Retiree Prescription Drug Benefits
Prescription Drug Coverage Options
Retirees and dependents under age 65 who select medical coverage through Penn are automatically covered under Penn’s prescription drug plan through CVS/Caremark. As a CVS/Caremark subscriber, you may fill prescriptions at the pharmacy of your choice. Your prescription drug costs will depend on what type of prescription you get and whether you use retail or mail order.
Retirees and dependents age 65 and over who elect medical coverage through Penn will be automatically covered under the SilverScript Medicare Part D Plan. Members will have the same coverage and services for prescription drugs as in the CVS Caremark plan for those under age 65. All members must be Medicare-eligible with a permanent and valid street address in the U.S. or a U.S. territory.
Some important points to note:
- You cannot enroll in Penn’s prescription plan if you enroll in a non-Penn sponsored Medicare Part D plan.
- Opting out of Penn’s prescription drug coverage is considered permanent unless you meet certain conditions as explained below.
- You will need to provide your Health Information Claim Number (HICN) from your Medicare card.
Based on the medical plan elected, Medicare-eligible retirees and dependents have the following prescription drug coverage options:
| Medical Plan |
Penn's Rx Coverage |
Opt Out of Penn's Rx Coverage |
A Non-Penn Sponsored Medicare Part D Plan |
| Aetna Medicare Plan PPO |
Yes |
Yes |
No |
| Keystone/AmeriHealth 65 Medicare-Advantage Plan (HMO) |
Yes |
Yes |
No |
| Medigap Security 65 Plans |
Yes |
Yes |
Yes |
Opting Out of Penn’s Prescription Drug Coverage
If you’re eligible for and have decided to enroll in a non-Penn sponsored Medicare Part D plan, you must opt out of Penn’s prescription drug coverage. You cannot enroll in Penn’s prescription plan if you enroll in an individual Medicare Part D plan. If this occurs, the Centers for Medicare & Medicaid Services (CMS) will disenroll you from Penn’s prescription coverage.
You also cannot enroll in one of Penn’s Medicare-Advantage plans (HMO and PPO plans) if you elect a non-Penn sponsored Medicare Part D plan. If you do this, CMS will cancel both your medical and prescription coverage as of the date you enrolled in both plans.
Opting out of Penn’s prescription drug coverage is considered permanent. This means you will not be able to obtain this coverage in the future unless Medicare’s change in policy adversely affects your coverage. Under this circumstance, you must notify the Penn Benefits Center immediately.
Medicare Part D
Through Medicare Part D, 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. Changes may be made annually to Medicare Part D deductibles and thresholds. For more information about 2011 Medicare Part D changes, you are encouraged to contact Medicare at 1-800-633-4227 or visit Medicare's website. If you are hearing-impaired, please call 1-877-486-2048.
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.