CTPF 2027 MEDICARE HEALTH INSURANCE HANDBOOK 12 Health Insurance Options for Medicare Eligible Members Overview The following pages offer general descriptions of the types of plans offered to CTPF annuitants who are eligible for and maintain active enrollment in Medicare Part A and Part B. All CTPF health insurance plans include comprehensive medical and prescription drug coverage. Specific plan information can be found in the charts in the Plan Cost Comparison section. Medicare Advantage Plans A Medicare Advantage plan completely replaces original Medicare Part A and Part B coverage. In an Advantage plan, the plan administrator assumes all of the financial cost of the services provided to you, less the applicable copayments. CTPF offers two Medicare Advantage plans: UnitedHealthcare Group Medicare Advantage PPO with Express Scripts by Evernorth Health Services® (PDP) for CTPF You can obtain medical care from any physician, hospital, or provider that accepts Medicare. The plan includes enhanced Medicare Part D prescription drug coverage administered by Express Scripts by Evernorth Health Services® (PDP) for CTPF (see Express Scripts Prescription Drug Coverage for more information). This plan covers most medical services at 100% once the deductible is satisfied. Plan premiums include the cost of prescription drug coverage. New enrollees must submit completed enrollment applications to CTPF. Medicare Advantage Note: This CTPF health plan is a custom plan that does not require the use of a network provider for coverage. Your benefit levels are the same whether or not you use a network provider. You may seek care from any provider nationwide that accepts Medicare. All Medicare Advantage plans are regulated by CMS (Centers for Medicare and Medicaid Services). CMS requires that certain language be included in all Medicare Advantage documents. If you have any questions, please call CTPF Member Services at 1-312-641-4464. Humana Group HMO with Part D Pharmacy This plan is a traditional HMO where you select a Primary Care Provider to direct your care. You must use network physicians to receive benefits. The plan includes enhanced Medicare Part D prescription drug coverage provided through Humana. You typically pay a copay for services. Plan premiums, including the cost of prescription drug coverage, are located in the 2027 Plan Cost Comparison section. New enrollees must submit completed enrollment applications to CTPF. Medigap (Supplement) Plan A Medigap policy is supplemental health insurance sold by private companies that helps pay the costs that Original Medicare (Parts A and B) does not cover, such as Part A and Part B deductibles, co-payments, and coinsurance. Original Medicare provides coverage first, then Medigap helps fill in the gaps. The federal government defines standard benefits for Medigap plans. Medigap premiums are regulated by each state. INFO Medicare Star Ratings The Centers for Medicare and Medicaid Services (CMS) uses a Star Rating system to measure how well Medicare Advantage plans and standalone Part D plans perform in categories such as customer service, member complaints, pricing and the array of services each offers. The ratings range from one to five stars, with five being the best and one the worst. To find your plan’s Star Rating, go to www.medicare.gov/find-a-plan/ Once there, enter your plan ID (shown below) and your home zip code. Please note that your plan is part of a larger health insurance contract with Medicare and will not match the name of your group plan: UHC Medicare Advantage Plan H2001 Humana Medicare Advantage Plan H1468 Express Scripts Part D Plan S5660 Medicare
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