Transcript Creating Your Path— Focusing on Your Future Retiree Health Care BB&T | August 2014

Creating Your Path—
Focusing on Your Future Retiree Health Care
BB&T | August 2014
Content
 New Delivery Model for Medicare-Eligible Retirees
Aon Retiree Health Exchange
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Overview of Retiree Benefit
For all BB&T retirees and spouses of retirees 65 or older:
 If you are over age 65 and your spouse is under age 65, you may elect to cover your spouse through
the BB&T Retiree medical coverage (Select or Consumer options ) through BCBS NC. BB&T will
draft your account for the pre-65 coverage
 If you elect the BB&T Retiree Life Insurance, BB&T will draft your account for the premium
 You may have 2 different enrollment periods:
– BB&T open enrollment for pre-65 Health care and for Life Insurance in November
 If you and your spouse are both 65 or older, you will each make an election with Aon Retiree Health
Exchange for your Medicare Supplement coverage and will be billed separately for coverage
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Support for Medicare-Eligible Retirees
Introducing Aon Retiree Health Exchange
 An independent insurance exchange
 Offers Medicare insurance plans from quality carriers
– Financially stable
– “Staying power” in the marketplace
– Name brands such as AARP, Blue Cross and Blue Shield, Humana, and United Healthcare
 Broad range of products to meet individual needs
 Employs licensed and certified benefit advisors
– Are salaried; no incentive to steer individuals to specific carriers and/or plans for you!
– Benefit advisors are licensed, certified, and experienced in Medicare related insurance.
– Will assist you through the entire process and will remain your advisor ongoing
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Why Aon Retiree Health Exchange?
 Aon Retiree Health Exchange is one of the nation’s most trusted advisors in navigating Medicare—it’s
advice you can count on
 We have a reputation for providing expert, independent assistance to Medicare recipients who expect
and deserve high-quality health insurance at an affordable price
 Aon Retiree Health Exchange presents complex health insurance information in an objective manner
via its Internet site and trained and licensed insurance professionals
 The Benefit Advisors are located in Lincolnshire, Illinois, Charlotte, North Carolina, Orlando, Florida,
The Woodlands, Texas and Winston-Salem, North Carolina
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Medicare-Eligible Retirees
Enrollment Process for Medicare-Eligible Retirees
Getting Started
 Confirm your appointment
 Read materials in the education kit or online
 Collect the following:
– Medicare card
– List of doctors
– List of medications
Learn/Compare/Enroll
 Talk with your benefit advisor
 Complete necessary paperwork
 Enroll over the phone
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2014 Medicare Part A (Inpatient Hospital Care)
What Is Covered
What You Pay
Part A covers part of the following services:
 Inpatient hospital care
 Inpatient care in a skilled nursing facility
(not custodial or long-term care)
 Hospice care services
 Home health care services
 Nursing home care
Enrollment in Medicare:
 Part A is automatic for most people who have
worked 40 quarters in their lifetime
 Deductible: $1,216 per benefit period
– A benefit period starts the day you leave the
hospital and lasts 60 days
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2014 Medicare Part B (Outpatient Hospital and Doctor Care)
What Is Covered
What You Pay
 Outpatient care
– Doctors’ visits
– Outpatient hospital
– Lab services
 Preventive care
 Emergency room visits
 Mental health
 Ambulance
 Lab tests
 Premium: $104.90
– Social Security determines the premium
amount based on the last 2 years of taxable
income
 Deductible: $147
 Coinsurance:
– Medicare pays 80%
– Participant pays 20%
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Current Plan
Original Medicare
Part A
Part B
(covers
hospital stays)
(covers doctors and
outpatient visits)
Government-Funded
Medicare Supplement Plan + Rx Drug
Coverage (Optional)
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Medicare Insurance Plan Options
Original Medicare
Part A
Part B
(covers
hospital stays)
(covers doctors and
outpatient visits)
Government-Funded
OR
Keep original Medicare and add:
Replace Original Medicare with
Medicare Supplement Insurance
Medicare Advantage
Medigap
(covers some or all of the costs
not covered by Part A or B)
MEDIGAP
Part C
(combines Part A and B
and may include prescription drugs)
Offered by Private Companies
And/Or
+
Medicare
Part D
If Part C of your plan
does not include prescriptions,
consider adding Part D.
Part D
(covers
prescriptions)
Offered by Private Companies
Offered by Private Companies
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Medicare Supplement (Medigap) plans
In the open market, there are options known as Medicare Supplements.
 Medicare Supplements supplement the Medicare coverage you already have
– Medicare remains your primary; your Supplement is your secondary
 With Medicare Supplement plans, you can go to any doctor, any medical facility in the country as long
as the doctor/medical facility accepts Medicare and the service is Medicare approved (similar to what
you currently have)
 Plans are all federally regulated
– Plans come with a range of coverage—Plans A through N
• Plan F has highest level of coverage
 Covers your deductibles and out-of-pocket expenses left over by Medicare
– Plans from company to company are the same—only difference is price
• Prices vary by company, age, and service area
 Current group supplement is similar to Medigap Plan F—except for Part B deductible
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Medicare Supplement Chart
Features
A
B
C
D
F
G
K
L
M
Medicare Part A
Hospital Deductible
50%
75%
50%
Skilled Nursing Facility Care
Copay/Coinsurance
50%
75%
Part A Hospice Care
Coinsurance or Copayments
50%
75%
50%
75%
50%
75%
Medicare Part A Coinsurance and Hospital
Costs (up to 365 days after Medicare
Benefits are used up)
Medicare Part B
Deductible
Medicare Party B Coinsurance
(Generally 20%)
Medicare Part B
Excess Charges
Blood
(First 3 Pints)
Foreign Travel Emergencies
(up to Plan Limits)
For illustrative purposes only.
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N
Guaranteed Issue of Coverage for Medicare Supplement (Medigap)
 “Guaranteed issue” means that during this special election enrollment period for retirees, you’re
automatically accepted by the insurance plan without having to answer medical questions
– You have guaranteed acceptance into any Medicare Supplement Plan, regardless of any
pre-existing health conditions
 Enrolling in a Medicare Supplement Plan after this period, in most states, requires approval from the
insurance company
 This is a one-time chance for those age 65 and older
– For those turning age 65 in the future, you have the same opportunity during your initial enrollment
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2014 Medicare Part D Plans
(Prescription Drug Coverage)
100% Paid by Participant
Deductible $310
Initial Coverage
Level $2,850 Limit
The Donut Hole
Exit at $4,550
Catastrophic
Coverage
25% Paid by
Participant
BRANDS:
(50% Discount)
75% Paid by Plan
2.5%
47.5% Paid
by Participant Paid by
Plan
GENERICS:
72% Paid by Participant
28% Paid
by Plan
15% Paid by Plan
80% by Medicare
5%
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Medicare Advantage Plans (Part C)
 Obtain Medicare Parts A/B coverage through the Medicare Advantage Plan, not Original Medicare
 Must pay:
– Part B premium
– Medicare Advantage Plan premium (if any)
– Copays/coinsurance and deductibles, as applicable
 Network-based:
– PPO, HMO, HMO-POS, PFFS
 Medicare Advantage Plans may offer extra coverage:
– Vision, hearing, dental, health/wellness programs
 Most plans include prescription drug coverage (Part D)
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Choosing a Medical Plan Comparison
Supplement Plan (Medigap)
Medicare Advantage (Part C)
 Can be higher premium/low to no cost on the
back end
 Can go to any doctor or medical facility in the
country that accepts Medicare
 Does not include prescription drugs
 Most plans include foreign travel emergency
coverage
 Guaranteed issue under certain circumstances
 Low to no monthly premium/Pay as you go
 Network based plans/HMOs, PPOs
 Typically includes prescription drugs copays,
coinsurance, and deductibles
 No medical underwriting
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Choosing a Medical Plan
 Even if you and your spouse are both Medicare-eligible, your health needs may differ—each eligible
person can choose a medical or prescription drug plan
 You may change your Medicare Advantage and Part D plans every year during the Annual
Enrollment Period (AEP) October 15–December 7
 You may change your Medigap plan at any time during the year. However – you may be subject to
underwriting
 Initial Enrollment Period (IEP) – Newly Eligible
 Tricare and VA coverage
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Choices to Meet Retirees’ Needs
Telephonic Enrollment
Prefilled Paper
Online
 Highly trained benefit advisor
guides retirees through
process
 Many retirees prefer to
review printed materials
before making decision
 Detailed summary of benefits
information
 Retirees work with same
benefit advisor throughout
process (if desired)
 Paper applications
accepted via prepaid
envelopes or fax
 Enrollments can be
completed over the phone
with telephonic signature
 Comparison of current plan
and alternate plans
 Online plan application
collection up to signature
requirements
 www.retiree.aon.com/bbt
 Preferred method—98%
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Conveniently Paying for Your Coverage
Two options:
 Pay your health insurance premium by check each billing period
or
 Have your premium automatically withdrawn from a checking or savings account
– Most insurance providers allow automatic withdrawal as a convenient alternative to paper checks
Aon Retiree Health Exchange
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Retiree Health Reimbursement Account (HRA) Highlights
 Retiree HRA can only be used for reimbursement of eligible premiums for Medicare Supplement,
Medicare Advantage, and/or Medicare Prescription Drug Plan, Medicare Part B and D coverage
(including Part D penalties paid or surcharges)
– Any additional premium expenses for the year would be paid by you
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Premium Billing and HRA Reimbursement
Retiree
Pays insurance premiums
directly to carrier
Carrier
Reports premium
payments to Aon Retiree
Health Exchange
Aon Retiree
Health
Exchange
Reimburses retirees
for premiums
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Premium Billing and Manual Claim HRA Reimbursement
Retiree
Pays insurance premiums directly to carrier and completes manual claim form each
month for eligible expense and submits to Aon Retiree Health Exchange/Your Spending
Account™
Aon Retiree
Health Exchange
Retiree
Retiree receives premium increase from carrier and fills out a
manual claim form for premium increase and submits to Aon Retiree
Health Exchange/Your Spending Account
Aon Retiree Health Exchange
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Reimburses retirees
for premiums
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Advocacy—The Solution
Retirees Need Assistance
Advocacy Services
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Access to care and prescription drugs
Claim denials and incorrect payments
Billing disputes
Authorization and referrals
Medicare coordination
Aon Retiree Health Exchange
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Pioneered service in 1999
200 clients
3.6 million participants
Advocates average 18 years of industry
experience
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Medicare Advocacy Examples
PROBLEM
SOLUTIONS
Receiving
unexpected
bills from
rheumatologist
 Provider miscoded
diagnosis and
CPT code; as a result,
charges were not
eligible for Medicare
reimbursement
 Advocate worked with
provider to correct and
refile bill with Medicare
Medicare denied
a claim, indicating
Medicare was
not the primary
payer
 Retiree did have
additional coverage;
however, Medicare
was primary
 Advocate facilitated refiling
claim with Medicare, then
forwarded EOBs to health plan
for secondary payment
Medicare denied
a retiree’s
request for
a wheelchair
 Medicare denied
claim as not medically
necessary
 Advocate collected medical
records and forwarded them
to Medicare
Erroneous CPT code
Incorrect Medicare
claim denial
ROOT CAUSE
Access to wheelchair
Aon Retiree Health Exchange
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 After bill was reprocessed,
advocate communicated
accurate liability to retiree
 Once approved, advocate
made arrangements for
home delivery of wheelchair
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Website
 Visit retiree.aon.com/bbt
 On the website, you can:
– Confirm your appointment
– Change you appointment
– Add your prescriptions
– Compare plans
– Create a unique user ID
Aon Retiree Health Exchange
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Website retiree.aon.com/bbt
Proprietary
& Confidential
Aon
Retiree Health
Exchange
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Educational and Informative Content
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Quick and Easy Plan Entry
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Guided Tools, Including Personalized Rx Calculations
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Simplified Browsing Experience
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Side-by-Side Comparison Shopping—Comparing Apples-to-Apples
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Prescription Profiler
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Questions?
If you have questions:
Call Aon Retiree Health Exchange at +1.888.628.2393