Retiree Prescription Drug Benefits
Medicare Part D
Medicare Part D was introduced effective January 1, 2006. Through this plan, Medicare beneficiaries have access to prescription drug benefits administered by private companies such as health insurers. Beneficiaries can get the prescription drug benefit in one of two ways: (1) as a separate policy for prescription drugs, or (2) as part of private health plans that also provide overall medical coverage. Similar to Medicare Part B, there is a monthly premium for Medicare Part D. You are encouraged to compare Penn’s prescription drug coverage to Medicare Part D and determine which plan would best meet your needs. Due to inflation, changes will be made annually to Medicare Part D deductibles and thresholds. For more information about 2008 Medicare Part D changes, you are encouraged to contact Medicare at 1-800-633-4227 or visit www.medicare.gov. If you are hearing-impaired, please call 1-877-486-2048.
The prescription drug program offered by Penn to Medicare-eligible individuals meets CMS’s creditable coverage definition. This means that you will be able to enroll in Medicare Part D during future Medicare enrollment periods without a penalty if you choose to discontinue your Penn coverage as long as you present this certificate when you enroll. For more details on creditable coverage, you can call Medicare at 1-800-633-4227 or visit www.medicare.gov. If you are hearing-impaired, call 1-877-486-2048.
Prescription Drug Coverage Options (Medicare-Eligible Retirees/Dependents)
Retirees and dependents age 65 and over or under age 65 and Medicare-eligible who elect medical coverage through Penn have a choice when it comes to prescription drug coverage. Generally, you can choose among three options: 1) elect Penn's prescription drug coverage through Caremark [pdf], 2) waive Penn's prescription drug coverage, or 3) elect Medicare Part D.
Some important points to note:
- If you elect the Keystone/AmeriHealth 65 HMO or Aetna Golden Choice PPO, you cannot elect Medicare Part D.
- You cannot enroll in both Penn's prescription drug plan and Medicare Part D.
- Waiving Penn's prescription drug coverage is considered permanent.
Based on the medical plan elected, Medicare-eligible retirees and dependents have the following prescription drug coverage options:
| Medical Plan |
Penn's Rx Coverage |
Waive Penn's Rx Coverage |
Medicare Part D |
| Aetna Golden Choice PPO |
Yes |
Yes |
No |
| Keystone/AmeriHealth 65 Medicare-Advantage Plan |
Yes |
Yes |
No |
| Independence Blue Cross 65 Special Plan |
Yes |
Yes |
Yes |
| Aetna Indemnity Plan |
Yes |
Yes |
Yes |
Medicare-Advantage (HMO & PPO) Plans
Regulations issued by the Centers for Medicare & Medicaid Services (CMS) state that you cannot elect Medicare Part D if you enroll in a Medicare-Advantage plan. If you enroll in the Keystone/AmeriHealth 65 HMO or the Aetna Golden Choice PPO and you enroll in a Medicare Part D prescription plan, CMS will cancel your medical coverage retroactive to the date you were enrolled in both plans.
Waiving Penn's Prescription Drug Coverage
If you are eligible for and have decided to enroll in Medicare Part D, you must select the Waive box for prescription drug coverage on the Retiree Health Enrollment Form [pdf] and return it to Retiree Assist. You cannot have coverage under both Penn's prescription plan and Medicare Part D. If this occurs, Penn will be notified by the Centers for Medicare & Medicaid Services (CMS) and will disenroll you from Penn's prescription drug coverage.
Waiving Penn's prescription drug coverage is considered permanent. This means you will not be able to obtain this coverage in the future unless a change in Medicare's policy adversely affects your coverage. If this happens, you must notify Retiree Assist immediately.
Split Family Coverage
Split family coverage occurs when one person is under age 65 (not eligible for Medicare) and enrolled in an under age 65 medical plan, and one person is age 65 and older and enrolled in a Medicare-eligible plan for retirees. Certain rules apply:
- Retiree under age 65 / Dependent age 65 and older — If the retiree enrolls in Penn's medical coverage, prescription drug coverage is automatically provided through Penn. The dependent must also enroll in Penn's prescription drug plan even though he/she is eligible for Medicare Part D.
- Retiree age 65 and older / Dependent under age 65 — If the retiree elects not to enroll in Penn's prescription drug coverage, the dependent can remain covered under Penn's prescription drug plan only until he/she reaches Medicare-eligible age.