Notice to Medicare Eligible Participants
Creditable CoverageThe following letters were mailed last month to pensioners covered under the Seafarers Health and Benefits Plan from the SHBP Board of Trustees. Please note that separate information was mailed to Marine Cooks & Stewards pensioners who were covered under the MC&S Welfare Plan before that union merged into the SIU in 1979 and who also retired before the merger.
November 9, 2005
Dear Medicare Eligible Participant:
You may have heard about Medicare’s new prescription drug coverage, also known as Medicare Part D, and wondered what this new coverage might mean to you. Starting January 1, 2006, the Federal Government will be providing limited prescription drug coverage to retirees eligible for Medicare.
Seafarers Health and Benefits Plan (SHBP) is pleased to inform you that the current prescription drug coverage you have now with SHBP is superior coverage to the standard Medicare Part D prescription drug plan. Since the prescription drug benefit provided by SHBP provides you with better coverage than the coverage offered under Medicare Part D, this means that SHBP provides you with “creditable prescription drug coverage.”
Enclosed is your notice of creditable coverage which the government requires us to send to you. Be sure to read the notice carefully and keep it in a safe place where you can find it. It may be necessary to refer back to the notice should you decide to change your pharmacy benefit coverage in the future.
To maintain coverage through SHBP, you do not need to take any action. The SHBP will continue your coverage at no cost to you, other than the applicable co-payments and annual deductible.
In order to maintain the coverage that you currently enjoy through SHBP, you should not enroll in any Medicare prescription plan offered through other insurance companies licensed to sell these plans. If you enroll in one of the Medicare prescription drug plans, you may lose your coverage under the SHBP prescription plan. In addition, you may have to provide the insurance company with a copy of this notice to prevent them from charging you a higher premium than what other enrollees pay.
Again, no action is required by you to maintain your coverage through SHBP. If you have any questions concerning your SHBP prescription drug plan and Medicare Part D, please call the Plan’s membership services line at 1-800-252-4674.
Sincerely,
BOARD OF TRUSTEES
Important Notice from the Seafarers Health and Benefits Plan About Your Prescription Drug Coverage and Medicare
Creditable Coverage
November 9, 2005
Dear Plan Participant,
By now you may have heard about Medicare’s new prescription drug coverage. This letter will provide a description of your options for pharmacy benefit coverage after January 1, 2006. This letter will also tell you where to find more information to help you make decisions about your prescription drug coverage. The Seafarers Health and Benefits Plan (SHBP) is sending this letter to retired participants to make sure that retirees understand what options are available.
This notice provides plan participants with important information. Please read this notice carefully. It can help you decide whether or not you want to enroll in Medicare’s new Part D program.
Please keep this notice in a safe place. It may be necessary to refer back to this letter should you decide to change your pharmacy benefit coverage in the future.
What is Medicare Part D?
Medicare Part D is a new benefit for all individuals entitled to Medicare. Medicare currently provides eligible individuals coverage for hospitalization and doctors visits under Medicare Parts A and B. After January 1, 2006, Medicare Part D will provide Medicare recipients with a certain amount of pharmaceutical benefit coverage as well. This new program means that Seafarers retirees and others eligible for Medicare now have a choice. You can choose to keep pharmacy benefits from the SHBP or you can pay to join another plan serving your area.
How will Medicare Part D affect my Seafarers’ pharmacy benefits?
SHBP would like all participants to know that the Plan’s drug benefit is, on average, expected to provide a benefit that is as good as what would be available to you in the standard Medicare Part D prescription drug plan.
If you choose to stay in the SHBP, you do not have to take any other action. You pay the same co-payments and deductibles in effect at this time. Currently, there is no insurance premium to pay as there will be for the new Medicare pharmaceutical plans. A summary of your prescription coverage under the SHBP is attached to this letter. You will not need to go through any additional enrollment process if you choose to stay in the SHBP. There will also be deductibles and co-payments in the Medicare plans which will be offered in your area.
If you continue to receive pharmacy benefit coverage through the SHPB and decide to switch to another plan in the future, there will be no additional penalty to enroll in a Medicare prescription drug plan.
Since spouses do not receive benefits from the SHBP, they should seek information from any employer sponsored coverage they may have or enroll in a Medicare Part D plan.
What happens to my Seafarers’ prescription drug coverage if I enroll in a Medicare Part D prescription drug plan?
This year, if you enroll in a Medicare Part D prescription drug plan, you will lose prescription drug coverage from the SHBP. You will still be eligible for other benefits available from the plan if you are retired with enough eligibility time for medical health care coverage.
When do I have to make a decision about which coverage I want?
Everyone entitled to enroll in the new Medicare Part D must do so between November 15, 2005 and May 15, 2006. Once again, if you choose to continue to receive benefits from the Seafarers Plan, you do not need to do anything.
What happens if I choose to enroll in a Medicare part D plan but do not make a decision to participate by May 15, 2006?
If you wish to enroll in a Medicare prescription drug plan but do not take action for 63 days or longer after May 15, 2006 you will have to pay an increase in the monthly premium that will be charged for your Medicare prescription plan. That increase will be 1% per month of the premium charged by the plan. You will have to pay this increased premium for as long as you have Medicare prescription drug coverage. You may also have to wait until November 2006 to enroll.
If I choose to remain in the SHBP this year, may I switch plans in the future?
Yes, you may choose to switch to a Medicare part D prescription drug plan in the future.
You may do so without paying a higher premium as long as you provide that new plan with this document to prove that you have had coverage by another plan that was as good as the benefit offered by the standard Medicare plan.
If you do decide to choose coverage under Medicare Part D, you must make sure that your Seafarers benefit will remain in effect until you are new coverage becomes effective.
As in all cases, the SHBP reserves the right to modify benefits at any time, in accordance with applicable law.
How can I get more information about this notice or my current pharmacy benefit coverage?
To receive another copy of this notice, you may contact the Plan’s membership services at 1800-252-4674. If you have questions about the current Seafarers prescription plan coverage, you may contact Express Scripts at 1-800-467-2006. You may receive this notice at other times in the future such as before the next enrollment period for Medicare prescription coverage or if this coverage changes.
Is there any help if I am on a limited income and need extra resources?
For people with limited income and resources, extra help paying for the Medicare prescription drug plan is available. Information about this extra help is available from the Social Security Administration (SSA). For more information about this extra help, contact SSA by calling 1-800-772-1213. For TTY call 1-800-325-0778.
How can I learn more information about my options under the Medicare Part D prescription drug program?
More detailed information about Medicare plans that offer prescription drug coverage will be available to you in a publication entitled the Medicare and You 2006 handbook. You will be receiving this handbook in the mail from Medicare. You may also be contacted directly by Medicare prescription drug plans offered in your area. You can also get more information about Medicare prescription drug plans by contacting the following sources:
- Medicare’s web site: www.medicare.gov
- Medicare’s telephone number: 1-800-633-4227. TTY users should call 1-877-486-2048.
- Your state health insurance assistance program. These programs are listed in the phonebook and will be listed in the Medicare handbook.
Once again, we provide this information to you in accordance with federal government requirements.
Sincerely,
BOARD OF TRUSTEES
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