Human Resources
Group N Plan for Medicare-Eligible Retirees
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Resources |
| Group N Plan | Group N Plan Summary |
| Group MedicareBlue Rx | Applications |
| Enrollment | Group Plan N application |
| For More Information | MedicareBlue Rx application |
| Health Insurance Certificate | Premium |
| Group Retiree Program N | Group N Plan & MedicareBlue Rx |
Group N Plan
The Group N Plan is a State of Iowa sponsored group health insurance plan offered by Wellmark Blue Cross Blue Shield. The plan design of the Group N Plan is similar to the Medicare Supplement Plan N that you can purchase individually.
Eligibility
You are eligible to enroll in the Group N Plan and in one of the two Group MedicareBlue Rx Plans if you are:
- Medicare-eligible State of Iowa retiree or
- A Medicare-eligible surviving spouse of a retiree
You are not eligible to enroll in the Group N Plan and in one of the two Group MedicareBlue Rx Plans if you are:
- A State of Iowa retiree not eligible for Medicare
- A State of Iowa retiree eligible for Medicare, but whose covered dependent is not eligible for Medicare
- A surviving spouse of a State of Iowa retiree who is not eligible for Medicare
- A Medicare-eligible State of Iowa retiree or eligible dependent that is participating in either the SLIP or SERIP program. (Note: Retirees who were SPOC supervisors and are utilizing the SPOC Sick Leave Trust Fund are eligible for this coverage.)
If you currently have family coverage and you enroll in the Group N Plan, your dependents must also enroll in the Group N Plan. If your dependents are not eligible for Medicare, they cannot enroll in the Group N plan, so instead, they would be dropped from your coverage. They are not allowed to stay on the regular State of Iowa insurance plans (Program 3 Plus, Blue Access, etc.) if you move to the Group N Plan. If your spouse or dependent is eligible for Medicare, but you are not, they cannot enroll in the Group N Plan until you, the retiree, are also eligible for Medicare and enroll in the Group N Plan.
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Group N Plan Supplements Your Medicare Coverage
The Group N Plan summary indicates what Medicare, Wellmark, and you pay. Group N Plan provides extensive coverage in supplementing your Medicare coverage. You have national coverage with any healthcare provider that accepts Medicare. The plan covers the Medicare Part A expenses not covered by Medicare. After meeting the Medicare Part B annual deductible, you pay up to $20 per office visit and $50 per emergency room visit (waived if admitted and if covered under Medicare Part A).
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Benefits of Enrolling in the Group N Plan
Lower monthly premiums than the traditional State of Iowa plans.
Plan design benefits that are more in line with the benefits and services that Medicare covers.
No network restrictions, you can see any provider who accepts Medicare.
Ability to move back to the traditional State of Iowa plans (Program 3 Plus, Blue Access, etc.) during the next Enrollment and Change period.
Enroll midyear if you need to wait for everyone on your plan to become eligible for Medicare.
Includes a foreign travel benefit.
Advantages of the Group N Plan over an Individual Medicare Supplement Plan
No age or gender-related premiums
Remain in the State of Iowa’s group health insurance and may move between the different health plans
No preexisting conditions
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Group MedicareBlue Rx
Coupled with the Group N Plan is a Group MedicareBlue Rx plan. You have the option of two MedicareBlue Rx plans.
- Group MedicareBlue Rx (Silver)
- Group MedicareBlue Rx (Gold)
Differences between the MedicareBlue Rx plans
The differences in the two MedicareBlue Rx Plans are:
- The copayments (amount you pay) are different.
- The most significant difference is the amount of coverage you have while in the gap or “donut hole.”
More information about the two MedicareBlue Rx is available at the MedicareBlue Rx FAQ.
MedicareBlue Rx 1 (Silver) |
MedicareBlue Rx (Gold) |
|
| Level 1 - Covered Generic | $10 copay |
$10 copay |
| Level 2 - Covered Preferred Brand | $30 copay |
$25 copay |
| Level 3 - Covered Non-Preferred Brand | $50 copay |
$40 copay |
| Covered Specialty | $50 |
25% |
| Supplemental Drugs 2 | 25% |
25% |
| Monthly Premium | $89.00 |
$122.00 |
1 Coverage for generics only in the coverage gap.
2 The amount members spend on supplemental drugs does not apply towards catastrophic coverage.
Since Group MedicareBlue Rx is a Medicare Plan D, you are not eligible to enroll in SilverScript because you cannot be enrolled in two Medicare Plan D plans at the same time.
The Employer Group N Plan and the Group MedicareBlue Rx plan is a health insurance package. You cannot elect to just take the Group N Plan or the Group MedicareBlue Rx plan.
More information on MedicareBlue Rx is available at http://www.wellmark.com/_soiretiree.
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Premium for Group N Plan
2013 Premium for the Group N Plan and MedicareBlue Rx
Extra help You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call: Medicare Social Security Administration Your State Medicaid Office |
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Enrollment in Group N Plan and in a MedicareBlue Rx Plan
To enroll in Group N Plan, you must complete both:
- a Group Plan N application and
- a MedicareBlue Rx application (indicating the Gold or Silver option you are electing)
If both you and your spouse enroll in this plan, each of you would need to complete a separate Group N and MedicareBlue Rx application.
Complete the applications and mail them to:
Department of Administrative Services
Human Resources Enterprise
ATTN: Rachel Orris
Hoover Building, Level A
1305 E. Walnut Street
Des Moines, IA 50319-0150
Remember: You must submit both a Group N Plan application and a MedicareBlue Rx application.
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For More Information
Contact Rachel Orris, DAS-HRE Retirement Specialist at 515-281-6124 or rachel.orris@iowa.gov if you have any questions.
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Last updated 12/06/2012