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About the following notice: You are receiving this notice because our records indicate that you are/or will be eligible for Medicare in the next 12 months
Important Creditable Coverage Notice From LifeWise Health Plan
of Washington About Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with LifeWise Health Plan of Washington and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join
a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage
in your area. Information about where you can get help to make decisions about
your prescription drug coverage is at the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
LifeWise Health Plan of Washington has determined that the prescription drug coverage offered by your health plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th through December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
What Happens To Your Current Coverage
If You Decide to Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current LifeWise Health Plan of Washington coverage will not be affected. You can keep your current coverage, but we will coordinate benefits with your Medicare Part D coverage so as not to duplicate payments. If your current coverage pays for other health expenses in addition to prescription drugs, you and your covered dependents will also still be eligible to keep your current health coverage.
If you do decide to join a Medicare drug plan and drop your current LifeWise Health Plan
of Washington coverage, be aware that you and your dependents may not be able to get this
When Will You Pay A Higher Premium (Penalty)
To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with LifeWise Health Plan of Washington and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
For More Information About This Notice Or Your
Current Prescription Drug Coverage…
For further information, call the Customer Service number on your ID information.
NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through LifeWise Health Plan of Washington changes. You also may request a copy of this notice at any time.
For More Information About Your Options Under
Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare offering prescription drug coverage, you may be required to provide a copy of this notice to show whether or not you maintained creditable coverage and whether or not you are required to pay a higher premium amount (a penalty).
LifeWise Health Plan of Washington
PO Box 327
Seattle, WA 98111
What drugs are covered by Part D? • Regional differences in Part B drug coverage policies can occur in the absence of a national coverage decision. • Part D — Prescription Drug Insurance covers drugs defined as: • Drugs available only by prescription, approved by the FDA, and used for a medically accepted indication which are not covered under Part B (or Part A). • Note: Certain drugs or classes of drugs (or their medical uses) are excluded by law from Part D coverage.