CIGNA Medicare Surround Option Retirees of Cobb County
Understanding CIGNA Medicare Surround § The CIGNA Medicare Surround indemnity medical plan helps pay some of the health care costs that your Medicare Part A or Part B do not cover. § With the CIGNA Medicare Surround plan you have the freedom to choose any health care professional that accepts Medicare. § Your out-of-pocket costs may be lower when you use a health care professional who accepts Medicare assignment. § To find doctors who accept Medicare, or to learn more about Medicare benefits and services, visit www. medicare. gov or call 1 -800 -MEDICARE 24 hours a day, 7 days a week. TTY users call 1 -877 -486 -2048. 2 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA
Your CIGNA Medicare Surround Plan: How it Works § CIGNA Medicare Surround is available only if you and/or your eligible dependent qualify for Original Medicare benefits (Part A and Part B). – It is important for you to enroll in Part A and Part B Medicare coverage. Coverage under the CIGNA Medicare Surround plan depends upon you being covered by both Medicare Part A and Part B. – Medicare typically pays 80% for most expenses. CIGNA’s benefit is based on the remaining 20%. – If you do not enroll in Medicare, we will assume the amount payable under Part A and/or Part B has still been paid by Medicare. § You will need to use your Red White and Blue Medicare ID card and your new CIGNA Medicare Surround Indemnity card when you go to the doctor or hospital. – Expenses covered by CIGNA Medicare Surround must be submitted to Medicare before being considered for payment. – Your health care professional will send the claim directly to Medicare. – Medicare will pay the claim and send the claim electronically to CIGNA for additional benefits. 3 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA
Understanding Medicare Part D § § § Medicare Part D provides prescription drug coverage through private insurers. Medicare Part D plans use a drug list called a Formulary, which is a list of prescription drugs that a Medicare drug plan will cover subject to limits and conditions. Medicare defines the types of drugs included in Part D plans based on the medical and pharmacy needs of seniors. You should show your Medicare Part D ID card each time you pick up prescription drugs. CIGNA Medicare Rx (PDP) is a Medicare approved Part D prescription drug plan 4 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA
Your CIGNA Medicare Rx (PDP) Plan: How it Works § Although some Medicare prescription drug plans do not provide coverage during the Coverage Gap section, the CIGNA Medicare Rx (PDP) plan does… so there actually is no gap in coverage. § The CIGNA Medicare Rx (PDP) drug list covers over 6, 000 medications. That’s 94% of the most commonly used drugs used by Medicare Individuals! – Our drug list covers several different options for each type of drug covered by Medicare. – Many of these options include generic drugs that save you money while providing the same clinical effectiveness as brand name drugs 5 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA
Your CIGNA Medicare Rx (PDP) Plan: Part B vs. Part D § Medicare requires certain medications and durable medical equipment (such as diabetic test strips, lancets, and wheelchairs) be covered under Medicare Part B first then the CIGNA Medicare Surround plan. – Even if you buy these items at a pharmacy, they may not be covered by your pharmacy plan. – Many pharmacies can bill your medical plan directly if you ask. § Sometimes, where or why you receive a drug or service determines how it is covered. Vaccinations are one example of this. – Vaccinations, like the ones against shingles, are covered by Medicare Part D if you get the vaccine at the pharmacy. – Other vaccinations, like the ones against the flu, are covered by Medicare Part B first then the CIGNA Medicare Surround plan. 6 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA
Your New Plan: Understanding Which Cards to Use When you go to the doctor or hospital, use these two cards. 2 1 3 When you go to the pharmacy, use this card. 7 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA
Why CIGNA? Excellent Coverage and Access § With the CIGNA Medicare Surround indemnity medical plan: – You don’t need to send your claims to CIGNA. This means less paperwork for you! – You have the freedom to choose any health care provider that accepts Medicare. § With the CIGNA Medicare Rx (PDP) plan: – Our expansive drug list includes over 6, 000 medications and the most commonly used drugs for Medicare-eligible individuals. – A broad network of over 60, 000 retail pharmacies in all 50 states and the District of Columbia ensures you’ll have easy access to pharmacies. – Or save time and money by getting prescriptions delivered directly to your home with CIGNA Home Delivery Pharmacy. • Up to a 90 -day supply of your medication mailed directly to your home, with savings up to 17% off retail. • Convenient ordering is available by phone, online, or by mail. • Our automatic Refill Reminders will identify any prescription that’s late for a refill so you won’t run out. 8 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA
Why CIGNA? Extra Benefits § my. CIGNA. com: secure, online access to information and health resources § CIGNA's Healthy Rewards® * Program: special offers and discounts on fitness clubs, dental care products, laser vision care, natural supplements, everyday health products and more! *The products and services described for Healthy Rewards are neither covered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the CIGNA Medicare Rx® (PDP) grievance process. Some Healthy Rewards are not available in all states. Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2010 CIGNA 9
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