Because you will be choosing coverage that coordinates with Medicare, it’s good to become familiar with what Medicare offers. To decide how to best supplement Medicare you should take into consideration your budget and the extent of coverage you feel comfortable with. The cost of the supplement(s) you choose is one of the expenses you may submit to your HRA for reimbursement.
* The Medicare information provided is intended as a general summary. For more information, please call 1-800-MEDICARE, visit www.Medicare.gov , or refer to the “Medicare and You” book provided to you each year.
Original Medicare consists of Part A and Part B. As a retiree, when you reach age 65 and qualify for Medicare, you automatically receive Part A and become eligible for Part B.
Provides you with inpatient care and covers inpatient hospital stays, home health care, stays in skilled nursing facilities, and hospice care. Provided at no cost.
Provides you with outpatient care, and covers physician fees and other medical services not requiring hospitalization. To enroll, contact your Social Security office and keep your Medicare A&B card when it arrives in the mail. You pay a monthly premium.
The ORNL Rx plan, provided by Express Scripts, is included when you enroll in a medical plan with Via Benefits. ORNL Rx coverage is an enhanced Medicare Part D plan which exceeds the level of coverage provided by a standard Medicare Part D prescription drug plan or a Medicare Advantage prescription drug (MAPD) plan.
Original Medicare pays for many, but not all, health care services and supplies. A Medicare Supplement Insurance policy can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.
Medigap plans are “standardized” policies identified in most states by letters A-N. All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. Different insurance companies may charge different premiums for the same exact policy. As you shop for a policy, be sure you’re comparing the same policy (for example, compare Plan A from one company with Plan A from another company). Medigap SELECT policies, if available in your area, require you to use a network of hospitals, doctors and other health care providers to get full coverage.
Medicare Advantage (MA) plans often include a drug plan with limited coverage and, due to CMS rules, very few plans are available that coordinate with the ORNL Prescription drug coverage. In addition, some physicians do not accept these plans. Generally speaking, they are only available to ORNL retirees who live in a rural area. Via Benefits will help determine if a MA plan is available for you.
Via Benefits offers separate dental and vision plans. The plans are not sponsored or supplemented by ORNL and enrollment is optional.
You may combine the supplemental plans above to create a package of plans that covers all of your needs. Choosing the best combination requires some education and some comparison of plan features and costs. Via Benefits benefit advisors have the experience and knowledge to help. They can determine which plans are available to you and help you choose the best options.