the CA service area Blue Cross Core XXX1Medicare Coordination with Blue Cross Plans, 200922(>You may see any Medicare provider* Find doctors using the Participating Physician Directory online at: http://www.medicare.gov Medicare pays as primary Each plan has an annual deductible* - Once the deductible is met, Blue Cross coordinates their payment after Medicare pays, to cover a percentage of your expenses P#P\PP#\c0g~xMedicare Coordination with Blue Cross Plans  Medicare Terms==( Provider Accepts Assignment Provider will accept Medicare contracted rates for services Provider Does not Accept Assignment Provider can charge up to 15% above Medicare contracted rates Provider Opts Out of Medicare or Does Not Have a Medicare Contract Claims from a provider that has opted out of Medicare or from a provider without a Medicare certificate number will not be paid by Medicare and will not be paid by your UC sponsored health plan ZZ=Z$Z>ZZCZZZZ =$>C Health Coverage Costs {1How much will my medical plan cost when I retire?22(JIf you began work at UC prior to 1/1/90 and did not have a break in covered service for more than 120 days, you will receive 100% of UC s maximum contribution toward the medical monthly premium. You will still pay the employee/retiree portion of the cost If you began work on or after 1/1/90 you will be subject to graduated eligibility. You will receive a percentage of UC s maximum contribution. Your percentage corresponds to your years of UC service credit. In addition, you will still pay the employee/retiree portion of the cost No  salary banding  all retiree rates are equal to the second band ($46, 001 - $92, 000) with the exception of Medicare coordinated plans0P PP,.Part B Reimbursement #Things to Consider in a Health Plan$$(Your total annual health plan costs: Services that are and are not covered Medicare and UC Health Plan Premiums Deductibles and Co-insurance Include both medical, prescription drugs and behavioral health Factor in your Out-of-Pocket Maximum (OOPM) protection If your co-pays, co-insurance and deductibles paid equal your OOPM, additional care in the plan year for covered expenses is paid at 100% - review the plan for excluded items %h?7 %h?7  Additional Issues to Consider lX Additional Considerations Changing Plans& ..--(*Open Enrollment (OE) When you retire you will continue to have the option to change plans during November Open Enrollment, the change will be effective the first of the following January Move Out of the Service Area/Out of the US If you move out of your plan s service area you will have a  Period of Initial eligibility to switch plans outside of Open Enrollment Process: Call UCOP customer service, alert them of your new address. The rep will mail you a form so you can select a new plan. If the form is returned to UCOP by the 15th of the month, typically the change is effective the first of the following month UCOP Customer Service 1-800-888-8267 PP+PP%PP P+3 R%  ?% (Plan options if you move outside California Blue Cross PPO, High Option Supplement to Medicare, and Core Plan options if you move outside the U.S. for longer than 6 months Blue Cross PPO and Core Will switch to Non-Medicare version of plan Higher premiums, different coverage levels j,=CX! =CX  >$(Additional Considerations Changing Plans))(Use the Medical Plan Wizard to find the medical plans available in your service area You will need a zip code Tool on At Your Service Website Always call the plan for the most current information because service areas are subject to change&UUA'Tips for Planning Ahead(NRead Open Enrollment materials each year to track changes in coverage Stay informed of general developments in Medicare and medical insurance Use your UC online resources for retirees UC  At Your Service Website http://atyourservice.ucop.edu/ UCSF HCF Website http://ucsfhr.ucsf.edu/hcf PP PPPP Sc0fc0 $rXTips for Planning Ahead( Use your Medicare resources www.medicare.gov - Medicare General Information  1-800-633-4227 Social Security  1-800-772-1213 Health Insurance Counseling and Advocacy Program (HICAP)  1-800-434-0222 Still have questions? UC Retiree, Health and Welfare - 1-800-888-8267 Contact Your Health Plan UCSF Health Care Facilitator (HCF) Pgrm  (415) 514-3324 sforstat@hr.ucsf.edu ZZA" Zk0 " dZ0 " dZZZZ0 " dZ0 " dZc0-pThe End THANK YOU FOR PARTICIPATING! Additional information about Medicare is available on the Health Care Facilitator website at: www.ucsfhr.ucsf.edu/hcf . /79<B     \  0` 3f` ]fff3` W.f36d` ff3fffe̙` 3f3` kuos` f___ff̙` /!fff3̙` f3f` f3f` ff3f` f3f>?" dd@,? " xd@  d  " x@ d`vP n?" dd@   @@``PR    @ ` `p>> vn h(  h h 63 " `   T Click to edit Master title style! !$ h 0DB " `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S h 6G #" `^ `  @* h 6TR #" `^   B* h 6H\ #" `^ `  B*x h LA޽h ?ocean_pale#" @@ f3f80___PPT10. P:4  OceanY 0 0 l)(  l l 6j "p  T Click to edit Master title style! ! l 0Tn " `    W#Click to edit Master subtitle style$ $ l \@ABCxDE k'<xx"^ l 6r #" `^   B* l 6} #" `^ `  B* l 6\ #" `^ `  @*x l LA޽h ?ocean_pale#" @@ f3f80___PPT10. P:40 @8 (    N+kk P%   \* K%%KKpp  NB+kk  %  ^* K%%KKppd  c $ ?(K  4  N?+kk  0)  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  T0P+kk P   \* K%%KKpp  T X+kk    ^* K%%KKppH  0޽h ? 3380___PPT10._ ((    Nh+kk P%  + \* K%%KKpp  N,+kk  % + ^* K%%KKpp  Tt+kk P  + \* K%%KKpp  Tl}kk   + ^* K%%KKppH  0޽h ? 3380___PPT10.0N-0 &t(  t~" t s *4blp  H t 0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' = @B + 0 0(  x"  c $8h `    x  c $h `  H  0޽h ? 3fffff3̙3f̙___PPT10i.4 +D=' = @B +0 &x(  x~" x s *4lp  H x 0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' = @B + 0 0 6(  ~  s *h `    x  c $_h  H  0޽h ? 3333y___PPT10Y+D=' = @B +  0 <4@ (    3 rH/B/Bh     3 r/B/BhPP  H  0޽h ? f33y___PPT10Y+D=' = @B + 0 p*(  px" p c $h `    r p S h  H p 0޽h ? 3fffff3̙3f̙___PPT10i.P+D=' = @B +0 P T(  ~"  s *Tnvl0 v   HA l"` < H  0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' = @B +  0 0(  x"  c $Luvh `   v x  c $$vvh / v H  0޽h ? 3fffff3̙3f̙___PPT10i.BL$6+D=' = @B +0 |6(  |~" | s *vlp v x | c $vl L v H | 0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' = @B + 0 ` 6(  ~"  s *d#h     x  c $|h@.   H  0޽h ? 3fffff3̙3f̙___PPT10i.JD+D=' = @B +0 `B(    s *vh   v l<Medicare Coordination with HMO plans (Advantage Plans), 2009==($  s *vh v  You must live in the plan s CA service area Medicare pays a flat fee to the HMO each month - the HMO agrees to accept full responsibility for your care You pay a low monthly premium *You cannot use Medicare outside the plan -Z ZlZ ZZ, ZZ,* -  H  0޽h ? f;v3ff___PPT10i.0`+D=' = @B +h 0 wP(    s **vh p  v l<Medicare Coordination with HMO plans (Advantage Plans), 2009==(  s *@1h` v  You select a primary care provider (PCP) to coordinate your care though your medical group You pay a small co-pay when you receive services No need to submit claim forms \Z Z1Z Z!Z ZZ[Q( H  0޽h ? f;v3ff___PPT10i.0`+D=' = @B + 0 6(  ~  s *1hP  1 x  c $11h` 1 H  0޽h ? f;v3ff___PPT10i.'`'+D=' = @B + 0  D(   ~   s *g1h `   1 x   c $h1hP`F 1    6i1(0 R*Exceptions  Blue Cross Plus in-network 2*0lKZ(H   0޽h ? f;v3ff___PPT10i.0|+D=' = @B +0 &` (  ~"  s *\1lp 1 H  0޽h ? 3fffff3̙3f̙___PPT10i.Z+D=' = @B +O  0N0 VN (  x  c $3h `@  3  0 HA ?h0  z  0  p  ,$D0t  6fԔ"` Pb   04P 0 TPart B reimbursement$ 2f  <'Df+ 0 $  030 x \Reimbursement for Part B may apply if UC s contribution for a plan is greater than the gross premium Maximum individual reimbursement currently is $96.40 per person (2009) * &H  0޽h ? 3f___PPT10a.m׵+r}D5' = @B D' = @BA?%,( < +O%,( < +D'' =%(D' =%(Dw' =4@BBB B%()))D' =1:Bvisible*o3>+B#style.visibility<*%(D' =-6B'blinds(horizontal)*<3<*+ 0 6(  ~  s *1h `   1 x  c $1h 1 H  0޽h ? 3333y___PPT10Y+D=' = @B +0 bZ0(  d  c $(K   +N  3 rz+kk )  + d_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ c  H  0޽h ? ̙33!0 bZ(  d  c $(K   +N  3 r+kk )  + d_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ c  H  0޽h ? ̙33"0 bZ(  d  c $(K   +N  3 r+kk )  + d_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ c  H  0޽h ? ̙33D'0 @(     `1 ?&I   +   `+ k k ? @)  + H  0޽h ? ̙330 e] (  ^  S (K   uW  c $$7 0)  u For individuals who will be or are Medicare eligible when retire and eligible for UC retiree coverage. Medicare overview; UC medicare requirements; Medicare enrollment/coordination~0H  0޽h ? 3380___PPT10.REH0  ,(  ^  S (K     c $} 0)   "Brief overviewH  0޽h ? 3380___PPT10.0M0  ](  ^  S (K     c $ 0)   S?Many calls from employees who are turning 65 and still working.H  0޽h ? 3380___PPT10.$0 ^VP (  d  c $(K   J  3 r,kk )   `True for most companies who provide retiree coverage  UC not exception _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ /  H  0޽h ? ̙33^0 p (  ^  S (K      c $| 0)    Very important to ensure you speak with SS if you have a unique situation. If qualify based on work history of spouse, they must be 62.H  0޽h ? 3380___PPT10. UP#w0  3(  ^  S (K     c $4 0)   )MAPD may be changing.H  0޽h ? 3380___PPT10. \*(0  :(  ^  S (K     c $h^ 0)   0PCP 30 miles of home addressH  0޽h ? 3380___PPT10. PX0  h(  ^  S (K     c $R 0)   ^JHigh Option  all members in MedicareH  0޽h ? 3380___PPT10. p3~J0   (   ^   S (K      c $8u 0)   pRetirement not allow for switching plans. CIGNA available to retirees, but not if Medicare eligible. (HRA issue)H   0޽h ? 3380___PPT10.!<5$0 @ pE(  p^ p S (K   3 p c $y3 0)  3 ;'May also suspend coverage as a retiree.H p 0޽h ? 3380___PPT10.-JG0 zr` x (  xX x C (K   ur x S Nu 0)  u H x 0޽h ? 3380___PPT10..$0  4(  d  c $(K     s *T 0)    H  0޽h ? 3380___PPT10.phm NxT]561`k~1^4UvRVIcvcjDTBR)_nRQQYU+TUHW~pگFjJM;s}xQ,;y͙3{n"s`l Ջ ށ=f0gDc0)7 z6yY^(z.B,fLyJӃ(\F>C4ҧ RqM0Hn OC4iG0G1ǀt,k-2<4Õ6 U4Ur(6ҳ>5~ʙonXNRqn܂y#M C+>`cnÜ܎V|Lܙ`į| "KrW:=myW{C~=Nz7JUREh]e#b81FCF<9b*޶3Ƀ0&:F1 IL4v2pb3ǯNϤ&d_Nh F^I/bS8N[!lGoFggg56.~ae#rQ[xG\g~ѻ<#ϯ 8I\pѻwq-¿>BK޵=kNHAP!.[VKҵ pATjt휮kov\A]ԵM$xXt ZŘ3:,HzI>+1CYw˓ i淮ftژO$*M]ga6=l9F kraAczfP :`V mmYFt\lp[TK-1hI4r,hS̡T`!yp?m K4J1͒aMϱiC?pH~WIv!MWǛǛ& {~(.c'NTb>i"@=IB~c9V^ށE z5\&W#X(˰s^hN^<۪Kݏj4_^{\\_t`wҍJljJs,!Nf}5v`{ ا a{ M_ k^v U3 Jm:+d:+h H&ų{:[n< sFd%/N۵($gN6$^oqv8:m;]%|='|;#.!ln!ZJCCZ߾Zsu;8fuجPOy) ٸwaٯYmC(E)բ@r*S0ۃb۶KE ̳vTe5pPw^2ic'0N,?1Ae.ErUXVpʰ>KŹMG^7\./| ^\b!/49[Er!ؒj %x ?ma:lj9o糬.rA uӉ&e(ith%psphT:dkac~Y,zfs2CJN@8D^-fUFF2/,eI%bb6tms+~ɽˆ]ktэlE+> ^Xg>w3TYl0JUZʂ o>ŤgSeIn>ܪv#b006:59=45r|X:8D w?|_#Zs$\MA=zXIr;>wU*U [UA"!a?' ֧D6+ FDL4j'YRuwxR(f nQV-rO-LEbtg[ ?ˏ7U7zni޹iˏ7cU\eñWTR?d7,hQ0gp8X*oENԿST*)71߃ݱ QAK|kE~=Q+]rLAE;GQ2QA/I]6ڿb+"r7 )1ܺ7Z9< >B XEa@\xW~ es #P&p{(* -{/1 5|3# |7sA1Cr( 1E @ S<http://atyourservice.ucop.edu/<http://atyourservice.ucop.edu/l www.medicare.gov0http://www.medicare.gov/z.httXDoơm4`32yYO*M%_rq'WZ\rwM <@k/~|u|,M~V8gc$C۟G_eY`C+|5@iZVOkiMM.xj~oi+?OiMg4Me#s`||c,Lq;~#9l6Gxn\ ΅gkqkjTR}eVT*_|xL+y5Y`wtVd(f}(BCCiގD/Rʒ|35 KrtC8vnznC* -(Ws l4oP9~[àjμo9PX+xl^7_ j9%R;R;R;fR;FR;&R;R"g.ˈ pNHR2vn,5LqLnlT2jFc1v;T]v^#ؽqʣ1{Ydvƿk[K>{CٗzנQ_\. L ¿L] QbLYՏZ?Juna桟9KXԻŬn1ԄzQg;t^bo}v*҇[+YrYZ#Wg$fUC^K히H to!WL ;d?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~p://www.medicare.gov0http://www.medicare.gov/f4http://ucsfhr.ucsf.edu/hcf4http://ucsfhr.ucsf.edu/hcfl www.medicare.gov0http://www.medicare.gov/ Chart MSGraph.Chart.80*Microsoft Graph ChartL/ 0|DArialll RomanPP ؖF0ؖ"DTahomal RomanPP ؖF0ؖ" DWingdingsRomanPP ؖF0ؖ0DTimes New RomanPP ؖF0ؖ@DRockwell RomanPP ؖF0ؖ C .  @n?" dd@  @@``    #%9  B  >!"#'()*0134598  = B ry^G]M M[ \]^_` qr x} ~ \ 0  .   ?b$rd%`sA5"$Vu:,oݖBk`IR$ u0 |`  0AA 3@8 vjFʚ;p0ʚ;g4?d?d00F0&ppp@ <4dddd@0P <4BdBd@0P <4!d!d@0P g48d8dF0Dpp pp0___PPT10 f___PPT9H@X(? %O =s]@Medicare Enrollment and Your UC Sponsored Medical Plan Coverage ; UCSF HR/Benefits Health Care Facilitator Program, 2009&<8bHMedicare Basics 'What is Medicare?Medicare is a Federal Medical Insurance Program for: People 65 years of age and older regardless of their income or medical history In 1972 Medicare was expanded to include the following groups: Some people with disabilities under age 65 End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) In 2000, individuals with Lou Gehrig s Disease (amyotrophic lateral sclerosis) could enroll at time of diagnosis (rather than having to satisfy the 24-month waiting period l5ZZZZZ5~cMedicare Coverage,Part A Hospital Coverage Part B Medical Coverage Part C Medicare Advantage Program Part D Out-Patient Prescription Drug Coverage  established in 2006ZZZZZZZ=Z  =fGaps in Medicare Coverage3If you had only Medicare insurance you would experience large gaps in coverage requiring significant out-of-pocket expenses Your UC medical plan coverage coordinates with Medicare to reduce these gaps and decrease your out-of-pocket expenses See www.medicare.gov for information on coverage and exclusionsD@ @",c0$Delaying Medicare Part B enrollment %%(Medicare allows you to delay Part B enrollment as long as you are covered by an Employer Group Health Plan (EGHP) either as an employee or the dependent of an employee You will have a special enrollment period to enroll in Medicare if you are older than 65 when your EGHP ends and you will not be subject to the late enrollment penalty SS will provide you with a form requiring documentation of EGHP enrollment and terminationJP PP P[PcI*UC Medicare Enrollment Policy for Retirees+"  3fUC s Medicare Enrollment Requirements for Retirees  4*( ( 4  UC requires that you/your dependents enroll in Medicare Part B when you/your dependents become eligible for premium free, Medicare Part A ** You/your dependents are transferred into the  Medicare-coordinated version of the plan You/your dependents do not need to enroll in a non-UC sponsored Medicare Part D plan Your plan will enroll you in Medicare Part D ** Adult Dependent Relatives that become eligible for Medicare Part A may not continue their UC sponsored medical coverage.ZYZUZ.Z} " Zl YU-}   dUC s Medicare Enrollment Requirements for Retirees 3*( (2  Retirees and their dependents risk de-enrollment from UC sponsored medical coverage if they& . Do not enroll in Medicare Part B when eligible for premium free Medicare Part A Enroll in a non-UC sponsored Medicare Part D plan Are HMO members who do not assign/lock Medicare to the plan and/or uses Medicare outside of the plan d_Z ZZ Z_#Why UC Mandates Medicare Enrollment$$$ $  MRetirees over age 65 without Medicare cost at least twice as much to insure as those with Medicare Enrollment in Medicare partially reduces the cost of the plan, which keeps the UC premiums affordable for all Allows UC to continue to fund health benefits for retirees Many employers are dropping or reducing retiree health coveragepcP PnP P;P@P;@ N  aG!Exceptions to UC Medicare Mandate""(!  JRetirees that didn t pay Medicare taxes may not be eligible for premium free Medicare Part A UC does not require retirees ineligible for premium free Medicare Part A, to enroll in Part B. These retirees may continue with their current non-Medicare medical plan. Please note: You may qualify for premium free Medicare Part A through a spouse, former spouse or prior work history. Contact Social Security, 1-800-772-1213^Z_ZKZZ^ 8K6!!Exceptions to UC Medicare Mandate""( "  UC does not require you to enroll in Medicare Part B if: You reside outside the United States you must enroll in Medicare if you return You may incur a penalty from Medicare when you re-enroll You are still working at UCSF and have health coverage as an employee (never retired from UC) You have UC sponsored health coverage through your spouse or domestic partner who is still working at UC.Z  Z%ZdZ Z^ZZiZ. %d      Medicare Enrollment x^Medicare EnrollmentTo enroll in Medicare or determine if you are eligible, contact Social Security 1-800-772-1213 Remember if you don t qualify on your own, you may qualify through a current or former spouse If you don t qualify now but continue to work you may qualify in the future You are required to enroll at age 65 unless covered by an employer group health plan (EGHP) or pay a penalty for late enrollment z_Z Z_Z ZLZ ZZP/vTips for Enrolling in MedicareIf you are retired, when you reach age 65, you should apply for Medicare three months before your reach age 65 If you are receiving SS benefits at the time, you will automatically be enrolled in both Part A and Part B and a Medicare card will be sent to you about 3 months before your birthday If you are not receiving SS benefits you will need to initiate enrollment into Medicare yourselfJoZ ZZ ZaZw7Coordinating Medicare with your Retiree Health Coverage88(Approximately 3 months prior to your 65th birthday UC will send you the following documents (if you are retired): UC Medicare Declaration Form Universal Medicare Advantage Form (to be completed by those in an HMO plan: Health Net, Kaiser, WHA) UCOP will transfer your medical plan enrollment to the Medicare version of the plan once they receive your documents and adjust your plan premiums as indicated Your family members enrolled as dependents who are not eligible for Medicare will remain in the basic non-Medicare version of the plan rPPPP PPP' I  x( Period of Darkness There is usually a three week period of transition from a non-Medicare plan to the Medicare version of the plan During this time period it can appear that your coverage has been terminated. It hasn t! If you experience problems obtaining medical care or accessing your pharmacy benefits during this time, call your Health Care FacilitatorvpZ ZYZ ZZ) dJ7How UC Sponsored Health Plans Coordinate with Medicare 88(1Information based on coverage for plan year, 2009:" Medicare vs. Non-Medicare Plans !(, !  All the UC medical plans have a separate  Medicare -coordinated version When you become eligible for Medicare you coordinate your current medical plan with Medicare The Medicare-coordinated version of a plan may differ in: Plan benefits/drug formulary Costs Service area Network providers Enrollment/de-enrollment processnIZ Z]Z Z:ZcZ:c E  <Medicare Coordination with HMO plans (Advantage Plans), 2009==(If you are enrolled in an Health Maintenance Organization plan (HMO) -- Health Net, Kaiser, or WHA -- Medicare Parts A, B and D must be  assigned/locked into the plan You cannot use Medicare outside the plan You will need to complete a MAPD form assigning Medicare to your plan If you change plans you will need to  unlock Medicare from your plan ZZ)EF`  C(1Medicare Coordination with Blue Cross Plans, 200922(High Option Supplement to Medicare Blue Cross PPO (Preferred Provider Organization) Blue Cross Plus POS (Point of Service Plan) Includes in-network (HMO), and out-of-network coverage Must live in the CA service area Blue Cross Core XXX1Medicare Coordination with Blue Cross Plans, 200922(>You may see any Medicare provider* Find doctors using the Participating Physician Directory online at: http://www.medicare.gov Medicare pays as primary Each plan has an annual deductible* - Once the deductible is met, Blue Cross coordinates their payment after Medicare pays, to cover a percentage of your expenses P#P\PP#\c0g~xMedicare Coordination with Blue Cross Plans  Medicare Terms==( Provider Accepts Assignment Provider will accept Medicare contracted rates for services Provider Does not Accept Assignment Provider can charge up to 15% above Medicare contracted rates Provider Opts Out of Medicare or Does Not Have a Medicare Contract Claims from a provider that has opted out of Medicare or from a provider without a Medicare certificate number will not be paid by Medicare and will not be paid by your UC sponsored health plan ZZ=Z$Z>ZZCZZZZ =$>C Health Coverage Costs {1How much will my medical plan cost when I retire?22(JIf you began work at UC prior to 1/1/90 and did not have a break in covered service for more than 120 days, you will receive 100% of UC s maximum contribution toward the medical monthly premium. You will still pay the employee/retiree portion of the cost If you began work on or after 1/1/90 you will be subject to graduated eligibility. You will receive a percentage of UC s maximum contribution. Your percentage corresponds to your years of UC service credit. In addition, you will still pay the employee/retiree portion of the cost No  salary banding  all retiree rates are equal to the second band ($46, 001 - $92, 000) with the exception of Medicare coordinated plans0P PP,.Part B Reimbursement #Things to Consider in a Health Plan$$(Your total annual health plan costs: Services that are and are not covered Medicare and UC Health Plan Premiums Deductibles and Co-insurance Include both medical, prescription drugs and behavioral health Factor in your Out-of-Pocket Maximum (OOPM) protection If your co-pays, co-insurance and deductibles paid equal your OOPM, additional care in the plan year for covered expenses is paid at 100% - review the plan for excluded items %h?7 %h?7  Additional Issues to Consider lX Additional Considerations Changing Plans& ..--(*Open Enrollment (OE) When you retire you will continue to have the option to change plans during November Open Enrollment, the change will be effective the first of the following January Move Out of the Service Area/Out of the US If you move out of your plan s service area you will have a  Period of Initial eligibility to switch plans outside of Open Enrollment Process: Call UCOP customer service, alert them of your new address. The rep will mail you a form so you can select a new plan. If the form is returned to UCOP by the 15th of the month, typically the change is effective the first of the following month UCOP Customer Service 1-800-888-8267 PP+PP%PP P+3 R%  ?% (Plan options if you move outside California Blue Cross PPO, High Option Supplement to Medicare, and Core Plan options if you move outside the U.S. for longer than 6 months Blue Cross PPO and Core Will switch to Non-Medicare version of plan Higher premiums, different coverage levels j,=CX! =CX  >$(Additional Considerations Changing Plans))(Use the Medical Plan Wizard to find the medical plans available in your service area You will need a zip code Tool on At Your Service Website Always call the plan for the most current information because service areas are subject to change&UUA'Tips for Planning Ahead(NRead Open Enrollment materials each year to track changes in coverage Stay informed of general developments in Medicare and medical insurance Use your UC online resources for retirees UC  At Your Service Website http://atyourservice.ucop.edu/ UCSF HCF Website http://ucsfhr.ucsf.edu/hcf PP PPPP Sc0fc0 $rXTips for Planning Ahead( Use your Medicare resources www.medicare.gov - Medicare General Information  1-800-633-4227 Social Security  1-800-772-1213 Health Insurance Counseling and Advocacy Program (HICAP)  1-800-434-0222 Still have questions? UC Retiree, Health and Welfare - 1-800-888-8267 Contact Your Health Plan UCSF Health Care Facilitator (HCF) Pgrm  (415) 514-3324 sforstat@hr.ucsf.edu ZZA" Zk0 " dZ0 " dZZZZ0 " dZ0 " dZc0-pThe End THANK YOU FOR PARTICIPATING! 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%O =s]@Medicare Enrollment and Your UC Sponsored Medical Plan Coverage ; UCSF HR/Benefits Health Care Facilitator Program, 2009&<8bHMedicare Basics 'What is Medicare?Medicare is a Federal Medical Insurance Program for: People 65 years of age and older regardless of their income or medical history In 1972 Medicare was expanded to include the following groups: Some people with disabilities under age 65 End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) In 2000, individuals with Lou Gehrig s Disease (amyotrophic lateral sclerosis) could enroll at time of diagnosis (rather than having to satisfy the 24-month waiting period l5ZZZZZ5~cMedicare Coverage,Part A Hospital Coverage Part B Medical Coverage Part C Medicare Advantage Program Part D Out-Patient Prescription Drug Coverage  established in 2006ZZZZZZZ=Z  =fGaps in Medicare Coverage3If you had only Medicare insurance you would experience large gaps in coverage requiring significant out-of-pocket expenses Your UC medical plan coverage coordinates with Medicare to reduce these gaps and decrease your out-of-pocket expenses See www.medicare.gov for information on coverage and exclusionsD@ @",c0$Delaying Medicare Part B enrollment %%(Medicare allows you to delay Part B enrollment as long as you are covered by an Employer Group Health Plan (EGHP) either as an employee or the dependent of an employee You will have a special enrollment period to enroll in Medicare if you are older than 65 when your EGHP ends and you will not be subject to the late enrollment penalty SS will provide you with a form requiring documentation of EGHP enrollment and terminationJP PP P[PcI*UC Medicare Enrollment Policy for Retirees+"  3fUC s Medicare Enrollment Requirements for Retirees  4*( ( 4  UC requires that you/your dependents enroll in Medicare Part B when you/your dependents become eligible for premium free, Medicare Part A ** You/your dependents are transferred into the  Medicare-coordinated version of the plan You/your dependents do not need to enroll in a non-UC sponsored Medicare Part D plan Your plan will enroll you in Medicare Part D ** Adult Dependent Relatives that become eligible for Medicare Part A may not continue their UC sponsored medical coverage.ZYZUZ.Z} " Zl YU-}   dUC s Medicare Enrollment Requirements for Retirees 3*( (2  Retirees and their dependents risk de-enrollment from UC sponsored medical coverage if they& . Do not enroll in Medicare Part B when eligible for premium free Medicare Part A Enroll in a non-UC sponsored Medicare Part D plan Are HMO members who do not assign/lock Medicare to the plan and/or uses Medicare outside of the plan d_Z ZZ Z_#Why UC Mandates Medicare Enrollment$$$ $  MRetirees over age 65 without Medicare cost at least twice as much to insure as those with Medicare Enrollment in Medicare partially reduces the cost of the plan, which keeps the UC premiums affordable for all Allows UC to continue to fund health benefits for retirees Many employers are dropping or reducing retiree health coveragepcP PnP P;P@P;@ N  aG!Exceptions to UC Medicare Mandate""(!  JRetirees that didn t pay Medicare taxes may not be eligible for premium free Medicare Part A UC does not require retirees ineligible for premium free Medicare Part A, to enroll in Part B. These retirees may continue with their current non-Medicare medical plan. Please note: You may qualify for premium free Medicare Part A through a spouse, former spouse or prior work history. Contact Social Security, 1-800-772-1213^Z_ZKZZ^ 8K6!!Exceptions to UC Medicare Mandate""( "  UC does not require you to enroll in Medicare Part B if: You reside outside the United States you must enroll in Medicare if you return You may incur a penalty from Medicare when you re-enroll You are still working at UCSF and have health coverage as an employee (never retired from UC) You have UC sponsored health coverage through your spouse or domestic partner who is still working at UC.Z  Z%ZdZ Z^ZZiZ. %d      Medicare Enrollment x^Medicare EnrollmentTo enroll in Medicare or determine if you are eligible, contact Social Security 1-800-772-1213 Remember if you don t qualify on your own, you may qualify through a current or former spouse If you don t qualify now but continue to work you may qualify in the future You are required to enroll at age 65 unless covered by an employer group health plan (EGHP) or pay a penalty for late enrollment z_Z Z_Z ZLZ ZZP/vTips for Enrolling in MedicareIf you are retired, when you reach age 65, you should apply for Medicare three months before your reach age 65 If you are receiving SS benefits at the time, you will automatically be enrolled in both Part A and Part B and a Medicare card will be sent to you about 3 months before your birthday If you are not receiving SS benefits you will need to initiate enrollment into Medicare yourselfJoZ ZZ ZaZw7Coordinating Medicare with your Retiree Health Coverage88(Approximately 3 months prior to your 65th birthday UC will send you the following documents (if you are retired): UC Medicare Declaration Form Universal Medicare Advantage Form (to be completed by those in an HMO plan: Health Net, Kaiser, WHA) UCOP will transfer your medical plan enrollment to the Medicare version of the plan once they receive your documents and adjust your plan premiums as indicated Your family members enrolled as dependents who are not eligible for Medicare will remain in the basic non-Medicare version of the plan rPPPP PPP' I  x( Period of Darkness There is usually a three week period of transition from a non-Medicare plan to the Medicare version of the plan During this time period it can appear that your coverage has been terminated. It hasn t! If you experience problems obtaining medical care or accessing your pharmacy benefits during this time, call your Health Care FacilitatorvpZ ZYZ ZZ) dJ7How UC Sponsored Health Plans Coordinate with Medicare 88(1Information based on coverage for plan year, 2009:" Medicare vs. Non-Medicare Plans !(, !  All the UC medical plans have a separate  Medicare -coordinated version When you become eligible for Medicare you coordinate your current medical plan with Medicare The Medicare-coordinated version of a plan may differ in: Plan benefits/drug formulary Costs Service area Network providers Enrollment/de-enrollment processnIZ Z]Z Z:ZcZ:c E  <Medicare Coordination with HMO plans (Advantage Plans), 2009==(If you are enrolled in an Health Maintenance Organization plan (HMO) -- Health Net, Kaiser, or WHA -- Medicare Parts A, B and D must be  assigned/locked into the plan You cannot use Medicare outside the plan You will need to complete a MAPD form assigning Medicare to your plan If you change plans you will need to  unlock Medicare from your plan ZZ)EF`  C(1Medicare Coordination with Blue Cross Plans, 200922(High Option Supplement to Medicare Blue Cross PPO (Preferred Provider Organization) Blue Cross Plus POS (Point of Service Plan) Includes in-network (HMO), and out-of-network coverage Must live in the CA service area Blue Cross Core XXX1Medicare Coordination with Blue Cross Plans, 200922(>You may see any Medicare provider* Find doctors using the Participating Physician Directory online at: http://www.medicare.gov Medicare pays as primary Each plan has an annual deductible* - Once the deductible is met, Blue Cross coordinates their payment after Medicare pays, to cover a percentage of your expenses P#P\PP#\c0g~xMedicare Coordination with Blue Cross Plans  Medicare Terms==( Provider Accepts Assignment Provider will accept Medicare contracted rates for services Provider Does not Accept Assignment Provider can charge up to 15% above Medicare contracted rates Provider Opts Out of Medicare or Does Not Have a Medicare Contract Claims from a provider that has opted out of Medicare or from a provider without a Medicare certificate number will not be paid by Medicare and will not be paid by your UC sponsored health plan ZZ=Z$Z>ZZCZZZZ =$>C Health Coverage Costs {1How much will my medical plan cost when I retire?22(JIf you began work at UC prior to 1/1/90 and did not have a break in covered service for more than 120 days, you will receive 100% of UC s maximum contribution toward the medical monthly premium. You will still pay the employee/retiree portion of the cost If you began work on or after 1/1/90 you will be subject to graduated eligibility. You will receive a percentage of UC s maximum contribution. Your percentage corresponds to your years of UC service credit. In addition, you will still pay the employee/retiree portion of the cost No  salary banding  all retiree rates are equal to the second band ($46, 001 - $92, 000) with the exception of Medicare coordinated plans0P PP,.Part B Reimbursement #Things to Consider in a Health Plan$$(Your total annual health plan costs: Services that are and are not covered Medicare and UC Health Plan Premiums Deductibles and Co-insurance Include both medical, prescription drugs and behavioral health Factor in your Out-of-Pocket Maximum (OOPM) protection If your co-pays, co-insurance and deductibles paid equal your OOPM, additional care in the plan year for covered expenses is paid at 100% - review the plan for excluded items %h?7 %h?7  Additional Issues to Consider lX Additional Considerations Changing Plans& ..--(*Open Enrollment (OE) When you retire you will continue to have the option to change plans during November Open Enrollment, the change will be effective the first of the following January Move Out of the Service Area/Out of the US If you move out of your plan s service area you will have a  Period of Initial eligibility to switch plans outside of Open Enrollment Process: Call UCOP customer service, alert them of your new address. The rep will mail you a form so you can select a new plan. If the form is returned to UCOP by the 15th of the month, typically the change is effective the first of the following month UCOP Customer Service 1-800-888-8267 PP+PP%PP P+3 R%  ?% (Plan options if you move outside California Blue Cross PPO, High Option Supplement to Medicare, and Core Plan options if you move outside the U.S. for longer than 6 months Blue Cross PPO and Core Will switch to Non-Medicare version of plan Higher premiums, different coverage levels j,=CX! =CX  >$(Additional Considerations Changing Plans))(Use the Medical Plan Wizard to find the medical plans available in your service area You will need a zip code Tool on At Your Service Website Always call the plan for the most current information because service areas are subject to change&UUA'Tips for Planning Ahead(NRead Open Enrollment materials each year to track changes in coverage Stay informed of general developments in Medicare and medical insurance Use your UC online resources for retirees UC  At Your Service Website http://atyourservice.ucop.edu/ UCSF HCF Website http://ucsfhr.ucsf.edu/hcf PP PPPP Sc0fc0 $rXTips for Planning Ahead( Use your Medicare resources www.medicare.gov - Medicare General Information  1-800-633-4227 Social Security  1-800-772-1213 Health Insurance Counseling and Advocacy Program (HICAP)  1-800-434-0222 Still have questions? UC Retiree, Health and Welfare - 1-800-888-8267 Contact Your Health Plan UCSF Health Care Facilitator (HCF) Pgrm  (415) 514-3324 sforstat@hr.ucsf.edu ZZA" Zk0 " dZ0 " dZZZZ0 " dZ0 " dZc0-pThe End THANK YOU FOR PARTICIPATING! 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%O =a]@Medicare Enrollment and Your UC Sponsored Medical Plan Coverage ; UCSF HR/Benefits Health Care Facilitator Program, 2009&<8bHMedicare Basics 'What is Medicare?Medicare is a Federal Medical Insurance Program for: People 65 years of age and older regardless of their income or medical history In 1972 Medicare was expanded to include the following groups: Some people with disabilities under age 65 End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) In 2000, individuals with Lou Gehrig s Disease (amyotrophic lateral sclerosis) could enroll at time of diagnosis (rather than having to satisfy the 24-month waiting period l5ZZZZZ5~cMedicare Coverage,Part A Hospital Coverage Part B Medical Coverage Part C Medicare Advantage Program Part D Out-Patient Prescription Drug Coverage  established in 2006ZZZZZZZ=Z  =fGaps in Medicare Coverage3If you had only Medicare insurance you would experience large gaps in coverage requiring significant out-of-pocket expenses Your UC medical plan coverage coordinates with Medicare to reduce these gaps and decrease your out-of-pocket expenses See www.medicare.gov for information on coverage and exclusionsD@ @",c0$Delaying Medicare Part B enrollment %%(Medicare allows you to delay Part B enrollment as long as you are covered by an Employer Group Health Plan (EGHP) either as an employee or the dependent of an employee You will have a special enrollment period to enroll in Medicare if you are older than 65 when your EGHP ends and you will not be subject to the late enrollment penalty SS will provide you with a form requiring documentation of EGHP enrollment and terminationJP PP P[PcI*UC Medicare Enrollment Policy for Retirees+"  3fUC s Medicare Enrollment Requirements for Retirees  4*( ( 4  UC requires that you/your dependents enroll in Medicare Part B when you/your dependents become eligible for premium free, Medicare Part A ** You/your dependents are transferred into the  Medicare-coordinated version of the plan You/your dependents do not need to enroll in a non-UC sponsored Medicare Part D plan Your plan will enroll you in Medicare Part D ** Adult Dependent Relatives that become eligible for Medicare Part A may not continue their UC sponsored medical coverage.ZYZUZ.Z} Zl YU-}   dUC s Medicare Enrollment Requirements for Retirees 3*( (2  Retirees and their dependents risk de-enrollment from UC sponsored medical coverage if they& . Do not enroll in Medicare Part B when eligible for premium free Medicare Part A Enroll in a non-UC sponsored Medicare Part D plan Are HMO members who do not assign/lock Medicare to the plan and/or uses Medicare outside of the plan d_Z ZZ Z_#Why UC Mandates Medicare Enrollment$$$ $  MRetirees over age 65 without Medicare cost at least twice as much to insure as those with Medicare Enrollment in Medicare partially reduces the cost of the plan, which keeps the UC premiums affordable for all Allows UC to continue to fund health benefits for retirees Many employers are dropping or reducing retiree health coveragepcP PnP P;P@P;@ N  aG!Exceptions to UC Medicare Mandate""(!  JRetirees that didn t pay Medicare taxes may not be eligible for premium free Medicare Part A UC does not require retirees ineligible for premium free Medicare Part A, to enroll in Part B. These retirees may continue with their current non-Medicare medical plan. Please note: You may qualify for premium free Medicare Part A through a spouse, former spouse or prior work history. Contact Social Security, 1-800-772-1213^Z_ZKZZ^ 8K6!!Exceptions to UC Medicare Mandate""( "  UC does not require you to enroll in Medicare Part B if: You reside outside the United States you must enroll in Medicare if you return You may incur a penalty from Medicare when you re-enroll You are still working at UCSF and have health coverage as an employee (never retired from UC) You have UC sponsored health coverage through your spouse or domestic partner who is still working at UC.Z  Z%ZdZ Z^ZZiZ. %d      Medicare Enrollment x^Medicare EnrollmentTo enroll in Medicare or determine if you are eligible, contact Social Security 1-800-772-1213 Remember if you don t qualify on your own, you may qualify through a current or former spouse If you don t qualify now but continue to work you may qualify in the future You are required to enroll at age 65 unless covered by an employer group health plan (EGHP) or pay a penalty for late enrollment z_Z Z_Z ZLZ ZZP/vTips for Enrolling in MedicareIf you are retired, when you reach age 65, you should apply for Medicare three months before your reach age 65 If you are receiving SS benefits at the time, you will automatically be enrolled in both Part A and Part B and a Medicare card will be sent to you about 3 months before your birthday If you are not receiving SS benefits you will need to initiate enrollment into Medicare yourselfJoZ ZZ ZaZw7Coordinating Medicare with your Retiree Health Coverage88(Approximately 3 months prior to your 65th birthday UC will send you the following documents (if you are retired): UC Medicare Declaration Form Universal Medicare Advantage Form (to be completed by those in an HMO plan: Health Net, Kaiser, WHA) UCOP will transfer your medical plan enrollment to the Medicare version of the plan once they receive your documents and adjust your plan premiums as indicated Your family members enrolled as dependents who are not eligible for Medicare will remain in the basic non-Medicare version of the plan rPPPP PPP' I  x( Period of Darkness There is usually a three week period of transition from a non-Medicare plan to the Medicare version of the plan During this time period it can appear that your coverage has been terminated. It hasn t! If you experience problems obtaining medical care or accessing your pharmacy benefits during this time, call your Health Care FacilitatorvpZ ZYZ ZZ) dJ7How UC Sponsored Health Plans Coordinate with Medicare 88(1Information based on coverage for plan year, 2009:" Medicare vs. Non-Medicare Plans !( !  All the UC medical plans have a separate  Medicare -coordinated version When you become eligible for Medicare you coordinate your current medical plan with Medicare The Medicare-coordinated version of a plan may differ in: Plan benefits/drug formulary Costs Service area Network providers Enrollment/de-enrollment processnIZ Z]Z Z:ZcZ:c E  <Medicare Coordination with HMO plans (Advantage Plans), 2009==(If you are enrolled in a Health Maintenance Organization plan (HMO) -- Health Net, Kaiser, or WHA -- Medicare Parts A, B and D must be  assigned/locked into the plan You cannot use Medicare outside the plan You will need to complete a MAPD form assigning Medicare to your plan If you change plans you will need to  unlock Medicare from your plan ZZ)EF_  C(1Medicare Coordination with Blue Cross Plans, 200922(High Option Supplement to Medicare Blue Cross PPO (Preferred Provider Organization) Blue Cross Plus POS (Point of Service Plan) Includes in-network (HMO), and out-of-network coverage Must live in the CA service area Blue Cross Core XXX1Medicare Coordination with Blue Cross Plans, 200922(>You may see any Medicare provider* Find doctors using the Participating Physician Directory online at: http://www.medicare.gov Medicare pays as primary Each plan has an annual deductible* - Once the deductible is met, Blue Cross coordinates their payment after Medicare pays, to cover a percentage of your expenses P#P\PP#\c0g~xMedicare Coordination with Blue Cross Plans  Medicare Terms==( Provider Accepts Assignment Provider will accept Medicare contracted rates for services Provider Does not Accept Assignment Provider can charge up to 15% above Medicare contracted rates Provider Opts Out of Medicare or Does Not Have a Medicare Contract Claims from a provider that has opted out of Medicare or from a provider without a Medicare certificate number will not be paid by Medicare and will not be paid by your UC sponsored health plan ZZ=Z$Z>ZZCZZZZ =$>C Health Coverage Costs {1How much will my medical plan cost when I retire?22(JIf you began work at UC prior to 1/1/90 and did not have a break in covered service for more than 120 days, you will receive 100% of UC s maximum contribution toward the medical monthly premium. You will still pay the employee/retiree portion of the cost If you began work on or after 1/1/90 you will be subject to graduated eligibility. You will receive a percentage of UC s maximum contribution. Your percentage corresponds to your years of UC service credit. In addition, you will still pay the employee/retiree portion of the cost No  salary banding  all retiree rates are equal to the second band ($46, 001 - $92, 000) with the exception of Medicare coordinated plans0P PP,.Part B Reimbursement #Things to Consider in a Health Plan$$(Your total annual health plan costs: Services that are and are not covered Medicare and UC Health Plan Premiums Deductibles and Co-insurance Include both medical, prescription drugs and behavioral health Factor in your Out-of-Pocket Maximum (OOPM) protection If your co-pays, co-insurance and deductibles paid equal your OOPM, additional care in the plan year for covered expenses is paid at 100% - review the plan for excluded items %h?7 %h?7  Additional Issues to Consider lX Additional Considerations Changing Plans& ..--(*Open Enrollment (OE) When you retire you will continue to have the option to change plans during November Open Enrollment, the change will be effective the first of the following January Move Out of the Service Area/Out of the US If you move out of your plan s service area you will have a  Period of Initial eligibility to switch plans outside of Open Enrollment Process: Call UCOP customer service, alert them of your new address. The rep will mail you a form so you can select a new plan. If the form is returned to UCOP by the 15th of the month, typically the change is effective the first of the following month UCOP Customer Service 1-800-888-8267 PP+PP%PP P+3 R%  ?% (Plan options if you move outside California Blue Cross PPO, High Option Supplement to Medicare, and Core Plan options if you move outside the U.S. for longer than 6 months Blue Cross PPO and Core Will switch to Non-Medicare version of plan Higher premiums, different coverage levels j,=CX! =CX  >$(Additional Considerations Changing Plans))(Use the Medical Plan Wizard to find the medical plans available in your service area You will need a zip code Tool on At Your Service Website Always call the plan for the most current information because service areas are subject to change&UUA'Tips for Planning Ahead(NRead Open Enrollment materials each year to track changes in coverage Stay informed of general developments in Medicare and medical insurance Use your UC online resources for retirees UC  At Your Service Website http://atyourservice.ucop.edu/ UCSF HCF Website http://ucsfhr.ucsf.edu/hcf PP PPPP Sc0fc0 $rXTips for Planning Ahead( Use your Medicare resources www.medicare.gov - Medicare General Information  1-800-633-4227 Social Security  1-800-772-1213 Health Insurance Counseling and Advocacy Program (HICAP)  1-800-434-0222 Still have questions? UC Retiree, Health and Welfare - 1-800-888-8267 Contact Your Health Plan UCSF Health Care Facilitator (HCF) Pgrm  (415) 514-3324 sforstat@hr.ucsf.edu ZZA" Zk0 " Z0 " ZZZZ0 " Z0 " Zc0-pThe End THANK YOU FOR PARTICIPATING! Additional information about Medicare is available on the Health Care Facilitator website at: www.ucsfhr.ucsf.edu/hcf . /79<B      0 ` 6(  ~"  s *8h    8 x  c $8h@.  8 H  0޽h ? 3fffff3̙3f̙___PPT10i.JD+D=' = @B +g 0 ~vP(    s *9h p  9 l<Medicare Coordination with HMO plans (Advantage Plans), 2009==(  s *9h` 9 ~ You select a primary care provider (PCP) to coordinate your care through your medical group You pay a small co-pay when you receive services No need to submit claim forms ]Z Z1Z Z!Z ZZ\Q(H  0޽h ? f;v3ff___PPT10i.0`+D=' = @B +rN[C(# *[1