Important Notice of Prescription Drug
Creditable Coverage From Wisconsin Carpenters’ Health Fund
To All Medicare-Eligible Participants and Dependents:
This Notice is being sent to inform you how your benefits through Wisconsin Carpenters’ Health Fund are affected by Medicare Part D. Starting January 1, 2006, everyone on Medicare will be eligible for Medicare prescription drug coverage, referred to as “Medicare Part D”.
The following information is provided to help you decide whether it would benefit you to enroll in Medicare Part D for prescription drug coverage.
What do you need to do now? It is not necessary to enroll in a separate Medicare prescription drug plan at this time. Wisconsin Carpenters’ Health Fund Trustees have determined that your current prescription drug coverage is “creditable coverage”, which means it is, on average, at least as good as the standard Medicare prescription drug coverage.
Since you have prescription drug coverage through Wisconsin Carpenters’ Health Fund, the most cost effective option for you, generally, is to not enroll in a Medicare prescription drug plan unless you are eligible for extra help from Medicare for persons with low income. Joining a Medicare prescription drug plan will not reduce the monthly self-payment required by Wisconsin Carpenters’ Health Fund because your current self-payment is for both medical and prescription drug expenses.
Retirees with limited income may be eligible for financial support from the government to help pay the deductible, monthly premiums and copayments under a Medicare prescription drug plan. If you receive an application from Social Security, you should complete and return the application to determine if you are eligible for the special assistance. If you are eligible for special assistance, you should review your options carefully because it may be beneficial for you to enroll in a Medicare prescription drug plan. For more information about this assistance, call SSA at 1-800-772-1213 (TTY 1-800-325-0778) or visit them online at www.socialsecurity.gov.
Will your current coverage through Wisconsin Carpenters’ Health Fund be affected if you join a Medicare prescription drug plan?
Yes. Your Medicare prescription drug plan will become the primary payer for your prescription drug benefits, unless you are covered under an Active Plan through Wisconsin Carpenters’ Health Fund, in which case the Fund remains the primary payer. The Fund will consider your prescription drug expenses for payment only after the expenses have been considered by your Medicare prescription drug plan. In addition, it will be your responsibility to submit proof of what the Medicare prescription drug plan paid (Explanation of Benefits) before the Fund considers any balance. Again, joining a Medicare prescription drug plan will not reduce your monthly self-payment to Wisconsin Carpenters’ Health Fund since you receive both medical coverage as well as prescription drug coverage from the Fund.
Will Medicare penalize participants who do not enroll in a Medicare prescription drug plan?
Because coverage through Wisconsin Carpenters’ Health Fund is, on average, at least as good as standard Medicare prescription drug coverage, you will not have to pay a penalty if you enroll later, provided you do not go 63 days or longer without prescription drug coverage that is at least as good as Medicare prescription drug coverage.
What will happen if you drop your Wisconsin Carpenters’ Health Fund coverage?
In addition to prescription drug benefits, your current Fund coverage provides medical benefits, death benefits, and optional dental and vision benefits. None of these benefits are available separately, so if you decide to drop your Fund coverage, ALL Fund benefits will terminate. If you drop your coverage through the Fund, you will need to obtain coverage elsewhere for ALL your benefits, not just prescription drugs. We cannot guarantee that in all cases our prescription drug coverage is more advantageous than Medicare prescription drug coverage, although it generally will be. You must ultimately decide for yourself which program offers the better coverage at the most affordable price. If you drop your coverage with Wisconsin Carpenters’ Health Fund, you cannot reinstate in the Fund’s Retiree Program at a later date.
Where can you find information about your current prescription drug coverage through Wisconsin Carpenters’ Health Fund?
Please refer to the Quick Reference Card in your Summary Plan Description (SPD) for information on your current prescription drug coverage or call the Fund Office at (715) 835-3174 or 1-800-424-3405.
Where can you find information on Medicare prescription drug coverage?
The following resources are available to explain your options and help you make your decision:
- Medicare & You 2006 handbook, which will be mailed in October.
- Visit www.medicare.gov for personalized help. An online Medicare Prescription Drug Plan Finder tool will be available on this website.
- Call your State Health Insurance Assistance Program (see your copy of the Medicare & You 2006 handbook for their telephone number).
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
Keep this Notice of Prescription Drug Creditable Coverage. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage after May 15, 2006, you may need to give a copy of this Notice when you join to show that you are not required to pay a higher premium amount. An updated Notice will be provided to you annually. However, upon receipt of the updated Notice, DO NOT THROW AWAY THIS NOTICE! You may need it in a future year to prove you had creditable coverage in 2006.
If you have any questions, please call the Fund Office at
(715) 835-3174 or 1-800-424-3405.
Yours truly,
THE BOARD OF TRUSTEES
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