Enroll in a plan
The State Health Plan does plan to offer Medicare-primary retirees Medicare Advantage Plans beginning January 1, 2014. Plan members will have the option to remain on the current premium-free 70/30 plan or select a Medicare Advantage plan. Details and any premiums associated with the Medicare Advantage plans have yet to be determined. Enrollment for these new options will be held October 1–November 15, 2013.
You should receive a State Health Plan newsletter mid-August which will include important information about the Medicare Advantage products. It will be important for you to be sure your address is current with the State's Retirement System and to read any mail you receive from the State Health Plan.
Frequently Asked Questions:
1. I have heard the NC State Health Plan will be offering your Medicare Advantage plans? True?
Yes, the NC State Health Plan will be offering Medicare primary retirees several Medicare Advantage options for plan year 2014. Medicare Advantage options will be available from both Humana and United Healthcare.
2. How can I learn about what Medicare Advantage plans are being offered by the NC State Health Plan?
The State Health Plan is currently working on an educational outreach campaign to inform their retired members of the upcoming options for 2014. You should receive a State Health Plan newsletter mid-August which will include important information about the Medicare Advantage products. It will be important for you to be sure your address is current with the State's Retirement System and to read any mail you receive from the NC State Health Plan.
3. Will I have to pay a monthly premium for a Medicare Advantage plan?
The State Health Plan will be offering member premium-free Medicare Advantage options along with buy-up options that will have a member monthly premium.
4. When can I enroll in the Medicare Advantage plan?
The Medicare Advantage options will not go into effect until January 1, 2014. You will have the opportunity to enroll in your plan choice during the NC State Health Plan's Fall enrollment period. The Fall enrollment period will be held October 1–November 15, 2013.
5. Will information be posted on the NC State Health Plan website?
Yes, the State Health Plan will be posting information about plan options for 2014 before the Fall enrollment period begins.
6. Are there informational meetings being planned that I could attend where I live?
The State Health Plan is working on an educational outreach campaign that will include meetings across the state. The locations, dates and times for these meetings will be posted on the State Health Plan website mid-August and will be included in the information you will receive in the mail.
7. If I don't want to enroll in a Medicare Advantage plan, will I be able to enroll in a 70/30 or 80/20 plan with the State Health Plan?
Medicare-primary retirees will still have the option to enroll in the premium-free 70/30 plan. However, the 80/20 plan will not be available as the Medicare Advantage options are comparable to the current PPO 80/20 with additional benefits (Silver Sneakers, disease and case management assistance).
8. My doctor does not accept Medicare Advantage plans as insurance. What can I do?
The Medicare Advantage plans will include a passive network meaning even if your doctor is not in the Medicare Advantage plan's network of providers, the doctor could still treat you and file a claim with the Medicare Advantage plan you select. Your out-of-pocket cost will not be greater.
Need help or have questions?
Eligibility questions? Call Benefit Focus at 1-855-859-0966, 8 a.m. - 5 p.m. ET, each state business day. TTY users, call 711. Contact information can also be found on the back of your ID card. Or, contact us.
Medicare Advantage plan questions? For general questions prior to enrollment, call 1-866-747-1014, 8 a.m. - 8 p.m., local time, Monday through Friday. TTY users, call 771.