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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2018 Local Deductible Health Plan Insurance Program
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2018 It's Your Choice - Local Deductible Health Plan Insurance for Employees and Retirees
Wisconsin Department Of Employee Trust Funds It's Your Choice 2018


Local Deductible Plan
Insurance for Employees
and Retirees
(PO4, PO14)


IYC Medicare Plus

Administered by WEA Trust
1-866-485-0630
weatruststatehealthplan.com

Open Enrollment October 2 – 27, 2017

If you are currently enrolled in IYC Medicare Plus and do not wish to change plans during open enrollment, you will automatically be enrolled in IYC Medicare Plus for 2018.

What’s New for 2018

WEA Trust is the new administrator of IYC Medicare Plus. If you are currently enrolled in the IYC Medicare Plus and take no action to change health plans during It’s Your Choice, you will be automatically enrolled with WEA Trust and will receive new ID cards in the mail prior to January 1, 2018. There are no benefit changes in 2018, unless initiated by Medicare.

General Information

IYC Medicare Plus will continue to be a Medicare supplement plan for eligible annuitants and their dependents who select the IYC Access Plan and the State Maintenance Plan (SMP).

IYC Medicare Plus will pay your Medicare Part A and B deductibles and coinsurance. This group plan is superior to individual Medicare supplements as it provides protections from fees that exceed usual, customary and reasonable amounts if members use a provider who is not affiliated with Medicare. It also offers coverage during foreign travel. Note, however, in cases where Medicare excludes coverage for a service, this plan will also deny coverage.

The IYC Medicare Plus plan is designed to supplement, not duplicate, the benefits available under Medicare for State and Local Group Health Insurance Program annuitants.

See the Comparison of Benefit Options online for more details and the Certificate of Coverage for complete information.

Provider Directory

None. This plan provides you with freedom of choice among hospitals and physicians in Wisconsin, nationwide and for travel abroad. When receiving services for non-Medicare benefits covered by this plan, please use providers from the WEA Trust Preferred Network or through our out-of-state network. Each of those networks can be accessed at weatruststatehealthplan.com/providers.

Referrals, Prior Authorizations

Referrals and prior authorizations are not necessary under this plan as benefits only supplement approved Medicare benefits.

Service Area

IYC Medicare Plus offers health systems and providers who accept Medicare assignment both statewide and nationwide. It includes a foreign travel rider.

Mental, Behavioral Health and Substance Abuse

Medically necessary services are available when performed by licensed mental health professionals practicing within the scope of their license. Inpatient services will be limited to 120 days.No prior authorization is required for outpatient services from a network provider, except for psychiatric and neuropsychiatric testing. Prior authorization is required for in-patient and transitional care. For other services, contact 1-866-485-0630.

24-Hour Nurseline

WEA Trust contracts with a variety of health care provider systems that offer their own nurselines. A list of those nurselines can be found at weatruststatehealthplan.com/nurseline.

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 9/21/2017 2:18:37 PM