Q: Can I see any doctor?
A: Yes, as long as your provider accepts Medicare, they will accept this plan. No networks or referrals are required.
Q: Do I still have to pay my Medicare Part B premium?
A: Yes. All Medicare-eligible retirees must continue paying their Part B premium, regardless of plan choice.
Q: Are any non-Medicare services covered?
A: Yes, this plan includes a fitness benefit at no additional cost.
Q: Does this plan cover prescriptions?
A: This plan only covers Medicare Part B drugs (like infusions or injectables in a doctor’s office). For traditional prescription coverage, you should enroll in the Express Scripts Medicare Part D plan.
Q: Do I have to enroll in the Express Scripts drug plan with this option?
A: No, it is optional. You may choose a different Part D plan or none at all, depending on your needs.
Q: Will my doctor accept this plan?
A: Most providers who accept Medicare will accept this plan. It’s a national Passive PPO, which
means you can see any Medicare-accepting provider without a referral.
Q: What extra benefits are included?
A: This plan includes annual physicals, post-discharge meals and transportation, in-home support, telehealth, and a fitness program.
Q: Is enrollment in the Express Scripts Part D plan required?
A: Yes. The Humana plan is bundled with our Group Part D plan through Express Scripts.
Q: What happens if I enroll in a different Part D plan?
A: You will be automatically disenrolled from the Humana Medicare Advantage plan if you enroll in a separate Part D plan.
Q: Do I still have to pay my Medicare Part B premium?
A: Yes. This is still required by Medicare.
Q: How do I know if my drug is covered and what it will cost?
A: You can visit the Express Scripts member portal or call Benistar for assistance verifying drug coverage, copays, and pharmacy participation.
Q: Can I keep using my local pharmacy?
A: Most major pharmacies are in-network. Call Benistar to confirm your preferred pharmacy is
included.
Q: Do I have to be enrolled in a medical plan to get this drug coverage?
A: No, this plan can be elected on its own.
Q: Are there added drug benefits beyond standard Medicare Part D?
A: Yes. Our group plan includes enhanced coverage for over-the-counter items, vitamins, and cough and cold medications.
Q: Can I go to any dentist?
A: You have access to the MetLife Preferred Dentist Program (PDP). While you can see any provider, you’ll save more by using in-network dentists.
Q: What services are covered?
A: The plan typically covers preventive services (exams, cleanings, x-rays), basic restorative (fillings), and major services (crowns, bridges). Coverage details may vary by state.
Q: Is orthodontia included?
A: No, orthodontic coverage is not included in the retiree plan.
Q: Is there an annual maximum?
A: Yes, MetLife plans generally include an annual benefit maximum. Please refer to your specific plan details or contact Benistar for more information.
Q: What does the vision plan cover?
A: The plan covers annual eye exams, lenses, frames, and contact lenses. Frequency of coverage depends on the service type (e.g., frames every 24 months).
Q: Do I need to use a specific vision provider?
A: The plan uses the Superior Vision network. In-network providers offer better pricing, but you may also use out-of-network providers with reduced reimbursement.
Q: Are there discounts on additional eyewear?
A: Yes, members often receive discounts on non-covered items like LASIK or additional glasses.
Q: Can I use this plan with Medicare vision benefits?
A: Yes. This plan provides additional vision care beyond what Medicare typically covers.
Q: I have tried accessing my account based on the recover account option and I am given an error?
A: You are not loaded into the system. Please call us at 844-413-1989 to assist you further.
Q: Do I have to enroll online?
A: No, we are happy to help you over the phone at 844-413-1989. We can pick up where you left off on the online enrollment process or send you a physical packet to review, complete and return.
Q: Is my personal information secure when enrolling?
A: Yes. All of your personal information and enrollment data is managed, stored and transmitted following industry standard data security protocols that have been developed and are audited for integrity and fitness meeting HIPAA, HiTrust, SOC2 and covered entity specific requirements that meet or exceed legal, operational and data security requirements under both HIPAA and other Federal and State level laws governing PHI and related data use.