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

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