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Group Medicare Plans

Support your retirees once they become Medicare-primary with group Medicare plans made to fit their needs. It’s another way to help retain top talent, letting your employees know you’re there for them every step of the way, even after they retire.

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Or call (877) 917-8489 (TTY 711).

Plans Made Easy

Plans That Fit

We work with you to find the plan that fits the needs of your organization.

Less Paperwork

We administer the plan, which means less paperwork for you.

Member Materials

We send plan materials, including an ID card and policy, to all new members and upon renewal.

No Yearly Enrollment Period

Retirees can enroll in a group Medicare plan at any time during the year.

How It Works

Employer Contribution Toward Premium

You can contribute anything from $0 to the full amount for enrollee premiums. If retirees within the organization qualify for different levels of employer contribution, you can establish those levels.

Billing Options

We can do a group bill or bill members individually.

Dedicated Employer Group Client Consultant

You have a single point of contact for all questions about group Medicare benefits. This representative can help with every aspect of your plan.

Low-Income Subsidy

Members may qualify for the Extra Help program from the federal government for help paying their monthly premium and prescription drug copayments. If retirees qualify for assistance, the premium billed for those members will be reduced by the amount of assistance they receive. This can vary from member to member, and you must pass the subsidy to the member’s portion of the premium. State help may also be available for certain people who qualify.

Eligibility

Retirees with Medicare Parts A and B are eligible for group Medicare coverage. If your group has fewer than 20 total employees, active employees ages 65 and over might also be eligible. Underwriting isn’t required. Members must continue to pay their Medicare Part B premium if not otherwise paid for under Medicare or by another third party.

Group Medicare Plans

HMO

Health Maintenance Organization

Employers can choose this if they’re based in Illinois, Indiana, Iowa, Ohio or Washington and at least 51% of their eligible retirees reside in Medicare Advantage-licensed counties.

HMO-POS

Point of Service

Employers can choose this if they’re based in Illinois, Indiana or Washington and at least 51% of their eligible retirees reside in Medicare Advantage-licensed counties. These plans combine some aspects of both HMO and PPO plans.

PPO

Preferred Provider Organization

Employers can choose this if they’re based in Iowa and at least 51% of their eligible retirees reside in Medicare Advantage-licensed counties.

Other Coverage Solutions

Stand-Alone Prescription Drug Plan (PDP)

  • Only includes drug coverage but can be paired with Medicare Supplement.
  • Two PDP options.
  • Nationwide prescription coverage.
  • Available to employers domiciled in Illinois; retirees may reside anywhere in the U.S.
  • Prescription coverage through the coverage gap with PDP Option 2.

Medicare Supplement

  • Ability to see any provider who accepts Medicare without a referral.
  • No copayments on most plans.
  • Available to employers domiciled in Illinois; retirees may reside anywhere in the U.S.
  • Doesn’t include drug coverage but can be paired with PDP coverage.

Note: Health Alliance™ Medicare Supplement members without prescription drug coverage can get a discount at the pharmacy when they present their ID card.

Pharmacy Coverage

Help your retirees get the prescription medication they need. Our Medicare Part D (drug coverage) formulary lists the drugs we cover. (Generally, we only cover drugs that are listed.)

Group Medicare Formulary

Group Medicare Formulary

Reid Group Medicare Formulary

Guide Group Medicare Formulary

See our Pharmacy Coverage Requirements for more details.

Large Provider Network

Give your retirees access to trusted care from respected doctors, hospitals and other healthcare professionals.

View Providers

Resources and Materials

Medicare Advantage Resources

Ready to get started?

Talk to a Client Consultant today at (800) 851-3379, ext. 28151.

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