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» Smilin' Jack   » Specific Discussions   » TWA Retiree Forum   » Turning 65 need med insurance ideas:

   
Author Topic: Turning 65 need med insurance ideas:
Phil
Post Captain
Member # 509

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Why re invent the wheel! Anyone that has come up with a good plan for medical, dental, and/or prescriptions PLEASE pass on your research. (I am one of the first group of TWAers that technically retired from American starting Jan 1, five years ago when they completed the phase out of TWA but the after 65 stuff should still be the same.) Also reply to Pirrottas@hotmail.com if you do not want to reply in public. Thanks Phil
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Phil
Post Captain
Member # 509

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Here is a synopsis of info sent to me about post Jan 1, 2002 Pilot retirees:
1. Your Retiree Standard Medical Plan (RSMP) will continue but now as the secondary insurer. It will pay after the Medicare Claim up to the present plan limits. (Basically bringing it up to about 80% plus a major medical cap.)
2. Your primary insurer will be Medicare Part A (Hospital) and Part B (Doctors.) This monthly premium will be automatically deducted from your Social Security check.
3. Your present "Medco" prescription plan will cease and you MUST purchase a Medicare Part-D "Prescription Drug Plan."
4. Spouses under age 65 and dependant children will continue on the present plans including Medco prescriptions.
5. In my area there are 57 additional plans I can elect for various additional Part A, B, D coverages. Direct contact with Medicare advisors is suggested with your history of all medical/prescription/dental services as billed not just the portion you paid. American HR people (online chat or live) cannot suggest plans but they can answer questions about the American coverages and help you find the information on jetnet.

PLEASE ADD YOUR OBSERVATIONS AS A REPLY SO WE CAN BUILD UP A DATABASE OF INFO HERE, THANKS.

Posts: 72 | From: Lake Oswego OR, USA  |  IP: Logged
Phil
Post Captain
Member # 509

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LATEST INFORMATION FROM AMERICAN AIRLINES CONCERNING PARTS A, B, & D:

I am the Manager of the retiree benefit plans for AA and TWA retirees. I am also an old
TWAer who was Manager of Health and Welfare benefits when AA took over.
I answered the previous question, but I do not want everyone to have my email address as I
don’t actually work in Employee Services. I am on the Health Strategy side and work more
with the plans than with individual employees or retirees. However, every once in awhile I see confusion on either TARPA or Smilin Jack’s web sites and I like to help retirees get the best information.

AA decided to integrate the Medicare Part D option offered by the government the same as we
would pay secondary to Medicare Parts A and B. We had to take Medicare eligible retirees
out of the Medco benefit because Medco could not pay claims as a secondary carrier. They
are in the business of filling prescriptions, not interested in adjudicating claims as a
secondary carrier.
So, we had UHC come up with a process to pay RX claims secondary to whatever PDP someone has
joined. If you buy a prescription through your PDP that costs $100, you will pay the co pay
or co insurance amount based on your benefit plan. If that amount is less than 80% of the
drug cost, your retiree benefit will pay the difference up to our benefit of 80%.
Let’s say your co pay for this $100 RX is $25 (25% or a co pay of $25). This would mean
that you paid 25% of the cost of the drug and the AA retiree plan could pick up 5% after
your retiree benefit deductible is satisfied. That way you would be out of pocket 20%, or
$20. I hope this makes sense to you.

The statement that someone from the “chat” feature told you there is no coverage if you do
not buy a PDP is not correct. We are secondary and pay after Medicare pays. If you do not
purchase a PDP, we will adjudicate the claim as if there is a PDP and pay secondary to the
basic Medicare offering. The basic offering from Medicare was $250 deductible, then 75%
coverage up to the donut hole, etc. Paying secondary to this plan we would apply our $150
deductible and pay 80% of claims up to the $250 deductible under the Medicare plan. Then we
would pick up the additional 5% while assuming the PDP would be paying 75%. This is hard to
digest without a chart, so if I’ve lost you let me know and I’ll try to make it simpler. Of
course, if you do not join a PDP you would not have a mail order option, since you would not
have a primary prescription benefit.
The AA retiree benefit will pay secondary for mail order prescriptions. You will receive a
monthly statement (EOB) from your PDP. You send it to UHC along with the claim form found
on Jetnet (Medicare Part D Prescription Drug reimbursement form) and a copy of the
prescription receipt. UHC then lookSs to see if there is anything payable under your retiree
medical plan. Sharon AA - Health Strategy

Posts: 72 | From: Lake Oswego OR, USA  |  IP: Logged
L1011Ret
Post Captain
Member # 1792

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I'm not sure what ideas you are looking for? I'm a veteran so I get my prescriptions at the VA and of course get medicare. I supplement medicare Doctor coverage with an AARP policy. I'm a retired TWA pilot, retired before AA bought TWA. My spouse a furloughed AA F/A bought an AARP drug plan. She has medicare also but it is supplemented by UHC through my AA/TWA retiree benefits. Thanks for the info, it is appreciated. We did not know about the part D 80% supplement for drugs.
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Phil
Post Captain
Member # 509

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SPOUSE'S PLAN DROPPED WHEN I TURNED 65 - HERE IS WHY:
The first time my wife tried to refill her prescriptions it came back "No coverage - over age limit." She is well under 65. With the help of the Pharmacy's insurance specialist we determinded that in the month that I turned 65 American Airlines sent a change removing me from Medco Prescriptions and removed my wife at the same time then reinstated her alone. A week or so later I received new UHC cards with only one name on each. BUT!!!!!
The Prescription coverage for my wife was not effective until the first day of the next month. Perhaps the same thing has happened to her Medical plan, but goes unnoticed unless you go to the hospital during that gap. I am trying to get this fixed for all those that will come after me.

Posts: 72 | From: Lake Oswego OR, USA  |  IP: Logged


 
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