Who Does The New Medicare Advantage Program Apply To
The changes to retiree health care plans only apply to SERS and SURS annuitants and their covered dependents who are enrolled in Medicare Parts A& B and reside in the United States. Also, in order to transition to the new plans ALL your covered dependents must be enrolled Medicare eligible. So, if you are 66 and your spouse is 60, neither of you will transition onto the new plans until your spouse is 65.
Unitedhealthcare And Humana Have Consistently Accounted For A Large Share Of Medicare Advantage Enrollment
UnitedHealthcare has had the largest share of Medicare Advantage enrollment since 2010. Its share of Medicare Advantage enrollment has grown from 19 percent in 2010 to 27 percent in 2021. Humana has also had a high share of Medicare Advantage enrollment, though its share of enrollment has grown more slowly, from 16 percent in 2010 to 18 percent in 2021. BCBS plans share of enrollment has moderately declined over the years, initially rising from 15 percent in 2010 to 17 percent in 2011, but then declining to 14 percent in 2021. CVS Health, which purchased Aetna in 2018, has seen its share of enrollment nearly double from 6 percent in 2010 to 11 percent in 2021. Kaiser Permanente has seen its share of enrollment moderately decline, from 9% in 2010 to 7% in 2021. The largest decline has been for all other insurers , which has dropped from 26 percent in 2010 to 17 percent in 2021.
Metropolitan Water Reclamation District Retiree Health Care Plans
General Information
Below is general information regarding the Districts Retiree Health Care Plans offered to qualified District retirees and their dependents. This is for general information only. If a conflict shall arise between this information and the Districts Plan Documents or information supplied by the providers of the Plans, the latter shall supersede.
Availability
The District Board of Commissioners offer these Plans annually at their sole discretion. Membership in the Retirement Fund has no correlation with the availability of Plans sponsored by the District.
Eligibility
Retirees and their dependents who meet the criteria under the District’s eligibility policy may enroll. For the current eligibility policy, click here.
Medicare Eligible – UnitedHealthcare Medicare Advantage Plan with Part D Non-Medicare Eligible – Blue Cross Blue Shield PPO or *Blue Cross Blue Shield HMO Illinois
* Must live in Illinois
Please refer to the comparison chart.
| $418.72 |
* Must have Parts A and B to qualify for the MAPD plan.
There may be tax implications for annuitants covering domestic partners. For more information, call the Retirement Fund office at 312-751-3222.
Medicare Eligibility
Prescription Drug Coverage
Retirees Prescription Drug Co-Payments for UnitedHealthcare, Blue Cross HMO Illinois and Blue Cross Blue Shield PPO are as follows:
| Rx Category |
* The mail order provider depends on what plan the member is enrolled in.
Vision Benefits
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Welcome State Of Illinois Retirees And Survivors
As a State of Illinois retiree or survivor , you may be eligible to enroll in the UnitedHealthcare® Group Medicare Advantage – CIP, UnitedHealthcare® Group Medicare Advantage – TRIP, UnitedHealthcare® Group Medicare Advantage – State plans. Learn more about benefits, enrollment and accessing care from your doctor.
Enrollment In Medicare Advantage Has More Than Doubled Over The Past Decade
In 2021, more than four in ten Medicare beneficiaries 26.4 million people out of 62.7 million Medicare beneficiaries overall are enrolled in Medicare Advantage plans this share has steadily increased over time since the early 2000s. Between 2020 and 2021, total Medicare Advantage enrollment grew by about 2.4 million beneficiaries, or 10 percent nearly the same growth rate as the prior year. The Congressional Budget Office projects that the share of all Medicare beneficiaries enrolled in Medicare Advantage plans will rise to about 51 percent by 2030
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What About Coverage For Prescription Drugs
All of these plans are what are known as MA-PD plans, which is short for Medicare Advantage Plan with Prescription Drug Coverage. Under all of the Medicare Advantage plans, Medicares so-called prescription drug donut hole does not exist. There is no gap in prescription drug coverage. Under both the HMO and PPO plans, drug coverage costs the same, both for copays and deductibles, as the current HMO and PPO plans respectively.
Illinois Unitedhealthcare Group Medicare Advantage Plans
UnitedHealthcare Group Medicare Advantage plans are only offered to groups such as employers, unions and government sub-entities. These plans provide group retiree Medicare beneficiaries with a variety of health care benefit plan choices, often with more benefits than those provided by Original Medicare. Plan members are still covered under the Medicare program and have federally regulated rights and protections.
Health Maintenance Organization plans have a defined network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Some HMO plans do not require referrals for specialty care.
Preferred Provider Organization plans offer members access to a network of contracted local physicians and hospitals, but also allow them the flexibility to seek covered services from outside of the contracted network, usually at a higher cost. Members do not need a referral for specialty care.
We offer a national PPO plan to employers who qualify under a Centers for Medicare & Medicaid Services Employer Group Waiver. PPO plans are available as either local PPO or regional PPO offerings. LPPOs cover certain counties within a state while RPPOs serve a larger geographic area – either a single state or a multi-state area.
Tools and Resources – UnitedHealthcare® Group Medicare Advantage Plans
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Nearly One In Five Medicare Advantage Enrollees Are In Group Plans Offered To Retirees By Employers And Unions In 2021
Nearly 4.9 million Medicare Advantage enrollees are in a group plan offered to retirees by an employer or union. While this is roughly the same share of enrollment since 2014 , the actual number has increased from 1.9 million in 2010 to 4.9 million in 2021 . With a group plan, an employer or union contracts with an insurer and Medicare pays the insurer a fixed amount per enrollee to provide benefits covered by Medicare. For example, some states, such as Illinois and Pennsylvania, provide health insurance benefits to their Medicare-eligible retirees exclusively through Medicare Advantage plans. As with other Medicare Advantage plans, employer and union group plans often provide additional benefits and/or lower cost sharing than traditional Medicare. The employer or union may also pay an additional premium for these supplemental benefits. Group enrollees comprise a disproportionately large share of Medicare Advantage enrollees in eight states: Alaska , Michigan , Maryland , West Virginia , New Jersey , Wyoming , Illinois , and Kentucky .
Unitedhealthcare Connected For Mycare Ohio
UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.
Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .
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Almost 4 Million Medicare Beneficiaries Are Enrolled In Special Needs Plans In 2021
Nearly four million Medicare beneficiaries are enrolled in Special Needs Plans . SNPs restrict enrollment to specific types of beneficiaries with significant or relatively specialized care needs, or who qualify because they are eligible for both Medicare and Medicaid. The majority of SNP enrollees are in plans for beneficiaries dually eligible for Medicare and Medicaid . Another 10 percent of SNP enrollees are in plans for people with severe chronic or disabling conditions and 2 percent are in plans for beneficiaries requiring a nursing home or institutional level of care .
While D-SNPs are designed specifically for dually-eligible beneficiaries, 1.5 million Medicare beneficiaries with Medicaid were enrolled in non-SNP Medicare Advantage plans in 2019 .
Enrollment in SNPs increased from 3.3 million beneficiaries in 2020 to 3.8 million beneficiaries in 2021 , and accounts for about 15% of total Medicare Advantage enrollment in 2021, up from 11% in 2010, with some variation across states. In the District of Columbia and Puerto Rico, SNPs comprise about half of all Medicare Advantage enrollees . In eight states, SNP enrollment accounts for about one-fifth of Medicare Advantage enrollment . Nearly 95% of C-SNP enrollees are in plans for people with diabetes or cardiovascular conditions in 2021. Enrollment in I-SNPs has been increasing but slightly declined in 2021 and is still fewer than 100,000.
Best For Supplementing Medicare: Humana
Humana
Humana offers excellent Medigap coverage with a user-friendly website and multiple plan options to choose from. It is our choice as the best Medigap provider for its customizable coverage options and the ability to keep the healthcare providers you trust.
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Multiple plans to choose from
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You can choose any healthcare provider.
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Majority of your Medicare costs covered
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Monthly premiums can be high.
If youre 65 or older, you may not think you need additional coverage since you qualify for Medicare. However, a 65-year-old couple that retired in 2021 can expect to pay $300,000 in healthcare and medical expenses during their retirement.
A Medigap policy can help cover your health costs, such as your Medicare deductibles, coinsurance, or copayments.
Medigap policies dont include prescription drug coverage, and your monthly premium may be expensive. Humana is licensed to offer Medigap policies in most states, but check to see if plans are available where you live.
Humana is one of the top Medigap providers, offering a user-friendly website that allows you to search through the companys Medigap plans easily. With a Humana Medigap policy, you can see any healthcare provider that accepts Medicare. Depending on which plan you choose, the majority of your Medicare costs may be covered. Humana has an A- rating from AM Best.
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Is A Trail Medicare Advantage Plan Still Medicare
Yes. This type of Medicare Advantage plan, also known as an MAPD plan, is a Medicare-approved plan that combines the different parts of Medicare – Part A, Part B and Part D into one plan. Since Medicare Advantage plans are a type of Medicare, you must continue to pay your federal Medicare premiums in order to remain enrolled in TRAIL.
What About Dental And Vision Coverage
Your dental and vision coverage will remain the same as it is now if you enroll in a Medicare Advantage plan. If you do not enroll in Medicare Advantage and instead decide to opt out of the state insurance plans during the enrollment period, you will not be able to keep your vision coverage, but you may elect to keep your dental.
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Group Medicare Advantage Hmo Plans
Medicare Advantage National Health Maintenance Organization plans from UnitedHealthcare are another cost-conscious way to offer health care coverage to your retirees.
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HMO plans provide coverage for plan members through a network of locally contracted doctors and hospitals
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While HMO plans do not provide out-of-network coverage , they may be more affordable
Tax Deduction For Retired Public Safety Employees
Retired or disabled public safety employees are eligible to take a tax deduction of up to $3,000 on their federal income tax return for health insurance or long term care insurance premiums.
To qualify, you must have held an eligible public safety position and reached full retirement age when you:
- Terminated IMRF participation for retirement, or
- Became totally and permanently disabled and are receiving IMRF disability benefits.
For additional details, including what positions meet the IRS definition of a public safety position, see IRS publication 575, Pension and Annuity Income, at www.irs.gov or talk with your tax advisor.
If youve determined you qualify for this deduction and want IMRF to deduct your premiums from your pension payment and pay your insurer directly, you will need to complete one of the following forms:
If you are continuing your health insurance coverage through your employer after retirement and you want to have your premium costs deducted directly from your monthly pension, complete a “Health Insurance Continuation Through Employer Premium Deduction Authorization” form and return it to your employer.
Doyle Rowe LTD provides a full range of health plan counseling and administrative services to more than 250,000 active and retired members of IMRF.
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Expanded access to care and support for COVID-19We are committed to helping you protect your health by expanding access to care, support and resources, including waiving cost-sharing for COVID-19 testing and the testing-related visit during the national public health emergency period, ending October 22, 2020. Were also waiving member cost-sharing for the treatment of COVID-19 until October 22, 2020 for Medicare Advantage plans. Implementation of self-funded employee customers may vary. Learn about COVID-19 resources.
Cost-sharing waived for primary care and specialist visits: For Medicare Advantage Group Retiree members there will be $0 cost-sharing for specialist and primary care provider services beginning May 11, 2020 until September 30, 2020. Find out more.
TeleHealth: We expanded access to telehealth so you can stay in the comfort of your home and get the right care. For COVID-19 testing related telehealth visits with a health care provider, cost-sharing is waived through the national public health emergency period. Learn about Virtual Doctor Visits and Virtual Behavioral Health Visits.
Group Medicare Advantage Ppo Plans
UnitedHealthcare has helped thousands of employers and plan sponsors transition their group retiree benefit plans to Medicare Advantage National Preferred Provider Organization plans. Medicare Advantage PPO plans can offer the following benefits:
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Effectively replaces employer plans that combine Original Medicare and a Medicare Supplement plan
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When combined with a Medicare prescription drug plan , these plans may offer more complete coverage than was available to employees prior to retirement
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Allows members to see health care providers in and out of network
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Offers administrative and cost efficiencies to employers and plan sponsors
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Medicare And Group Retiree Coverage
Do you need Medicare if you have retiree group health coverage? Watch this video for the answer.
A colorful cartoon female silhouette arises, facing left toward a speech balloon.
Text fades into the balloon.
ON SCREEN TEXT: If I have retiree group health coverage when I become eligible for Medicare, do I have to enroll?
The text fades out. The speech balloon slides off-screen to the left as the female silhouette slides offscreen downward.
A new speech balloon appears with text fading in.
ON SCREEN TEXT: This will depend on your retiree group health coverage and how it works with Medicare.
The speech balloon slides up, and a new one appears below it with text fading in.
ON SCREEN TEXT: Talk with your plan’s benefits administrator to understand your options.
The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, this time indicating a change of speaker. Text fades in.
ON SCREEN TEXT: What might I be able to do?
The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below and indicates another change of speaker. Text fades in.
ON SCREEN TEXT: Depending on how your retiree group health coverage works, you may–The speech balloons scroll up with the top balloon sliding off-screen, and a new one appears below, indicating the same speaker. Text fades in.
ON SCREEN TEXT: 1. Be able to delay in Medicare Part A and/or Part B.
Text fades in.
ON SCREEN TEXT: Yes, it’s possible to have both.
Do I Need Health Insurance If I Have Medicare
While Medicare is an excellent option for retirees, you wont qualify for it until you turn 65. If you retire before that date, youre responsible for getting your own coverage. However, even eligible Medicare beneficiaries may need additional insurance.
Medicare covers a large portion of your health expenses, but it doesnt pay for all of your necessary medical services. Original Medicarewhich includes Medicare Part A and Medicare Part B doesnt cover:
- Dental care
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How Does The Affordable Care Act Affect Me
In short, it doesnt. There is a lot of misinformation being spread about the Affordable Care Act to seniors. The switch to Medicare Advantage plans is not related in any way to the rollout of the ACA. The Affordable Care Act does make some improvements to Medicare benefits, such as allowing an additional wellness visit annually and some additional free preventative servicesand these will be available to retirees in the Medicare Advantage plans as well.
Benefits For State Government Employees
From online doctor visits to wellness rewards programs, plans are designed to help state employees stay healthier. UnitedHealthcare works with plan administrators to create plans that make sense for employees and help employers manage costs.
View the plans below for an overview of the coverage to expect from UnitedHealthcare for medical, dental and specialty plans.
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Medicare Advantage Open Enrollment
Oct 4, 2021 | News
The State of Illinois TRAIL Medicare Advantage open enrollment period for participating annuitants and survivors is October 15 November 15, 2021. The 2022 plan year will begin January 1, 2022, and will run through December 31, 2022.
The state of Illinois offers annuitants and survivors a healthcare program called Total Retiree Advantage Illinois . This program provides eligible members and their covered dependents comprehensive medical and prescription drug coverage through Medicare Advantage plans . The State of Illinois Group Insurance Program also includes vision coverage and optional dental and life insurance coverage.
The TRAIL MAPD enrollment period features a web-based online enrollment platform titled MyBenefits at MyBenefits.illinois.gov. This site streamlines your benefit options into a one-stop shop for your insurance needs. This includes learning more about your current insurance benefits, making enrollment decisions, changing your current coverage and finding contact information for all your plan administrators. How-to-enroll videos are on the site to walk you through the enrollment process.
Virtual Informational seminars will be held online at to give eligible retirees, annuitants and survivors an opportunity to learn and ask questions about the Total Retiree Advantage Illinois Program. Topics will include eligibility criteria and an explanation of the benefits provided through the Program.
