Your Retiree Medical/Drug Benefits (Age 65+)

Staying healthy is everyone’s priority! You do your part by taking care of yourself, and The Texas Annual Conference of The United Methodist Church (TAC) provides three valuable medical coverage options to help you protect your health.

Who is eligible?

  • Retired TAC clergy and lay employees (whose salary paying unit was the TAC’s fiscal office) who are enrolled in Medicare Part A and Part B are eligible for the medical plans described here. You do not have to be enrolled in Medicare to choose the TAC Stipend Program.
  • If you are a clergy retiree who has not yet reached age 65, please see Your Retiree Medical Benefits (Under Age 65). Conference lay employees are not eligible for retiree medical benefits prior to age 65.

About your retiree medical options

You have the following choices for medical coverage in 2017:

  • Medicare Advantage plan (Humana Medicare Advantage (MAP) Group PPO plan). This Medicare Advantage plan replaces the benefits that would be paid with a combination of traditional Medicare, a Medicare supplement plan and Medicare Part D (prescription drug coverage). This plan has no annual deductible but has small co-pays including hospital, emergency room and office visits. It includes prescription drug coverage. The Humana MAP plan does require that your provider bill Humana in order to receive any benefits under the plan. In-network and out-of-network benefits are identical under this PPO plan. Learn more about this plan.
  • Medicare Supplemental plan (UnitedHealthcare Senior Supplement plan and UnitedHealthcare Medicare Rx for Groups [PDP] plan). This plan covers most benefits after the $500 medical deductible is met. This plan can be used with any Medicare provider to help cover costs that Medicare may not cover. Prescription drug coverage is also provided.
  • TAC Stipend Program. TAC will provide funds ($190 per month per stipend participant) that you can use to purchase medical coverage on your own.
    Please note that the stipend option replaces your Group Health Benefits Plan in its entirety, as you will be purchasing your own medical policy in lieu of participating in a TAC Retiree Group Health Benefits Plan.
  • See your 2017 monthly cost of coverage.

 

Comparing your three options

Here is a high-level comparison of your three retiree medical options for 2017:

  Humana Medicare Advantage PPO Plan UnitedHealthcare Senior Supplement Plan and UnitedHealthcare Medicare Rx for Groups (PDP) plan TAC Stipend Program
Participant cost Individual $193.58 Family $387.16 Individual $277.38 Family $554.76

Because you will use the stipend to purchase medical coverage on your own, the plan provisions and coverage will depend on the plan you choose.

 

Impact on Medicare Replaces TraditionalMedicare Supplements Medicare
Annual deductible None $500.00/person
Per hospital co-pay $175 None
Emergency room co-pay $65 None
Office visit co-pay $5 / $15 None
Provider required to participate Yes No
Prescription drug deductible

None

None

Prescriptions Retail Mail Order

Retail

Mail Order

Generic Copay $10.00 $0.00 $10.00 $20.00
Preferred Brand

$20.00

$40.00

$45.00

$90.00

Non-Preferred Brand $40.00 $80.00 $75.00 $150.00
Specialty 25% of cost N/A $75.00 $150.00
Prescription coverage in the gap Yes Yes
Nurse Hot Line Yes Yes
Wellness Program Yes - Go 365 Humana and Silver Sneakers Yes - Silver Sneakers
Phone for questions 1-800-824-8242
1-800-851-3802 (Medical)
1-888-556-6648 (Part D)
* For those who retired before 1992: Retirees deduct $75 and surviving spouses deduct $55

 

Mental health benefits under your retiree plans

 

  Humana Medicare Advantage Group PPO Plan UnitedHealthcare Senior Supplement Plan TAC Stipend Program
Mental, substance abuse and nervous care
Requires precertification or preauthorization

Inpatient
Plan pays 100% after $175 copay per admission

Outpatient
Plan pays 100% per visit after $5–$50 co-pay (depending on where services are received)

Inpatient
Plan pays 100% after the $500 annual deductible is met

Outpatient
Plan pays 100% after the $500 annual deductible is met

Because you will use the stipend to purchase medical coverage on your own, the plan provisions and coverage will depend on the plan you choose.

 

Network providers

Need help finding providers or have questions about providers?

 

Want to know more?

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