Einstein Employees And Dependents: Case Study

To: Einstein Employees and Dependents Eligible for Medicare
This notice has information about your current prescription drug coverage with Einstein and about your options under Medicare’s prescription drug coverage, Medicare Part D. Each year Medicare-eligible individuals have an opportunity to enroll in Medicare Part D between October 15 and December 7.
The reason this memo is being sent to you is because employers are required to remind Medicare-eligible employees and dependents about the annual open enrollment for Medicare Part D and confirm that the prescription plan offered by Einstein is at least equal to the standard Medicare Part D benefit.
If you are an active employee and you or a covered family member is not Medicare eligible, you do not have to do anything. You are
receiving this letter and Notice simply to advise you that the prescription drug coverage offered through the Einstein Healthcare Network medical plan in which you are enrolled provides coverage at least equal to the new standard Medicare Part D benefit.
If you or a covered family member is Medicare-eligible now (or will be in the near future), you should be aware of your prescription drug options. Because your prescription drug coverage is included in your Einstein Healthcare Network medical plan, and since you will be enrolled in this plan in 2018, you do not need to do anything regarding Medicare Part D right now. However, we want to keep you informed about this coverage.
What is Medicare Part D?
Several years ago, Medicare began to cover prescription drugs. The coverage is called Part D, and private insurance companies offer it across the country through Prescription Drug Plans, or PDPs. The monthly premium for this coverage will vary depending on the level of benefits provided.
You Do NOT Need to Enroll in a Medicare Part D Plan
It’s important to know that while you may have the option to enroll (if you are eligible for Medicare), you are not required to do so. In fact, if you plan to continue your coverage through Einstein Healthcare Network, enrolling in Part D may not be to your advantage because you would pay a monthly premium for that coverage. Moreover, your current prescription drug coverage has been determined to provide coverage that is at least equal to the standard Medicare prescription drug benefit.
You DO Need to Keep the Notice
While you don’t need to enroll in Medicare Part D now, you may want this coverage in the future. Normally, Medicare charges higher premiums if you enroll after you are first eligible. That premium penalty does not apply if you do not enroll because you have comparable coverage (such as employer-sponsored
coverage).
Your annual notice of Creditable Coverage Disclosure Notice is on the reverse side of this notice. (If you receive this notice and you are not enrolled in Einstein’s plan through Express Scripts, the notice does not apply to you.) We encourage you to keep this information with your medical records. If you leave employment or drop coverage in this plan, you also will need to request a Certificate of Creditable Coverage that provides individual proof that your Einstein prescription drug coverage qualifies as creditable coverage and if you wish to enroll in Medicare Part D, you will need this document to prove coverage so you will not be required to pay a higher premium.
For More Information
To learn more about Medicare, visit www.medicare.gov or you can call 1-800-MEDICARE (1-800-633-4227). If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit www.socialsecurity.gov or call them at 1-800-772-1213.
If you have questions, contact your Human Resources Service Specialist.