HEALTH INSURANCE UPDATES FOR OUR RETIREES

5/7/20  - from Barbara Satz, Health Benefits Chair

Health Benefits Committee Information... 

I know that many members have gotten their Aetna Co-pay reimbursement checks.

If you have any members that did not, please have them call Aetna at 1- 866-816-3662 and tell the representative in member services that they did not receive their co-pay check. The person should verify their information and notify the task team that the member did not receive their co-pay reimbursement.

It is my understanding that the team should contact them in 3 - 5 days.

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Dear Colleagues,
   3/2020 -  I hope this finds you all well and not too stir crazy yet, especially with the rains of the day. So far, a good walk or a little while on the balcony when there is some sun has helped me.   I will have to come up with a new strategy today. If you have a cell phone try to FaceTime someone each day.
    On Friday I was able to join approximately 40 people on a conference call with Kevin Kelleher from NJEA. He and Steve Beatty thanked all of the Retired for all their lobbying efforts to get the Chapter 78 and ESP bills passed out of committee. One more vote necessary (probably a phone vote) and then Governor Murphy’s signature!  Hopefully, that will happen this week.
    Here is what I learned – and then I will give you the website for you to look at on your own.
1. Medicare Retiree:   NO CHANGE TO YOUR PLAN except for acupuncture, physical therapy, and chiropractic care. There are dollar limits on out of network coverage (which will bring down the cost overall).
2. We are keeping OPTUM RX mail in the drug program.
3. If a retiree is not yet on Medicare, they will receive a new health care card in the mail. The year will run from July 1 to June 30th. There will be some coverage changes. Check the website: www.njea.org/justice.
     4. If you were paying for retired health care, you will now be paying a percentage of your pension, NOT a percentage of the premium. Your cost will go down and the plan is still a “platinum plan” Those not paying for healthcare will continue to not pay for their healthcare. This will save the state another $30,000,000. The plan will not change for the next 7 years. Then you will have some choices. CO-PAY REIMBURSEMENT CHECKS are to go out on APRIL 1st. That was the plan. Hopefully, this will actually happen.
    Please take care of yourselves and call at least one MCREA friend today. They will appreciate it and so will you.
Susan Beekman
Health & Member Benefits by Barbara Satz

NJEA/NJREA indicate that Aetna reimbursement checks should be expected by the end of March. Members should be vigilant and open any mailing that they receive from Aetna between now and that time. If you believe that you entitled to and did not receive a reimbursement check by the end of March you should contact Aetna (number on the back of your ID card) prepared with the proper documentation to support your claim.

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The Aetna SEHBP Medicare Advantage program of reimbursing up to $250.00 for co-pays will continue for the calendar year 2020. Save your receipts and check your EOB’ s during the year.

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During the month of February, the Division of Pensions and Benefits will send a notice to retirees who qualify for reimbursement for the full cost of Medicare
Part B and Part D coverage from the State of New Jersey and paid more than the
Standard monthly premiums. The notice will explain what you need to send to the state as proof that you paid more and the address to send all documentation.
You should send in no later than April 1, 2020. Any questions should be directed to NJDPB at 609-292- 7524.

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***1/16/20 Memo from Susan Beekman, MCREA President
***Hi All,
     The letter below was sent from the Passaic County Retiree Education Association.   Sue Diehle, their President, agreed that I could forward it.  It basically changes the date I gave you for receiving your reimbursements.  Please share with whoever you share within our Association.
     Thank you,
Susan Beekman
Attention All Aetna Educators Medicare Plan Participants:    Here is some information about the co-payment reimbursement of up to $250 as outlined in the Aetna plan.  According to Aetna representatives, this money will begin to be mailed to members who are eligible at the end of March 2020.  The expected completion of the mailing of the checks will be before the end of the first quarter of the year (which would be by the end of March). Before you receive your check, you will get a letter from Aetna indicating how many co-payments you made during the year and thus, the amount of the check you will receive, the maximum being $250. Members do not have to do anything to apply for this benefit. Aetna has calculated all of the reimbursements. Once you receive your letter, if you believe your reimbursement is incorrect, it is hoped that you have kept your receipts from your doctors’ appointments as proof.    Please look for these mailings and don’t mistake them for junk mail.    I hope this notification answers any questions you have about this process.
Thank you,
Toni Gennarelli
Health Benefits Chair, PCREA

HEALTH & MEMBER BENEFITS (By Barbara Satz)

OptumRx is in the process of mailing “your 2020 Annual Notice of Changes” for the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP) Medicare Prescription Drug Plan.

It is important you read the Annual Notice of Changes as well as the Evidence of Coverage to see if other benefits or cost changes affect you.

The list of covered drugs is called a Formulary or “Drug List.” It is important to review the drug list to make sure your drugs will be covered next year and to see if there will be any additional restrictions.

To get a copy of the Pharmacy Directory, Formulary and/or Evidence of Coverage mailed to you call OptumRx Member Services at 1-844-368-8765 or visit Optumrx.com and download copies from the “Forms” page.

The Aetna Medicare Advantage reimbursement will not take effect until after
December 31, 2019. We have not yet received any information about how Aetna is completing the reimbursement. As soon as we know we will put it in the NJREA Newsletter.

BE PRO-ACTIVE WITH YOUR MEDICAL COVERAGE----

Read your Evidence of Coverage. The information about what is covered, what is not, co-pays, prior authorization, pre-certification, etc. is all in this document. You can also call the number on the back of your ID card and ask questions

Helpful Numbers

NJDPB- New Jersey Division of Pensions and Benefits http://www.nj.gov/treasury/pensions
Pension inquiries-including those related to health benefits: 609-292-7524
call center hrs 7:00 AM-4:30 PM M-F 6:45 PM on Thursdays, call early for less wait time. Automated Information System: 609-292-7524 (24hours /7days a week)
Can also send an e-mail, go to contacts on website and fill in the form
Mail address: Division of Pensions and Benefits, PO Box 295, Trenton, NJ 08625-0295 Medicare: 800-633-4227
Social Security: 800-772-1234 or online at http://www.SSA.gov
OptumRX: 1-844-368-8740 www.optumrx.com OptumRXMedicare: 1-844-368-8765
NJDirect/Horizon Plans: 800-414-7427
Aetna Member Services: 1-877-782-8365
Aetna Medicare Advantage PPO or HMO for SHBP members (state and local govt) 1-866-234-3129
Aetna Medicare Advantage PPO or HMO for SEHBP members (education) 1-866-816-3662
NJEA/NJREA website:http//www.njea.org
sign-in information on the back of the membership card
NJEA/NJREA Headquarters: 609-599-4561
NJEA Confidential Helpline: 866-AID-NJEA (866-243-6532)
NEA Member Benefits: www.neamb.com or 800-637-4636