Coverage for Medicare Eligible Retirees
You have unique needs when it comes to your health, this is why The University of Chicago offers 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.
Key Features
- 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 more information, review the Continuity of Care Transition Assistance Form under Related Documents (Aetna Advantage).
- 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.
Take Control
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 800.238.6716 or go online to aetnaretireeplans.com.
Key Features
- 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 the annual Open Enrollment (November).
Prescription Coverage
Prescription coverage for Medicare-eligible retirees is administered by SilverScript, which is licensed by CVS Caremark. For information on prescriptions or to find a CVS Caremark participating retail network pharmacy near you, visit caremark.com. You can also call CVS Caremark at 833.958.2658.
Monthly Premiums
These rates are effective January 1, 2024.
Monthly rates for the Retiree Medical Plan vary depending on the number of people that are being covered, their ages, and the plan that is chosen. Faculty emeriti who retired under the Faculty Retirement Incentive Program Early Retirement Option do not pay premiums for themselves or dependents over the age of 65 enrolled in Medicare.
| Level of Coverage | Aetna Medicare Advantage Plan | Aetna Medicare Supplement Plan |
| One person age 65 or older | $264 | $399 |
| Two persons age 65 or older | $529 | $798 |
The University does not require a separate prescription drug premium. However, Social Security Administration may require an Income Related Monthly Adjustment Amount, as required under the Affordable Care Act, for some retirees based on their income from two years ago. If you have to pay an extra amount, Social Security will send a letter telling you what the extra amount will be and how to pay it.
Turning Age 65
Your monthly premiums will be adjusted to reflect the lower, 65-and-older rate by taking the following actions:
- Call the Social Security Office 800.772.1213 to enroll in Medicare Parts A and B three months prior to your 65th birthday.
- Send a photocopy of your Medicare card showing Part A and Part B coverage to Human Resources - Benefits, Attention: Retiree Medical Plan, 6054 S. Drexel Ave., Chicago, IL 60637.
If you are Medicare-eligible, you must be enrolled in both Medicare Part A and Medicare Part B and not enrolled in Medicare Part D to be enrolled in the Retiree Medical Plan.
Payment Methods
University Billing is handled by WEX Health Inc. (WEX), P.O. Box 2079, Omaha, NE 68103-2079; telephone 866.451.3399. You may arrange with WEX for direct payments from your checking account for the Retiree Medical Program monthly rates.
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 cancelation form found under Related Documents and fax to 773.834.0996 or return via email to retiree@uchicago.edu.
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.