The following was emailed today by Rene Rodriguez, President, to retirees for whom we have email addresses.
Gary Johnson and Marta Freixas have put together the important things you need to know about CalPERS and OptumRx as the starting date of September 1 for CalPERS insurance plans approaches.
Retirees Be Aware!!!
We are all entering a different health benefit world than we have experienced in our history with the District, particularly for those of us on Medicare plans. We have been warned by other Community Colleges contracting with CalPERS that the District will be less able to assist or intercede for us than we are accustomed to. We will be more on our own interacting with CalPERS, Medicare, Anthem, OptumRx and Kaiser. We will be more dependent on on-line sources for information.
As they become available, study carefully all CalPERS, Medicare, Anthem, OptumRx and Kaiser documents that apply to you. There are rules, access requirements, limitations, reimbursement responsibilities and prerequisites we must understand and figure out how to work with to get the best use of the plans.
Medicare Supplement Plans: Transfer your prescription enrollment to OptumRx
Everyone on a Medicare Supplement Plan thus far has received a letter from OptumRx that states that by 8/28/2020 those on Choice and Care Plans must call OptumRx at 1-866-420-4471 and request to transfer your current Anthem prescription coverage to OptumRx so they can enroll you through Medicare and accept responsibility for your coverage. If you do not do this, you will lose all coverage, both medical and prescription.
CalPERS Basic Care Level Plan:
If you received a letter from CalPERS stating that you are delinquent in paying your monthly premium of $125.48, do not be alarmed. You will not be covered by this plan until 9/1/20 and prior to the unfortunate tone of this letter, neither CalPERS nor the District has provided any information as to the due dates or options for paying this premium. If you do not understand the best payment option for you, call CalPERS at 1-888-225-7377. Also, call and ask the District if they are paying for half of the Care Plan premium as previously indicated during negotiations at 805-652-5535.
Prescriptions with OptumRx:
You need to call OptumRx at to find out how your prescription information will be transferred from IngenioRx to OptumRx. Call 1-866-420-4471 if you have a Medicare Supplement Plan, and 1-855-505-8110 if you have a Basic plan. For a new start with prescriptions, especially if you want to take advantage of cost savings with a 90 day supply and to coordinate your refills coming due at the same time, your best option may be to have all of your doctors provide full new prescriptions and refill numbers to OptumRx on 9/1/2020, or as soon as possible afterward.
Make sure you fill prescriptions with an OptumRx Network Pharmacy. The best savings will be with designated “Preferred 90” pharmacies for Medicare plans, and “Select 90” Pharmacies for Basic plans.
CalPERS open enrollment period:
Given the limited information available on plans, the timing of the availability, and the quick deadlines for decisions, it is possible that some retirees chose a health care plan that does not best serve their needs. CalPERS has an open enrollment period yearly between October 1 and December 31 where you can change your enrollment from your initial choice to another plan. If this is you, take a more detailed look at the options and take advantage of this quick opportunity to change your mind.
Medicare Doctors/ Medicare Assignment:
Make sure your healthcare providers take Medicare, and know whether or not they accept “Medicare Assignment”. “Assignment” means the provider accepts the Medicare approved amount as full payment for covered services, which saves you money by not being responsible for the difference between what Medicare paid and what the provider bills. An increasing number of Doctors, and especially specialists and anaesthesiologists, do not accept Medicare. Be sure to learn how the doctors you choose, and the hospitals you utilize, handle Medicare. In addition, be aware that some of the doctors working and caring for you in hospitals do not take Medicare even if the hospital itself does.
HOW TO TELL IF YOU HAVE SUCCESSFULLY ENROLLED IN A CALPERS PLAN
If you have Medicare Part A and Medicare Part B and have successfully enrolled in either PERS Choice Supplement to Medicare or PERSCare Supplement to Medicare, you will have received two insurance cards. One will be from Anthem for a PERS Supplement Plan, and one will be from OptumRx. If you have not received your Anthem card, please call 1 (877) 737-7776. If you have not yet received your OptumRx insurance card, please call 1 (866) 420-4471. You MUST be enrolled in both plans.
If you have no Medicare or Medicare Part A only and are enrolled in either PERS Choice Basic Plan or PERSCare Basic Plan, you should have received only one card from Anthem for a PERS Basic Plan. If you haven’t yet received your card, please call 1 (877) 737-7776.
Because of current issues with the postal service, your cards may merely be delayed. We currently have no way for those of you who need to check on your OptumRx enrollment to achieve that without calling. However, for those of you with online Anthem access, you can check to see if your enrollment with PERS Choice or PERSCare was successful by:
-
- Logging into your current Anthem account;
- Hover your mouse over “My Plan”; and
- Select ID Cards from the drop-down menu
- Two Anthem cards should show for each person enrolled. One is for our current plan, and one has CalPERS in the upper right. If you find your CalPERS card here, you are have successfully enrolled in a Medical plan. These cards can be downloaded and printed.
- If you go back to “My Plan” and select Benefits from the drop-down menu, you should see that the words “California Public Employees Retirement System” appear to the right of our current plan. It will also show an effect date of Sept. 1, 2020
- If your card shows the word “Supplemental” in the upper right in addition to CalPERS, you must check your enrollment in OptumRx too!
CalPERS and OptumRx INFORMATION ON THE VCCCDRA BLOG: blog.vcccdra.org
Blogmaster Carmen Guerrero and Marta Freixas have created some pages in the Pages category of the Blog on the right hand side of the Home Page when you first enter the Blog. Just scroll down until you see the “Pages” category, and select the desired page. Here you can get a copy of the PERS Care Medicare Supplement plan, or a copy of the PERS Choice Basic Plan, plus you can download a copy of the expanded Select90 and Preferrred90 pharmacy list. Explore these pages to see what other valuable information is available to you here.
