Healthline member newsletter

Advantage Primetime - Understanding Your Prescription Drug Coverage

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Here are some important prescription drug changes to Capital Health Plan Medicare Advantage plans for 2011.

Capital Health Plan Advantage Plus (HMO)

Capital Health Plan Preferred Advantage (HMO)

There is a new Formulary (list of covered drugs which can change each year). Check your Annual Notices of Changes and Evidence of Coverage for changes in coverage, Tiers, and/or restrictions.

Copayments for Tier 1 generic drugs have been lowered. Check your Annual Notice of Changes and Evidence of Coverage for other changes to copayments/coinsurance.

The initial coverage limit has been raised from $2830 in 2010 to $2840 in 2011.

Members will now generally receive a 50% discount for covered name brand drugs in the coverage gap (donut hole).

There were no changes in catastrophic coverage in 2011.

Capital Health Plan Retiree Advantage (HMO)

 

There is a new Formulary (list of covered drugs which can change each year). Check your Annual Notices of Changes and Evidence of Coverage for changes in coverage, Tiers, and/or restrictions.

Some plans have made copayment changes. Check your Schedule of Retiree Advantage (HMO) Copayments for more details.

 

 

 

 

 

The Formulary and plan specific Annual Notices of Changes and Evidence of Coverage for each plan can be accessed on our website.

What stays the same:

Members still have access to our national network of pharmacies. You can look up network pharmacies on our website. All service area pharmacies are also listed in the Directory of Physicians, Services Providers and Pharmacies. For questions, call Member Services at 850-523-7441 or 1-877-247-6512 (TTY/TDD 850-383-3534 or 1-800-955-8771, 8:00 a.m. to 8:00 p.m., seven days a week. From March 1 through October 15 voice mail is available on weekends and holidays.

Capital Health Plan is a Health Plan with a Medicare contract. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2012.

Advantage Prime Time

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

If Medicare Is in Your Future, Come to One of Our Regular Seminars

At this time of year, many of Capital Health Plan’s large employer groups are holding their annual open enrollments. Capital Health Plan is also preparing for its Medicare annual election and open enrollment periods. It’s time to learn what the CHP Medicare Advantage program—ranked highest in the Southeast by the National Committee for Quality Assurance—offers you. Here’s an overview, with easy ways to get more information. Note: If you are a current CHP member and you become Medicare eligible, you do not need to wait for an open enrollment or annual election period to enroll.

CHP’s Three Medicare Advantage Plans.

Two plans—CHP Advantage Plus and CHP Preferred Advantage—are direct-pay plans open to everyone who (1) has Medicare Part A and Part B; (2) lives in Leon, Gadsden, Jefferson, or Wakulla counties; and (3) does not have End Stage Renal Disease (this restriction does not apply to current CHP members). The third plan is CHP Retiree Advantage. Seventeen of Capital Health Plan’s large-employer groups offer CHP Retiree Advantage to their Medicare-eligible retirees (and their Medicare-eligible dependents). With CHP Retiree Advantage, these individuals can maintain the same CHP health care benefits they enjoyed as active employees.

The Benefits Of CHP Medicare Advantage.

All of our Medicare Advantage plans offer extra benefits, as well as covering all parts of Medicare.

  • CHP coordination of all of your Medicare coverage.
  • Automatic enrollment in a Medicare Part D (prescription drug) plan.
  • No need for enrollment in a Medicare Supplemental or Medigap plan.
  • A network of over 300 physicians who accept CHP Medicare Advantage.
  • Emergencies covered anywhere in the world so you can enjoy worry-free travel.
  • The same high-quality and cost-effective care that all CHP members receive.
  • An eyeglass benefit of up to $150 every two years.
  • Reimbursement of up to $150 yearly for health and fitness fees.
  • Annual hearing exams.
  • Personal and online services such as CHPConnect and CHP Health Coaching.

Capital Health Plan is a health plan with a Medicare contract. Benefits, formulary, pharmacy, network, premium, and copayments/coinsurance may change each contract year. Contact Capital Health Plan for details.

Find Out More about CHP Medicare Advantage FREE Seminars

CHP Advantage Plus and Preferred Advantage: Second and fourth Friday of every month
CHP Retiree Advantage: Second and fourth Wednesday of every month
Time and place: 10 a.m., Governor’s Square Health Center
Reservations: 850-523-7333
Information: Please call member services at 850-523-7441 or 1-877-247-6512 (TTY users 850-383-3534 or 1-800-955-8771), 8:00 a.m. to 8:00 p.m., seven days a week.

Advantage Prime Time

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

If Medicare Is in Your Future, Come to One of Our Regular Seminars

Please note: CHP Medicare Advantage Plans do not have a cap on occupational therapy, physical therapy, or speech/language therapy.

You may have heard that original Medicare will have a $1,810 cap on these therapies in 2008, but this will not affect you if you are enrolled in a CHP Medicare Advantage plan. Please call Member Services if you have questions at 877-247-6512 or 850-523-7441 (TTY 850-383-3534 or 800-955-8771), seven days a week, 8 a.m. – 8 p.m. Capital Health Plan is a health plan with a Medicare contract.

Are you approaching age 65 or retirement? Do you have questions about Medicare? Capital Health Plan regularly offers seminars for our members to learn the basics of Medicare, get answers to questions, and review the options in CHP Medicare Advantage plans.

Our Medicare Advantage program—ranked highest in the Southeast by the National Committee for Quality Assurance in U.S. News & World Report, “America’s Best Health Plans 2007TM”—covers all parts of Medicare including Part D (prescription drug benefit), offers extra benefits, and costs less than many Medicare supplemental plans. The program has three options.

CHP Preferred Advantage includes coverage of generic prescription drugs throughout the year, even during the government’s coverage gap (known as the “doughnut hole”).

CHP Advantage Plus is our original, popular Medicare plan. It carries a lower premium than CHP Preferred Advantage but does not include coverage of generic drugs during the gap.

CHP Retiree Advantage is sponsored by some employers. Through these plans, Medicare-eligible retirees continue their employer group health plan, including the group copayments and unlimited drug coverage with no gap.

Medicare Information Seminar Schedule
Members Eligible for CHP Retiree Advantage: Second and fourth Wednesday of every month
All Other CHP Members: Second and fourth Friday of every month
Time and place: 10 a.m., Governor’s Square Health Center
Telephone: 850-523-7441or 1-877-247-6512;
TTY/TDD 850-383-3534 or 1-800-955-8771,
8 a.m. to 8 p.m., seven days a week