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Health Insurance after Medicare-Eligibility

You can continue your health coverage with the State of Iowa when you become eligible for Medicare.

Quicklinks

Resources

Medicare-Eligibility and SLIP Dollars 2018 Retiree Health & Dental Premiums
Medicare 2018 Medicare & You (Official Medicare Handbook) 
Health Plans Available to Medicare-Eligible Retirees 2018 Medicare Part D Creditable Coverage Letter
Health Insurance Plans and Medicare Senior Health Insurance Information Program (SHIIP) 
Group MedicareBlue Rx Group Program F and N Information
Group Program F and N Group Program F Highlights
For More Information Group Program N Highlights

Health Plans Applications

State of Iowa Group Retiree Application (use for Iowa Choice, National Choice, Group Program F, and Group Program N) 
Group MedicareBlue Rx - Iowa (use with Iowa Choice and National Choice) 
Wellmark Automatic Bank Account Withdrawal 
Cancellation of Retiree Health Insurance


Medicare-Eligibility and SLIP Dollars

If you were a Sick Leave Insurance Program (SLIP) retiree and you turn 65 or become Medicare-eligible, your SLIP money will no longer be available to you. The Department of Administrative Services will send you a letter if:

  • You are three months from your 65th birthday.
  • Your spouse is three months from his/her 65th birthday.
  • You are three months from exhausting your SLIP account.

The letter will remind you of your options for continuing State of Iowa group health insurance. If you receive Medicare due to Social Security disability, you need to contact DAS at 866.895.2464, as you are no longer eligible for SLIP.

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Medicare

You become eligible for Medicare when you are:

  • Age 65
  • Under age 65 with certain disabilities
  • Any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)

If you or your covered dependents on the insurance become eligible for Medicare before age 65, contact DAS-HRE at 866.895.2464.

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Medicare Resource

The Senior Health Insurance Information Program (SHIIP) is a great resource about Medicare.  You can contact SHIIP at 800.351.4664 or http://www.therightcalliowa.gov.

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Health Plans Available to Medicare-Eligible Retirees

The State offers retirees the following health plans.

  • Iowa Choice
  • National Choice
  • Group Program F
  • Group Program N

Information about these plans is available at Retiree Health Insurance.

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Iowa Choice/National Choice and Medicare

You can continue coverage with Iowa Choice or National Choice you become eligible for Medicare. The benefit design of Iowa Choice and National Choice is the same as the benefit design offered prior to becoming Medicare-eligible except Medicare becomes the primary payer on your claims and Iowa Choice or National Choice is the secondary payer.

If you have covered dependents who are not eligible for Medicare, Wellmark will continue to be primary on their health claims.

Iowa Choice or National Choice fills in the gap, if any, between what Medicare paid and what the options would have paid if you were not on Medicare.  Wellmark computes what it would have paid for your treatment as your primary insurer (including any unpaid deductible and co-pay).  Wellmark then subtracts the amount Medicare paid.  If the results are positive (that is, Medicare paid less than Wellmark would have), then Wellmark pays the difference.  If the result is equal to or greater than the amount Wellmark would have paid, they do not pay.

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Group MedicareBlue Rx

With iowa Choice or National Choice, you have an option of lowering your Wellmark premium by purchasing a Medicare Part D plan – Group MedicareBlue Rx Iowa. 

If you enroll in Group MedicareBlue Rx Iowa, Group MedicareBlue Rx will be your primary coverage for prescription drugs and Iowa Choice or National Choice will provide secondary coverage.  When you enroll in Group MedicareBlue Rx Iowa, you still pay the same prescription drug copayments according to the State's health insurance plan. 

Advantage of Group MedicareBlue Rx Iowa

Because Group MedicareBlue Rx Iowa is primary on prescription drugs and the Wellmark plan is secondary, Wellmark pays a lower portion of the total cost for all eligible prescription drug charges so they are able to significantly lower your health plan premium.

The Group MedicareBlue Rx plan (Group #38073-IOWA) was created specifically for the State of Iowa.  This plan is the only Medicare Part D that can lower the State’s Wellmark premiums.  If you drop the Group MedicareBlue Rx plan (Group #38073-IOWA) plan and purchase another Medicare Part D including a different MedicareBlue Rx plans, you will pay the higher Wellmark premium for Iowa Choice and National Choice.

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Notice of Creditable Coverage

The State of Iowa has determined that your prescription drug coverage with the state’s health care plans is as good as or better coverage than the standard Medicare prescription drug coverage (Part D). This means that your State of Iowa coverage is considered “creditable coverage” and that you will not pay extra if you later decide to enroll in Medicare prescription drug coverage.

2018 Medicare Part D Creditable Coverage Letter

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Group Program F and N

Medicare Parts A and B pays for many, but not all, health care services and supplies.  A Medicare Supplement Insurance policy helps pay some of the health care costs that Parts A and B don’t cover, like copayments, coinsurance, and deductibles.

The State offers both the Group Program F and the Group Program N to Medicare-eligible retirees and their Medicare-eligible dependents.  The designs of the Group Program F and Group Program N are identical to the Medicare Supplement Plan F and N that you can purchase individually.  Group Program F and Group Program N provide extensive coverage in supplementing your Medicare coverage.  They have national coverage with any healthcare provider that accepts Medicare.

For information about the Group Program F and N Plans, review the Group Program F and N webpage.

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For More Information

Contact the Department of Administrative Services, Human Resources Enterprise at 866.895.2464 or email stateretirees@iowa.gov if you have any questions or need additional information.

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12/27/2017