Important AlaskaCare Benefit Program Notices
Updated October, 2018
This newsletter contains important AlaskaCare benefit program notices of interest to you and your family. Please share this information with your family members. Some of the notices in this newsletter are required by law and other notices contain helpful information. These notices are updated from time to time and some of the federal notices are updated each year. Be sure you are reviewing the most updated version of these important notices.
Important Notice for AlaskaCare Employees About Prescription Drug Coverage and Medicare
AlaskaCare Employees, you only need to read the following if:
- you or your family members are not eligible for AlaskaCare Retiree Health Plan Coverage, and
- are Medicare eligible, or
- will become Medicare eligible in the next 12 months.
If you do not meet these criteria, the following information does not apply to you.
This notice holds information regarding your AlaskaCare prescription drug coverage and the options available to you. This information can help you decide if joining a Medicare drug plan is right for you. If you are considering joining, compare your current AlaskaCare coverage, including which drugs are covered and at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. If you would like assistance with choosing the right prescription drug coverage, please see the end of this notice.
Medicare prescription drug coverage is available to Medicareeligible people through Medicare Prescription Drugs Plans (PDPs) and Medicare Advantage Plans (like an HMO or PPO) that offer prescription drug coverage. All Medicare drug plans provide a standard level of coverage set by Medicare. Some other plans may also offer more coverage for a higher monthly premium.
The State of Alaska has determined that the prescription drug coverage is “creditable” under the AlaskaCare Employee Health Plan. “Creditable” means that the value of the Plan’s prescription drug benefit is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays. Because the plan option noted above are Creditable Coverage, you can elect or keep prescription drug coverage under the plan and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare prescription drug plan.
Benefits Provided by Your Employee AlaskaCare Prescription Drug Plan
| Prescription Teir |
Coinsurance |
Min. Covered
Person Payment |
Max. Covered
Person Payment |
| Retail 30-Day at Network Pharmacy
|
Generic
prescription drug |
80% |
$10 |
$50 |
Preferred
brand-name
prescription drug |
75% |
$25 |
$75 |
Non-preferred
brand-name
prescription drug |
65% |
$80 |
$150 |
| Mail Order 31-90 Day at Network Pharmacy
|
| Prescription Teir |
Copayment |
| Generic prescription drug |
$20 |
Preferred brand-name
prescription drug |
$50 |
Non-preferred
brand-name prescription drug |
$100 |
| Out-of-Pocket Limit
|
Annual individual
out-of-pocket limit |
$1,000 |
Annual family
out-of-pocket limit |
$2,000 |
