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Health Insurance Plan Options
 
A key feature of the Emeriti Program is access to Emeriti's fully insured indemnity-type health insurance plans1 (the Emeriti Health Insurance Plan Options), underwritten by Aetna Life Insurance Company2, that meet the unique needs of higher education's retiree population.

As an eligible Emeriti participant, you have a choice of Emeriti Health Insurance Plan Options designed for you, your spouse3 and dependent children.

Why choose an Emeriti Health Insurance Plan Option?
You spent much of your career planning and investing for your retirement. During retirement, it is important to protect your financial interests from catastrophic losses that can occur when serious health issues arise.

Medicare was never intended to cover all health care costs in retirement. A catastrophic illness or long periods of hospitalization may exceed the coverage provided by Medicare. Medicare does not cover necessary medical care received outside the United States at all. And the new Medicare Part D prescription drug program that covers prescription drugs for the first time will cover only about 50% of your prescription drug costs (depending on actual usage)–an expense that most retirees can expect will likely grow as they age.

The Emeriti Health Insurance Plan Options can help, with health insurance plans that enhance your existing Medicare coverage and deliver the peace of mind that comes with added protection now and into the future.

Your Emeriti Health Insurance Plan Options are designed to provide a number of key benefits that research has identified as important to individuals in the higher education community. These benefits are not standard in currently available Medicare supplemental programs.

Premium rates are also an important consideration. Rates for the Emeriti Health Insurance Plan Options are based on the Option you choose, your age, and where you live. For some plans—particularly the prescription drug only options—the rates and your share of the costs of each prescription are also affected by other provisions, such as your preferred way of purchasing prescriptions (mail order, retail pharmacy), the availability of the drug on the Aetna formulary, and the nature of the drug prescribed (generic or brand). Use the Emeriti Health Insurance Plan Option Rate Guide to see what your estimated health plan premiums may be for each option, including the options available to any eligible dependents.

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About the Health Insurance Plan Options
The Emeriti Program was established to provide these distinctive features:

Participants can choose a benefit based on their individual needs.

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Integration with Medicare
At their core, the Emeriti Health Insurance Plan Options are designed to complement the coverage needs of Medicare eligible retirees. These insurance options build upon the foundation of Medicare, and require that participants be enrolled in Medicare Part A insurance (mainly for hospital and skilled nursing stays) and Medicare Part B insurance (mainly for physician services and various diagnostic testing).

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Eligibility for the Health Insurance Plan Options
In order to be eligible for the Emeriti Health Insurance Plan Options you must meet the definition of Retirement Eligibility under your institution's Emeriti Plan. Refer to the Your Plan Highlights sheet or the Summary Plan Description for your institution's Emeriti Plan for a more detailed explanation of the rules regarding your Plan's enrollment eligibility.

You will be able to enroll during the 90-day period beginning with the last of three events:

  1. you cease employment;
  2. you attain age 65; and
  3. you enroll in Medicare Part A and Part B.
If you do not enroll during that 90-day period, you will not be eligible for the Health Insurance Plan Options again, unless you experience certain life events. The same is true for your eligible dependents; they must enroll with you when you become eligible or lose their eligibility except for certain life events. To learn more about these exceptions, consult your institution's Emeriti Summary Plan Description or call an Emeriti Specialist at 1-866-EMERITI (1-866-363-7484).

When you meet Retirement Eligibility for the Health Insurance Plan Options, you may also be eligible for Reimbursement Benefits for yourself and your eligible dependents. Even if you do not meet the Retirement Eligibility criteria, you may be eligible for Reimbursement Benefits for yourself and your eligible dependents upon attaining age 60.

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Eligibility for spouse/dependents
When you meet the Retirement Eligibility requirements for your institution's Emeriti Plan, you may be permitted to enroll your eligible spouse
3 or dependent children at that time, and you can use your Health Accounts to pay the premiums for that coverage.

View detailed definitions of the different types of eligible dependents.

  • For a spouse who is age 65 or over: He or she may enroll at the same time in the Emeriti Health Insurance Plan Option you selected. Your spouse must be retired and enrolled in Medicare Parts A and B.
  • For a spouse who is under age 65: He or she may enroll in the pre-65 Emeriti Health Insurance Plan Option available in your area at that the same time you are enrolling in the Health Insurance Plan Options.
  • For a spouse over 65 who has not yet retired: Upon retirement he or she must enroll in Medicare Parts A and B and must select the same Emeriti Health Insurance Plan Option in which you are already enrolled.
  • For dependent children: Children who qualify as dependents under federal law and are under age 19 (or under age 24 if a full-time student) may enroll in the available pre-65 Emeriti Health Insurance Plan Option available in your area.
Call an Emeriti Specialist at 1-866-EMERITI for further help on who is an eligible dependent, including information regarding permanently disabled children. Refer to the Your Plan Highlights sheet or the Summary Plan Description for your institution's Emeriti Plan for a more detailed explanation of the rules regarding enrollment eligibility.

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How to select and enroll in a Health Insurance Plan Option
Before reaching a decision, you should first look at your current annual health care expenses. Next, take a look at what you think your future health care needs might be and the type of coverage that would best serve your needs.

Emeriti Specialists from Aetna are available at 1-866-EMERITI (1-866-363-7484) to answer any questions you may have and assist you in making choices that will help to ensure your peace of mind in the years to come.

View more information about all of the Emeriti Health Insurance Plan Options including deductibles, annual out-of-pocket maximums, and other specific details about coverage under each plan; select Post-65 Plans or Pre-65 Plan.

Take the time to review your choices and select the Health Insurance Plan Option that is right for you and your family, then call 1-866-EMERITI to enroll in your selected health plan.

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1 Aetna health plans contain exclusions and some benefits are subject to limitations or visit maximums.

2 Aetna provides comprehensive coverage, including medical and prescription drug benefits, in 48 states and the District of Columbia. Aetna will also provide stand-alone prescription drug coverage in all 50 states and the District of Columbia. HealthPartners will provide comprehensive coverage for Minnesota institutions and their retirees in Minnesota. Emeriti will select a provider for New Mexico institutions.

3 Domestic partners' coverage may also be available if elected by your institution. If you have a non-dependent domestic partner, you cannot use your Emeriti Health Account to pay for the health insurance or qualified medical expenses. Insurance premiums must be paid each month via electronic transfer from other assets.



 
 


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