Dear Retiree,

You count on your healthcare coverage to give you access to the services you need and the providers you prefer.  We are pleased to let you know we are making your healthcare coverage even better.  Effective January 1, 2027, IUOE Local 138 will offer its Medicare-eligible retirees the Anthem Medicare Preferred (PPO) Medical and Prescription Drug with Senior Rx Plus Medical and Prescription Drug plan.

 

Shortly Anthem Blue Cross and Blue Shield Retiree Solutions will mail a Medicare Advantage Enrollment Guide to IUOE Local 138 Medicare-eligible retirees.  This guide will describe the new medical and prescription drug plan.  Please review this information carefully.  The current IUOE Local 138 medical and prescription drug plan for Medicare-eligible retirees through Aetna will not be offered effective January 1, 2027.

What is the Anthem Medicare Preferred (PPO) Medical and Prescription Drug with Senior Rx Plus plan?

The Anthem Medicare Preferred Medical and Prescription Drug plan is a Medicare Advantage plan that provides Medicare-eligible individuals with an alternative to the traditional Medicare program.

The plan uses a network of healthcare providers but gives you the freedom to see providers outside of the network.  No referrals are required.  However, some benefits or services may need prior authorization.  Prior authorization is approval that providers and pharmacies request and receive from your plan to provide you with certain services, drugs, treatments, or therapies.

Your medical plan pays the same benefit for in-network providers and out-of-network providers who accept both Medicare and the Anthem Medicare Preferred (PPO) Medical and Prescription Drug with Senior Rx Plus plan. This plan provides reimbursement for all covered services regardless of whether they are received in-network or out-of-network and are a Medicare-covered benefit.

 

 

 

Coverage you can count on:

The Anthem Medicare Preferred (PPO) Medical and Prescription Drug with Senior Rx Plus plan coverage includes:

 

• Doctor office visits

• Video provider visits

• Inpatient and outpatient hospital services
• Emergency care services
• Ambulance services

• Diagnostic tests such as X-rays and laboratory services

• Prescription Drug Coverage
• Large Network of Pharmacies – access to a vast network of pharmacies, including most national chains, and many local pharmacies.  Additional information on pharmacies is included in the Enrollment Guide.
• Vision, Hearing, Footcare

• Dedicated customer service unit specially trained to handle the needs of our retirees

• NurseLine – Registered nurses answer your call 24 hours a day, 7 days a week

• Voluntary HouseCalls – Personalized visit to your home once a year that can lead to a care plan tailored just for you (program is completely voluntary)

• SilverSneakers® – Fitness and lifestyle benefit, with access to thousands of participating locations
• Medicare Community Resource Support – a social worker will get you in touch with community services such as getting nutritious food, non-emergency transportation, assistance with pharmacy copayments and utility bills, and much more
• Nationwide Access – You can see any provider who participates in Medicare and accepts your group PPO plan either as an in-network or out-of-network provider

 

Added benefits without additional cost:

The Anthem Medicare Preferred Medical and Prescription Drug plan also offers wellness programs at no extra cost.  These programs include access to discounts on fitness club memberships, weight loss programs, nutritional supplements, and more.

If you have questions or concerns, please contact the Anthem Medicare Preferred Medical and Prescription Drug plan, First Impressions Welcome Center at 1-833-848-8729 and reference NY107GRS or you can always contact the Welfare Fund at 631- 694-2480 option 2.

We will be offering webinars in the upcoming weeks with frequently asked questions to help with a smooth transition.

Sincerley,

Board of Trustees – Welfare