Questions and answers for retired STATE participants
covered under the State's Group Health Insurance Program
What is Medicare Part D?
It is a new prescription drug benefit program created by the federal
government. Enrollment in Medicare Part D coverage through approved
prescription drug plans begins November 15, 2005, for coverage effective
January 1, 2006.
I have prescription drug coverage through the state's group health
insurance program. Should I enroll in a Medicare Part D prescription
drug plan when I become eligible?
We recommend against it. Keep in mind you are already paying for
and receiving comprehensive prescription drug coverage through the
state's group health insurance program. Your current drug coverage,
administered through Navitus Health Solutions, is "creditable coverage"
in comparison to the Medicare Part D prescription drug benefit.
This will allow you to defer enrollment in Part D without penalty.
Nevertheless, you should carefully consider all options before making
any kind of enrollment decision. Participation in Medicare Part
D is voluntary. If you would like to maintain your current level
of prescription drug benefits under our program, it is not necessary
to enroll in Medicare Part D at this time.
How will this change affect me?
The impact on retirees eligible for or enrolled in Medicare is expected
to be minimal, and virtually seamless. If you are not lower income
and thus not eligible for extra financial help from Medicare, and
the drugs you take now are typically covered by your retiree prescription
drug coverage, you will generally pay less out of pocket costs for
drugs if you do not join a Medicare drug plan. And best of all,
you can keep your coverage without doing anything new. No paperwork
needs to be filled out.
Will my state health insurance premium go down if I enroll in
a Medicare Part D prescription drug plan?
No. The 2006 health insurance premium printed in the 2006 It's
Your Choice booklet (ET-2108 rev. 10/05) includes both medical
and prescription drug coverage and is already reduced to account
for the Medicare drug subsidy. If you enroll in a Medicare prescription
drug plan, you will continue to pay the same premium in addition
to paying the Part D premium for the Medicare prescription drug
plan you choose. You may also have to manually submit claims to
Navitus if you choose to enroll in a Medicare Part D plan.
Will Medicare penalize me if I do not enroll in Medicare Part
D?
No. Because coverage through the State of Wisconsin Group Health
Insurance Program is, on average, as good as if not better than
the standard Medicare prescription drug coverage, you will not have
to pay a penalty if you enroll later. The certificate of creditable
coverage is located in your 2006 It's Your Choice booklet, pages
B-10 and B-11.
Where can I get more information about how my pharmacy benefits
are affected by the Medicare Part D program?
Information is available in the 2006 It's Your Choice booklet,
in the September edition of the It's Your Benefit Newsletter,
and on the Department Internet site. The Department also mailed
letters to state retirees in September explaining how pharmacy benefits
are affected by Medicare Part D.
Other resources for you include the following:
Navitus Customer Service
Phone toll free: 1-866-333 -2757
Regular Hours: 7 a.m. - 9 p.m. CST, Monday through Friday
Holiday Hours: 8:30a.m. - 5 p.m. CST (Closed Thanksgiving and Christmas
Day)
Department of Employee Trust Funds
Phone toll free: 1-877-533-5020
Local Madison: (608)266-3285
Prescription Drug Helpline
Phone toll free: 1-866-456-8211 Monday through Friday
Medigap Helpline
Phone toll free: 1-800-242-1060 (leave a message)
Wisconsin Coalition for Advocacy
Information and resources for Medicare beneficiaries who receive
disability benefits.
Phone toll free: 1-800-926-4862, Monday through Friday
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