SilverScript Prescription Drug Presentation

Report
M-NCPPC and
SilverScript
New Retiree Prescription
Drug Plan
Lissa Tarro
Strategic Account Executive
©2014 Caremark. All rights reserved. This presentation contains confidential and proprietary information of CVS/caremark and cannot be reproduced, distributed or printed without written permission from CVS/caremark.
Agenda Items
• Introducing SilverScript®
• EGWP & WRAP Explanation
• How to Enroll
• 2015 Open Enrollment
• Mailings
• Good to Know Information
• FAQ’s
• Recap of Important Points
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Introducing SilverScript!
• What’s happening
• Effective January 1, 2015, SilverScript (a subsidiary of CVS Caremark) will
administer prescription drug coverage for retirees and their dependents
eligible for Medicare
• Why the change
Because of the Affordable Care Act and some of the recent changes to
Medicare, M-NCCPC can provide you with the same prescription coverage
you have now by moving to the SilverScript Group Medicare Part D
Prescription Drug Plan with an Employer Group Wrap Plan, while taking
advantage of the savings provided by these changes
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SilverScript & M-NCPPC Medicare Eligible
Retiree Prescription Drug Plan
As a Medicare-eligible retiree who is enrolled in the M-NCPPC
prescription plan, you will have a comprehensive prescription drug
plan that is administered by SilverScript, a subsidiary of CVS
Caremark
Your Prescription Drug Plan consists of two parts:
• Medicare Part D Plan: Provides the same benefit coverage as the
Medicare Part D program offered by the federal government
• Wrap Plan: A prescription drug plan provided by M-NCPPC, which
covers the gaps in the Medicare Part D program to provide a benefit
that’s more comprehensive than Medicare Part D alone. This wrap
plan will mirror the coverage you have today.
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Part D Employer Group Wrap Plan (EGWP)
• SilverScript is the Medicare Part D prescription drug plan that
provides primary coverage for the member
• M-NCPPC’s plan provides secondary coverage or supplemental
coverage
• Single ID Card
• Seamless Transaction
______________________________
How the Plan Works
• Member picks up prescription at local pharmacy. If not covered under
the SilverScript Part D plan, the M-NCPPC plan will cover the cost of
the medication, if it is currently covered under the CVS Caremark
plan.
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Part D Employer Group Wrap Plan (EGWP)
M-NCPPC Caremark
Wrap Plan
Medicare Part D
Prescription Drug
Plan
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Eligibility Requirements for Employer Group
Wrap Plan
• Retiree must have Medicare A or B
• HICN number
• Must have physical address
• Must not be enrolled in another Medicare Part D plan (Annual
Election Period Oct 15th – Dec 7th)
• Effective date is always the first of the month
• Must reside in the United States
• Dependents are eligible
– Those who are not Medicare eligible will continue to be covered under the
CVS Caremark plan
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How To Enroll / Things To Do
• You are automatically enrolled in the SilverScript Part D prescription
plan effective January 1, 2015 if you are currently enrolled in the CVS
Caremark plan and you are now Medicare eligible
• You are automatically enrolled in the SilverScript Part D prescription
plan on the first of the month in which you reach age 65 or upon
becoming eligible for Medicare if you are currently enrolled in the
CVS Caremark prescription plan
• You do not need to fill out Part D enrollment forms, interact with
the Medicare program or take any other action to enroll in
coverage
• M-NCPPC / SilverScript will work together to enroll all the Medicare
eligible participants into the plan during Open Enrollment
• Make sure we receive your HICN
• Make sure you confirm your residential address with SilverScript
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Do Not Opt Out
• Your new prescription drug coverage is a Medicare Part D
prescription drug plan. SilverScript is required to send you a letter
giving you a chance to opt out or cancel your enrollment in
prescription drug coverage. You will receive this “opt out” letter from
SilverScript in early December.
– Do not opt out. If you opt out, prescription drug coverage for you and your
dependents will terminate
– Once you opt out you may not be able to re-enroll unless you provide proof
that you had similar coverage elsewhere during the time you were not
covered under the M-NCPPC prescription drug program.
– If you are allowed to re-enroll, you may be subject to a late enrollment
penalty
Do Not Enroll in Any Individual Medicare Prescription Drug Plan
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Open Enrollment
• M-NCPPC’s Open Enrollment is October 20th through
November 7th
–We’re “Going Green”. No thick packets mailed this
year.
–You can request a hard copy sent to you.
–You will receive information on the upcoming plan
changes for 2015 in September and October
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Standard Mailings for SilverScript
Part D Prescription Program
MAILING
•Opt Out Letter
•Summary of Benefits
•Welcome Letter
•Evidence of Coverage
•Formulary
•Pharmacy Directory
•ID Cards
•Monthly Explanation of Benefits
•Coordination of Benefits Survey
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Standard Mailings for SilverScript
Part D Prescription Program
DESCRIPTION
•Do not Opt Out, Ignore letter
•Shows Co-Pay Structure
•Confirmation of Enrollment
•Complete details of Plan
•Abridged list of Covered Drugs
•Same as Current Network
•Individual Id card for member
•(EOB) Monthly breakdown Fills
•(COB) For other Coverage
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Mailings From M-NCPPC
WE WILL MAIL THE FOLLOWING PIECES:
• Announcement Letters
• Invitation regarding Seminars and Web-exes
• Request Letters for Medicare HICN
• Name Change Letters
• P.O. Box Letters
• Open Enrollment Information
We will also have information in the Retiree Newsletter, The
Retiree Association webpage and M-NCPPC’s webpage under
Benefits.
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Health and Wellness Web Portal
• Part of www.SilverScript.com website
• Health-related information and tools
– Health Risk Assessment
– Health / lifestyle improvement programs
– Calculators / trackers and other tools to enable self assessment and
program utilization
• Articles written about health and wellness for members of all ages
with a focus on health issues for seniors
– 10 self-care centers that educate members on health-related topics for
seniors
• Free to all SilverScript members
• Easily accessed through SilverScript website
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ExtraCare® Health Card
CVS EXTRA CARE
• The ExtraCare Health card is a value-added
service provided for free to all SilverScript
Insurance Company members and their
immediate families
• Largest, most successful pharmacy
loyalty program in the U.S.
• 20% discount on OTC, CVS
brand products
– Applies to more than 1,500 items at 6,300 stores
– Helps participants access over-the-counter (OTC)
remedies at lower costs
• Discount is available at CVS pharmacy
locations and cvs.com
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CVS EXTRA CARE
http://mncppc.silverscript.com
Website built specifically for M-NCPPC retiree members
• Comprehensive and easy to understand information about all
SilverScript plans with side by side comparison
• Pharmacy locator by zip code
• Easy reference to all Plan documents (non-personalized)
• Print temporary ID cards
• Health and wellness information
• CMS and ADA Title 3 compliant, fully bilingual
• New log on ID and password required for caremark.com
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Contact Information
SilverScript, Customer Service Team:
• 866-270-3759 (Live on October 20th)
• http://mncppc.silverscript.com
Other Resources:
• www.socialsecurity.gov
• www.medicare.gov
• http://www.mncppc-retireesassociation.com
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Frequently Asked Questions
• Do I need to fill out any paperwork to enroll?
– No. You will automatically be enrolled in the plan if you are currently
enrolled in the CVS/Caremark prescription plan.
• What happens if I choose to Opt out?
– You will lose prescription drug coverage for you and your dependents and
may not be able to re-enroll at a later date.
• Will all of my current medications be covered?
– Yes, if your medications are currently covered they will remain covered. In
rare cases, a medication may not be covered under the Part D plan,
however, the M-NCPPC wrap plan may cover the medication. SilverScript
is required to send the member a letter stating that they are subject to a 30day transition fill. The member should disregard this letter.
• I didn’t receive a new SilverScript Card, can I use my Caremark
card? No, after 01/01/2015, your Caremark card will be inactive.
Please refer to the following slide for instructions.
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Frequently Asked Questions (continued)
• Can I continue to use the same pharmacy?
– Yes, the pharmacy networks are unchanged to the member.
• Why am I receiving an explanation of benefits every month if the
M-NCPPC Wrap Plan is covering all of my medication?
– The CMS regulations apply for all Part D prescription programs including
EGWP.
• What is a late enrollment penalty (LEP)?
– Only a handful of members may have a late enrollment penalty. This
means you did not enroll in a Medicare Part D plan when you originally
became eligible.
• What do I do if I receive a letter from SilverScript stating that I
am not eligible to participate in the plan?
– In most cases, the reason for this letter is that SilverScript and CMS do not
have the same eligibility information (date of birth, Medicare #, address).
You should follow the instructions in the letter to correct the eligibility
information.
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Recap of Important Points
• Respond immediately to any requests for a HICN, physical address,
name change, or any other information to avoid a delay in enrollment
• Do not opt out of coverage
• Do not enroll in any individual Medicare Prescription drug plan
• You do not have to enroll directly with Medicare
• Open enrollment begins October 20 and ends November 7, 2014
• New plan begins January 1, 2015.
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