ADDITIONAL MEDICARE SUPPLEMENT
AND PART D PLAN CHOICES AVAILABLE

 

Dear Medicare Eligible Retiree and/or Dependent,

The accompanying enrollment and educational guide is a follow up to Baltimore County’s announcement of offering additional Medicare Medical Supplement and Part D Prescription Drug Plan choices beginning January 1, 2018.

The County has partnered with Labor First, a Retiree Benefit Administrator and Advocacy Company that specializes in retiree healthcare, to help the County’s Medicare eligible retirees and their Medicare eligible dependents evaluate additional choices on an individual retiree basis to see if they are right for you.

THE COUNTY’S CURRENT MEDICARE AND NON-MEDICARE PLANS WILL CONTINUE TO BE AVAILABLE TO ALL ELIGIBLE RETIREES AND THEIR DEPENDENTS.

Your Selection is Annual- If you choose to enroll in a Labor First plan and are dissatisfied, you may return to a County sponsored Medicare Supplemental and/or Part D Prescription Plan during the next Open Enrollment.

As previously announced, credits are being offered to offset the plan cost.  Please refer to the rate information provided in your packet from Baltimore County to determine the amount of the credit available to you.  If you decide to enroll in a plan through Labor First, the County will credit your monthly Pension Check up to $130 (member)/ $65 (Spouse) toward the premium of the Medicare Supplemental plan of your choice and up to $30 (member)/ $15 (Spouse) toward the Part D Prescription Drug Plan of your choice. Credits are based on your date of retirement and years of service. This means that depending on the plan(s) that you select and the amount of your Pension Check credit(s), your premiums may be covered by more than 100%.

In the following pages, you will find abbreviated benefit summaries. There are two (2) Medicare Medical Supplement alternatives, insured by United American Insurance Company (UA). UA has been in business since 1947 and specializing in Medicare since 1966.

In addition, there are five (5) alternative Medicare Prescription Drug Plans (PDP) at various price points and benefit coverage levels. Three (3) of the plans are AARP® MedicareRx insured by UnitedHealthcare® and two (2) of the plans are being offered through Express Scripts, Inc (ESI).

We encourage you to speak with a Labor First Advocate as there could be annual savings (premium + co-pays) for many of you.

Sincerely,

Labor First

MEDICAL:  MEDICARE SUPPLEMENT BENEFIT SUMMARY

 

Health Benefits

Summary

Baltimore County Government Cigna Member Pays Labor First High Option Member Pays Labor First Low Option Member Pays
2018 Plan Premium (PMPM) $200.53 $168.00 $115.00
County Contribution or Pension Credit * ($150.40) ($130.00) ($130.00)
Retiree Net Cost with Maximum Credit $50.13 $38.00 ($15.00)
Deductible Part A: $0
Part B: $0
Part A: $0
Part B: $183
Part A: $0
Part B $1,500
Inpatient Hospital / Facility Services $0 days 1-60.
20% after day 60
$0 $0
Inpatient Professional / Practitioner Services $0 $0 $0
Organ Transplants $0 $0 $0
Emergency Care $0 20% $50
Office Visit 20% 20% $20
Outpatient Hospital / Facility Services $0 20% $0
Outpatient / Office Professional Services $0 20% $20
Preventative: Well Care / Diagnostic Testing / Mammogram & PSA Testing Covered in Full by Medicare Covered in Full by Medicare Covered in Full by Medicare
Radiation Chemo Therapy & Renal Dialysis $0 20% $0
Acupuncture 20% Not Covered Not Covered
Chiropractic 20% 20% $0
Durable Medical Equipment /

Prosthetic Devices & Ortho Braces

20% 20% $0
Mental Health $0 20% $0
Home Health Care Covered in Full by Medicare Covered in Full by Medicare Covered in Full by Medicare
Skilled Nursing Days 1-20: Covered in full by Medicare, Days 21-100 $0 Days 1-20: Covered in full by Medicare, Days 21-100 $0 Days 1-20: Covered in full by Medicare, Days 21-100 $0
Out-of-Pocket Maximum (OOPM) $2,000 $2,000 $1,500
Ancillary Benefit Coverage
Hearing Benefits Not Covered 30%-60% savings provided off MSRP 30%-60% savings provided off MSRP
Vision Benefits Not Covered 100% balance for eye exam (1) per calendar year; Discounted Frames, Lenses, Contacts and Lasik 100% balance for eye exam (1) per calendar year; Discounted Frames, Lenses, Contacts and Lasik
Dental Benefits Not Covered Not Covered Not Covered

*Example based on Maximum Retiree Credit

FOREIGN TRAVEL EMERGENCY COVERAGE: Emergency care outside U.S.: Covered at 80% coinsurance of the billed charges after a $250 deductible annually. Maximum $50K Lifetime

MEDICAL NETWORK:  PLAN ACCEPTED NATIONALLY AT ANY PROVIDER / FACILITY THAT ACCEPTS MEDICARE

PHARMACY:  PRESCRIPTION DRUG BENEFIT SUMMARY

 

Health Benefits Summary
Baltimore County Government Cigna Rx

 

AARP®
MedicareRx Walgreens (PDP) **
AARP®
MedicareRx Saver Plus (PDP) **
AARP®
MedicareRx Preferred (PDP) **
ESI Low Option ESI High Option
2018 Plan Premium (PMPM) $202.01 $26.80 $28.90 $76.50 $66.90 $90.80
County Contribution or Pension Credit * ($150.77) ($30.00) ($30.00) ($30.00) ($30.00) ($30.00)
Retiree Net Cost with Maximum Credit $50.25 ($3.20) ($1.10) $46.50 $36.90 $60.80
Annual Deductible  $100 $0 for Generic,
$405 for Brand
 $405  $0  $405  $150
Preferred Retail 30 Day 30 Day 30 Day 30 Day 30 Day 30 Day
Preferred Generic 20% $0 $1 $7 $5 $5
Generic 20% $6 $5 $12 $5 $5
Preferred Brand 30% $31 $34 $37 30% $65
Non-Preferred Brand 30% 32% 41% 40% 30% $80
Specialty 30% 25% 25% 33% 25% 25%
Mail Order 90 Day 90 Day 90 Day 90 Day 90 Day 90 Day
Preferred Generic 20% $0 $0 $0 $12.50 $12.50
Generic 20% $18 $0 $0 $12.50 $12.50
Preferred Brand 30% $93 $97 $96 30% $162.50
Non-Preferred Brand 30% 32% 41% 40% 30% $200
Specialty 30% 25% 25% 33% N/A N/A
Coverage Gap Full Coverage CMS
Minimum
CMS
Minimum
CMS
Minimum
Full Coverage Full Coverage
Catastrophic Coverage Standard Standard Standard Standard Custom Custom
 

This is a summary overview of benefits. For more detailed information on AARP® plans please refer to included booklets. For ESI please refer to ESI Handout.

*Example Based on Maximum Retiree Credit
**Rates vary by state of residence. All rates listed below above based on Maryland residence. If you reside in a different state, please call Labor First for accurate pricing.

COVERGE GAP:

CMS MINIMUM: After $3,750 of drug spend, you will pay 35% of the plan cost for Brand Drugs and 44% of the plan cost for Generic Drugs

FULL COVERAGE: You pay the same copay as the initial coverage phase.

CATASTROPHIC COVERAGE:

STANDARD: After True Out-Of-Pocket reaches $5,000, you will pay the greater of 5% or $3.35 for generics or $8.35 for all other medications.

CUSTOM: After True Out-Of-Pocket reaches $5,000, you will pay the greater of 5% or $3.35 for generics or $8.35 for all other medications not to exceed the copay in the initial coverage phase.

FREQUENTLY ASKED QUESTIONS

Who is Labor First?

Labor First is a Retiree Benefits Administrator and Advocacy Company that specializes in retiree healthcare. Our dedicated Member Advocates are here to not only assist members with enrollment, but to provide ongoing retiree support to Baltimore County Retirees throughout their enrollment in any of our plans.

1. What to have with you when speaking with a Member Advocate, in person or over the phone?
1.Medicare Card
2.List of Medications
3.Full Enrollment guide and applications

2. Do the Medicare Supplemental plans offered by Labor First have a special Physician/Provider Network?
No.  The Medicare Supplemental plans offered by Labor First are accepted by any facility or physician that accepts the Medicare assignment. Additionally, referrals are not required under the United American (UA) Plans.

3. Do I still need my Medicare Card?
Yes, Medicare will continue to be your Primary Insurance.  You will need to show your provider your Medicare card and your UA card at the hospital and doctor’s visits. The claim will automatically be processed by Medicare and UA. You will receive an Explanation of Benefits (EOB) from both.

4. How do I know which Medical plan to choose?
Based on your Doctor utilization one of the two plan options may be more suited to your needs. It will be beneficial to speak with a Retiree Advocate to go over both plan options, please call 410-431-2226 (TTY 711) to discuss plan options or to schedule an Individual Appointment.

5. Are my drugs covered?
Most likely yes. Please have your current list of medications available.  Our Retiree Advocates can review your information and provide prescription plan options that best meet your needs and budget.

6. Can I go to the same Pharmacy?
Most likely yes. There should be little to no pharmacy disruption. You do NOT need new prescriptions for retail pharmacy fills. However, you will see the most cost savings using the preferred retail pharmacies for the prescription plan that you choose.

7. Is there a Mail Order Pharmacy?
Yes, but you will need new prescriptions if you prefer to use the Mail Order Service.

8. I am a Veteran and I purchase my prescriptions from the VA, can I still go to the VA for my drugs?
Yes.

9. Will my mail order prescriptions transfer from the old plan?
No, you will need to obtain all new scripts from your Provider if you are using Mail Order.  If you use a retail Pharmacy you do not need new prescriptions.

10. Do I need Prior Authorizations for certain prescription medicines?
Yes. Some drugs require Prior Authorizations or may have quantity limits. This is standard in all Medicare type part D plans. Please contact Labor First if you have questions at (410) 431-2226 or Toll Free (855) 499-2656 (TTY 711).

11. When will I receive my card/ Welcome Kit?
Cards and Welcome Kits should be received around Mid-Late December based on your enrollment date. Members and covered Spouses/Medicare Eligible Dependents will each receive separate welcome kit and ID cards. UA Medicare supplement packets, AARP® MedicareRx packets and ESI Rx packets are mailed separately and at different times.

12. Will my premium change?
Yes. Premiums change on a yearly basis every January. Since the two UA Medicare Supplement Plans and the two ESI Rx plans are group rated plans the increases tend to be smaller than seen in individual plans. The three AARP options are individual plans and subject to the annual CMS regulated changes for 2019.

13. Is this information available online?
Yes, for additional information and enrollment instructions visit www.laborfirst.com/baltimorecounty.

14. May I elect to enroll in a Medicare Supplemental plan from Baltimore County and a Prescription plan offered by Labor First, and vice versa?
Yes, you may mix and match the coverage to best meet your needs and budget.

15. If I choose a plan offered by Labor First, can my spouse remain on the Baltimore County Plans, and vice versa?
Yes, you and your spouse/dependents can mix and match the coverage that best meets your needs.

       Application Forms                        Formularies

 Baltimore ESI Application 2018                                                 2018 ESI Formulary
                   Baltimore UA Application                                                            AARP® MedicareRx Preferred
                    AARP Preferred/Saver Application                                             AARP® MedicareRx Saver Plus
                   AARP Walgreens Application                                                      AARP® MedicareRx Walgreens
Baltimore Enrollment Guide 

GROUP INFORMATION SESSIONS

Date Location Time
10/11/17 CCBC-Dundalk 10am-1:30PM
10/17/17 Corrections 7-9am & 1:30-3:30PM
10/18/17 Historic Courthouse 10am-2pm
10/19/17 Fire Union Hall 10am-2pm
10/20/17 Oregon Ridge 10am-2pm
10/24/17 Public Safety Building 10am-2pm
10/25/17 Historic Courthouse 10am-2pm
11/02/17 Public Safety Building 10am-2pm
11/03/17 Historic Courthouse 10am-2pm
11/08/17 Oregon Ridge 10am-2pm
11/15/17 Oregon Ridge 10am-2pm
Historic Court House:  400 Washington Avenue, Towson, MD 21204
Oregon Ridge: 13401 Beaver Dam Road, Cockeysville, MD 21030
CCBC Dundalk Campus: 7200 Sollers Point Road, Dundalk, MD 21222
Fire Union Hall: 52 Scott Adam Road, Cockeysville, MD 21030
Public Safety Building: 700 E. Joppa Road, Towson, MD 21286
Baltimore County Detention Center:  720 Bosley Avenue, Towson, MD 21204

Group Presentations

In addition to individual appointments, Labor First will also be holding group presentations at 10am, 11am and 1pm on the dates listed above (No presentation at Fire Union Hall).  These presentations will provide you with a brief overview of the plans offered through Labor First.  No appointment necessary.

 

FOR MORE INFORMATION ABOUT MEETINGS OR TO SCHEDULE A FACE TO FACE APPOINTMENT DURING ONE OF THESE MEETINGS PLEASE CALL LABOR FIRST AT (410) 431-2226 OR TOLL FREE (855) 499-2656 (TTY 711)