Retiree Health and Dental Insurance Premiums
Applications and Forms
|State of Iowa Group Retiree Health Application||2018 Medicare & You (Official Medicare Handbook)|
|Wellmark Automatic Bank Account Withdrawal||Senior Health Insurance Information Program (SHIIP)|
|Group MedicareBlue Rx Application (Iowa Choice and National Choice)||2018 Medicare Part D Creditable Coverage Letter|
|Group MedicareBlue Rx Application (Group Plan F and Group Plan N)||Group Plan F and Group Plan N|
|Group MedicareBlue Rx EFT form||Group Program F Highlights|
|Cancellation of Retiree Health Insurance||Group Program N Highlights|
|2018 Group Formulary|
|Supplemental Drug List|
|Supplemental Plus Drug List|
|CVS/caremark Mail Service Order Form|
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.
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.
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.
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.
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.
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 ($10/$30/$50/$50 (GEN)).
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.
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.
Group MedicareBlue Rx Iowa Coordination with Wellmark
When you enroll in Group MedicareBlue Rx Iowa, Group MedicareBlue Rx Iowa becomes the primary payor for prescription drugs and Iowa Choice or National Choice is the secondary payor.
When you enroll in Group MedicareBlue Rx Iowa you will not notice any difference in your prescription drug coverage. You will still pay your prescription copayments according to your Wellmark plan, like you always have.
You will have two ID cards - Wellmark and Group MedicareBlue Rx. You will use the Group MedicareBlue Rx ID card in addition to your Wellmark ID card at the pharmacy. You must show both of these identification cards at the pharmacy for claims to be filed correctly. Tell your pharmacist to file your claim under the Group MedicareBlue Rx card first, and then under your State of Iowa Wellmark plan card. Under the coordinated pharmacy benefits, Group MedicareBlue Rx will pay your claims as primary and the State of Iowa's Wellmark plan will pay as secondary. You need to make sure your pharmacy files your claims this way in order to receive the correct State of Iowa plan copayments.
If you are not charged your usual copay amount, the pharmacist may not have filed your prescription to both cards.
Group MedicareBlue Rx Iowa Premium
The 2018 Group MedicareBlue Rx Iowa premium is $100.20 per month* per Medicare-eligible individual.
*Since January 1, 2011, higher-income beneficiaries will pay an additional amount to Social Security/Medicare for your Medicare Part D coverage. This amount is based on your income and will be deducted from your Social Security check or you get a paper bill if you do not receive Social Security benefits. Less than 5% of people with Medicare are affected, so most people will not pay this extra amount. Consult Social Security if you have questions regarding the amount you will pay.
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 Plan F and the Group Plan N to Medicare-eligible retirees and their Medicare-eligible dependents. The designs of the Group Plan F and Group Plan N are identical to the Medicare Supplement Plan F and N that you can purchase individually. Group Plan F and Group Plan N provide extensive coverage in supplementing your Medicare coverage. They have national coverage with any healthcare provider that accepts Medicare.
More information about the Group Plan F and Group Plan N is available at the Group Program F and N webpage.
Contact the Department of Administrative Services, Human Resources Enterprise at 866.895.2464 or email firstname.lastname@example.org if you have any questions or need additional information.
|2018 Group Formulary|