Frequently Asked Questions - Medicare Supplement Benefits

• Who is eligible to participate in PEHP's Medicare Supplement Program?
• When can an individual enroll in PEHP's Medicare Supplement Program that includes a Medicare approved prescription drug plan?
• Common Questions regarding the prescription drug benefits.

1) Retired individuals age 65 and over that have earned service credit with Utah Retirement System (URS) are a participant with a URS Defined Contribution Plan, or previously had PEHP medical coverage.

2) Individuals under the age of 65 that have Medicare coverage and are a member or a dependent of a member who has earned service credit with URS or is a participant with a URS Defined Contribution Plan.

3) Spouses of those eligible under #1 and #2.

However, the individual and their spouse must be enrolled in the same PEHP Medicare Supplement plan. If the retired individual and their spouse have both earned service credit with URS and/or are participants with a Utah Retirement Systems Defined Contribution Plan they do not need to be enrolled in the same PEHP Medicare Supplement plan.

1) When you first become eligible for Medicare, during the period that starts three months before the month you turn age 65 and ends three months after the month you turn age 65. If you receive Medicare benefits due to a disability, you can join three month before and after your 24th month of cash disability benefits.

2) When your active group coverage terminates you have 63 days to enroll in PEHP's Medicare Supplement Plan to avoid paying an enrollment penalty on PEHP's Medicare Prescription Drug plan.

Your effective date for PEHP's Medicare Supplement Plan will be the first day of the month following the date of PEHP's receipt of the enrollment form.

TO AVOID A LAPSE IN COVERAGE, PEHP MUST RECEIVE YOUR ENROLLMENT FORM 30 DAYS PRIOR TO THE MONTH THAT YOU TURN AGE 65 OR 30 DAYS PRIOR TO THE MONTH THAT YOUR ACTIVE GROUP COVERAGE ENDS. IF YOUR ENROLLMENT FORM IS RECEIVED TIMELY BY PEHP, YOUR COVERAGE WILL BE EFFECTIVE THE FIRST OF THE MONTH THAT YOU TURN AGE 65 OR THE FIRST OF THE MONTH YOUR ACTIVE GROUP COVERAGE TERMINATES.

3) PEHP's Medicare Supplement plans open enrollment is November 15th through December 15th of each calendar year. At that time you can elect to stay on the same PEHP Medicare Supplement option, select another PEHP Medicare Supplement option or cancel your PEHP Medicare Supplement coverage.

If you choose to cancel your PEHP Medicare Supplement coverage, your PEHP Medicare Supplement coverage for Medicare Parts A, B and D (the Medicare approved prescription drug benefit) will be cancelled.

Both of PEHP's prescription drug plans are administered by Medco Health and are approved by Medicare. The service area for both plans includes all 50 states and the District of Columbia. If you choose either the Basic Plan or the Enhanced Plan, you will be enrolled in the Medco YouRxPlan.

1) Where can you get your prescriptions?

The YouRxPlan includes a network of pharmacies. Please call Medco Customer service at 1-800-590-2239 for network pharmacy information, or for help finding a pharmacy.

2) Does PEHP cover Medicare Part B or Medicare Part D medications?

The YouRxPlan does not cover prescription drug that are covered under Medicare Part B as prescribed and dispensed. Generally PEHP only covers drugs, vaccines, bologicals, and medical supplies that are covered under the Medicare Part D Prescription drug benefit and that are included in the plan's formulary.

3) Does my plan have a prescription drug formulary?

Yes. A formulary is a preferred list of drugs selected to meet patient needs.

For information regarding the formulary drugs and a list of participating pharmacies, you can call Medco Customer Service at 1-800-590-2239 or visit the website at www.yourxplan.com. You will be required to register on the site.