Jeffrey Wade
The National Association of Letter Carriers (NALC) Health Benefit Plan offers a range of benefits to its members, including Medicare Parts A, B, and D. NALC members who are enrolled in the High Option Plan and Medicare Part B will have their Part B plan pay benefits as the primary payer. Additionally, those enrolled in Medicare Part D will have their retail fill limit and retail day's supply limitations waived by the NALC Health Benefit Plan High Option. The NALC Health Benefit Plan also offers enhanced benefits through the NALC High Option Plan - Aetna Medicare Advantage, which is available to members enrolled in Medicare Parts A and B. This plan provides extra value with $0 deductibles, prescription drug copays as low as $0, and a $75 monthly Medicare Part B premium reduction.
| Characteristics | Values |
|---|---|
| Medicare Part B | Pays benefits as the primary payor |
| Medicare Part B | Pays for doctor charges, diagnostic services, ambulance charges, surgeries, medical equipment and supplies |
| Medicare Part B | Offers a $75 monthly premium reduction |
| Medicare Part B | Offers a $600 annual reimbursement for premium payments |
| Medicare Part D | Waives retail fill limit and retail day's supply limitations |
| Medicare Part D | Pays the balance after Medicare's drug payment or the prescription drug benefit, whichever is the lesser amount |
| Medicare Part D | Offers prescription drug copays as low as $0 |
Explore related products
What You'll Learn
NALC Health Benefit Plan High Option and Medicare Part B
The NALC Health Benefit Plan has been providing letter carriers and their families with first-rate health insurance since 1950. The NALC Health Benefit Plan High Option is a special offering available to those enrolled in the NALC Health Benefit Plan High Option through the FEHB program and are enrolled in Medicare Parts A and B.
The NALC Health Benefit Plan High Option provides an enhanced level of benefits for annuitants with Medicare Parts A and B. For example, if you are enrolled in the NALC Health Benefit Plan High Option and Medicare Part B, your Medicare Part B plan will pay benefits as the primary payor. Your Medicare Part B claims are transmitted electronically to the NALC Health Benefit Plan High Option, where they will pay the Medicare Part B deductible and coinsurance on covered services. This means you will have no out-of-pocket expenses as they supplement Medicare's payment up to 100% of the covered charge.
Additionally, the NALC Health Benefit Plan High Option offers a $75 monthly Medicare Part B premium reduction. This will be credited to your Social Security account each month, up to $900 a year.
The NALC Health Benefit Plan High Option also offers the SilverScript PDP, which combines Medicare Part D prescription drug coverage with additional coverage provided by the NALC Health Benefit Plan. This plan is voluntary, and you can opt-out at any time.
If you are enrolled in Medicare Part D, you are eligible to enroll in a Medicare Prescription Drug Plan. When you are enrolled in a Medicare Part D Plan and Medicare Part D pays first, the NALC Health Benefit Plan High Option will waive your retail fill limit and retail day's supply limitations.
Understanding Medicare Supplement Insurance Underwriting
You may want to see also
Explore related products
$16.89 $28.99
$19.99
NALC Health Benefit Plan High Option and Medicare Part D
The NALC Health Benefit Plan has been providing letter carriers and their families with first-rate health insurance since 1950. It is the only health plan owned and operated by letter carriers, and as a not-for-profit organisation, its sole focus is the health of its members.
The NALC Health Benefit Plan High Option is a special offering available to those enrolled in the NALC Health Benefit Plan High Option through the FEHB program, and who are also enrolled in Medicare Parts A and B.
The NALC Health Benefit Plan High Option combines with Medicare Part D prescription drug coverage, with additional coverage provided by the NALC Health Benefit Plan. This fills the gaps between the standard Part D plan and the current NALC coverage.
If you are enrolled in a Medicare Part D Plan and Medicare Part D pays first, the NALC Health Benefit Plan High Option will waive your retail fill limit and retail day's supply limitations. They will coordinate benefits as the secondary payor and pay the balance after Medicare's drug payment or the NALC prescription drug benefit, whichever is the lesser amount.
The NALC High Option Plan — Aetna Medicare Advantage is a Medicare Part C plan and offers enhanced benefits without suspending your FEHB coverage. It provides all the benefits of a Medicare Advantage with a prescription drug plan and allows you to keep your Federal Employees Health Benefits (FEHB) coverage through the NALC Health Benefit Plan.
The NALC High Option Plan — Aetna Medicare Advantage also provides access to additional valuable programs and services such as Healthy Home Visits, home-delivered meals after discharge from an inpatient hospital stay, non-emergency transportation, and the SilverSneakers® fitness benefit.
Understanding Private Medical Insurance in the UK: A Guide
You may want to see also
Explore related products
SilverScript PDP and Medicare Part B
The SilverScript Prescription Drug Plan (PDP) is sponsored by the NALC Health Benefit Plan. It combines Medicare Part D prescription drug coverage with additional coverage provided by the NALC Health Benefit Plan. This additional coverage bridges the gap between the standard Part D plan and the current NALC coverage.
If you are an annuitant or an annuitant's family member enrolled in Medicare Part A or Parts A and B, you will be automatically enrolled in SilverScript. You can opt out of SilverScript PDP enrollment at any time. However, if you are a PSHB Member, opting out will result in losing all prescription drug coverage. On the other hand, if you are an FEHB Member, you will remain on your current NALC prescription plan.
SilverScript PDP participants are eligible to receive up to a $600 Medicare Part B premium reimbursement per enrollee from the NALC Health Benefit Plan. To receive this reimbursement, you must submit proof of your Medicare Part B premium payments through the online portal, HealthEquity's EZ Receipts app, by fax, or mail.
Medicare Part B is medical insurance that covers doctor charges, diagnostic services, ambulance charges, surgeries, medical equipment, and supplies. When enrolled in the NALC Health Benefit Plan High Option and Medicare Part B, your Part B plan pays benefits first. Your Part B claims are transmitted electronically to the NALC Health Benefit Plan High Option, which then pays the deductible and coinsurance for covered services. As a result, you do not incur any out-of-pocket expenses because NALC supplements Medicare's payment up to 100% of the covered charge.
Medicare Part D, on the other hand, is a prescription drug plan. Enrolling in a Part D Plan is optional but provides additional coverage for prescription drugs. When Medicare Part D pays first, the NALC Health Benefit Plan High Option will waive certain limitations and act as the secondary payer, covering any balance after Medicare's drug payment or the NALC prescription drug benefit, whichever is lower.
Schengen Visa Medical Insurance: Where to Get Covered
You may want to see also
Explore related products
Aetna Medicare Advantage and Medicare Part B
The NALC Health Benefit Plan High Option covers Medicare Part B and Part D. Medicare Part B covers doctor charges, diagnostic services, ambulance charges, surgeries, medical equipment and supplies. Meanwhile, Medicare Part D covers prescription drugs.
Aetna Medicare Advantage is a health plan option that is part of the Medicare program. It offers a variety of coverage and benefits, including dental, vision, hearing, DME, and fitness memberships.
Aetna Medicare Advantage is available to those with Medicare Parts A and B as their primary coverage. If you have Medicare Parts A and B and are enrolled in the NALC Health Benefit Plan High Option, you can opt in to the NALC High Option Plan – Aetna Medicare Advantage.
If you opt in to the NALC High Option Plan – Aetna Medicare Advantage and change your mind, you can switch back to the High Option Plan with Original Medicare at any time.
Accident Insurance: Pregnancy Coverage Explained
You may want to see also
Explore related products
Aetna Medicare Advantage and Medicare Part D
The NALC Health Benefit Plan High Option covers Medicare Part B and Part D. When enrolled in the NALC Health Benefit Plan High Option and Medicare Part B, your Medicare Part B plan will pay benefits first. Your Medicare Part B claims are transmitted electronically to the NALC Health Benefit Plan High Option, where they will pay the deductible and coinsurance on covered services. There are no out-of-pocket expenses since the NALC Health Benefit Plan High Option supplements Medicare's payment up to 100% of the covered charge.
NALC also offers a SilverScript PDP plan that combines Medicare Part D prescription drug coverage with additional coverage provided by the NALC Health Benefit Plan. This plan is voluntary and fills the gaps between the standard Part D plan and the current NALC coverage.
Now, onto Aetna Medicare Advantage and Medicare Part D.
Aetna offers Medicare Advantage plans, also known as Medicare Part C, which include Medicare Parts A and B (Original Medicare) plus Part D. These plans vary in cost and benefits, and some may include additional benefits like dental, eyewear, or hearing aid coverage. Aetna's Medicare Advantage plans allow you to use any licensed doctors and hospitals that accept Medicare payments and your plan. Your coverage follows you nationwide.
Medicare Part D, offered by Aetna, is a prescription drug plan (PDP) available in all 50 states and Washington, D.C. This plan may lower premiums for those eligible for the Medicare Part D Extra Help program. The SilverScript Choice drug plan, part of the PDP, offers a wide range of brand-name and generic drugs, with more than 1,400 drugs on the formulary.
Aetna handles premium payments for Part D plans through InstaMed, a trusted payment service. It is important to note that Resources For Living is not available for members with Aetna Part D plans, Dual Eligible Special Needs Plans (D-SNPs), Chronic Condition Special Needs Plans (C-SNP), Institutional Special Needs Plans (I-SNPs), or Medicare Supplement plans.
Before enrolling in a Part D plan, consider the potential late enrollment penalty, which permanently increases your Part D costs if you go without Medicare drug coverage for 63 days or more after your Initial Enrollment Period ends. Additionally, keep in mind the annual out-of-pocket maximum; once you spend $2,000 on out-of-pocket costs, your plan will pay the full cost for covered drugs for the rest of the plan year.
Medical Insurance for Kids: IRS Requirements and You
You may want to see also
Frequently asked questions
The NALC High Option Plan is a Medicare Advantage plan offered by the National Association of Letter Carriers (NALC) Health Benefit Plan. It provides enhanced benefits for members enrolled in Medicare Parts A and B.
The NALC High Option Plan coordinates with Medicare Part B as the primary payer. Once you are enrolled in both plans, Medicare Part B pays benefits first, and the NALC High Option Plan pays the deductible and coinsurance on covered services. There are no out-of-pocket expenses for covered charges. Additionally, the NALC High Option Plan reduces the Medicare Part B premium by $75 per month for eligible members.
The NALC High Option Plan combines with Medicare Part D to provide prescription drug coverage. When Medicare Part D is the primary payer, the NALC High Option Plan acts as the secondary payer, covering the balance after Medicare's drug payment or the plan's prescription drug benefit, whichever is lesser.
![Medicare and Social Security: [5 in 1] Maximize Your Retirement Benefits, Secure Medical Coverage and Quality Healthcare | Proven Strategies to Protect Your Financial Future Avoiding Costly Mistakes](https://m.media-amazon.com/images/I/71sRJGiWeQL._AC_UL320_.jpg)
