Coverage for Medicare Eligible Retirees
You have unique needs when it comes to your health, this is why The University of Chicago has chosen to offer you the choice of two medical plans, both administered by Aetna: the Medicare Advantage Plan or the Medicare Supplement Plan. Aetna is a top carrier in the Medicare space and offers a strong provider network.
AETNA MEDICARE ADVANTAGE PLAN
The Aetna Medicare Advantage Plan is a Medicare Part C plan that includes both Medicare Part A (hospital insurance) and Part B (medical insurance). Coverage under the Medicare Advantage Plan means you still have Medicare, but your insurance coverage is managed and paid for by Aetna.
Finding In-Network Providers
From a claims standpoint, it is always better to see an in-network provider, no matter which plan you choose. Call Aetna's Member Services Monday through Friday from 8:00 a.m. to 6:00 p.m. at (888)267-2637 or go online to aetnaretireeplans.com, to find an in-network provider or to confirm if your provider is in-network.
Care When Traveling Outside the U.S.
If you are traveling outside the country, you are covered for urgent and emergency care. Contact Aetna's Member Services at (888)267-2637 for assistance with finding a provider or care facility.
- Out-of-Network: The Aetna Medicare Advantage Plan has an Extended Service Area (ESA) that allows you to see out-of-network providers as long as they accept Medicare.
- Continuity of Care: Aetna provides care coordination for you if you have any planned surgery or tests scheduled for January 2020. For more information, review the Continuity of Care Transition Assistance Form under Related Documents.
- Prior Authorization: If you are using an in-network provider, the provider is responsible for obtaining prior authorization.
- Additional benefits: include, SilverSneakers, Routine vision care, routine hearing services, video doctor visits, and routine foot care.
AETNA MEDICARE SUPPLEMENT PLAN
The Aetna Medicare Supplement Plan coordinates payments with Medicare Part A and B and supplements the Medicare coverage by paying additional amounts not covered. Medicare provides your primary medical coverage and pays first. The Aetna Medicare Supplement Plan will process second and pay additional amounts not covered by Medicare.
Your medical services must be provided by a doctor who accepts Medicare.
The Aetna Medicare Supplement Plan lets you visit any licensed doctor or hospital that accepts Medicare. There are no networks and no referrals needed. The plan gives you access to tools, tips, programs and services to help you find doctors and estimate costs. To find a doctor call Aetna's Member Services (24 hours) at (888)982-3862 or go online to aetnaretireeplans.com.
- Streamline Claim Submission: Medicare Direct electronically links Medicare as the primary payer with Aetna as the secondary eliminating the need for a member to file a claim to Aetna for secondary consideration.
- Explanation of Benefits: The Aetna Explanation of Benefits (EOB) produced will reflect how much your plan pays and how much you pay for covered services.
- Find a Doctor: You can find doctors by name, specialty, and location. You’ll also find maps, directions, and more on aetnaretireeplans.com.
- Discount Program: The member discount program includes discounts on services such as vision services and hardware, fitness, and hearing aids.
YOUR CARE, YOUR CHOICE
Retirees and dependents in the University’s Retiree Medical Plan will remain enrolled in their current medical plan unless a change is requested during Open Enrollment.
TERMINATING THE RETIREE MEDICAL PLAN
If you no longer want to be covered by one of the University's Retiree Medical Plans, please complete the Retiree Medical Plan Opt-Out Form under related documents and fax to (773)834-0996 or return via email to email@example.com.
Cancellations cannot be made more than 30 days retroactively. Once enrollment in the Retiree Medical Plan is canceled you cannot re-enroll in the plan.
By terminating the plan, you are also forfeiting the prescription benefit.