Retiree Health Plan Options

Health Plan Options


As a retiree, what are my health plan options?

Your retiree health plan options depend on whether you (and your dependents) are eligible for Medicare or not. Learn more about the available options and premiums that you pay.

 

  • Medicare

    If you (and / or your dependents ) are eligible for Medicare, contact the Social Security Administration office to make sure you are enrolled in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B).

    • Medicare Part A helps pay for hospital care, skilled nursing, home health, and hospice care. Medicare requires patients to pay a hospital benefit period deductible and coinsurance.
    • Medicare Part B covers 80% of Medicare-approved fees, and other health services, after your calendar year deductible is paid.
    • Medicare Part D is an outpatient prescription drug benefit. When electing Medicare-coordinating coverage under the Retiree Health Benefits Program, choose between outpatient prescription drug coverage through the program or through a separate Medicare Part D plan. If you enroll in a Medicare Part D prescription drug plan, you may be asked for a copy of the Part D Notice of Creditable Coverage. This notifies a Medicare Part D plan that you had creditable drug coverage through the UVA Health Plan, and are not required to pay a late enrollment penalty.
    • Click here for more information health coverage for retirees through the Virginia Department of Human Resource Management.
    • For more information about separate Medicare Part D plans, contact Medicare at 1.800.MEDICARE or www.medicare.gov.  
  • Medicare Supplemental Health Options through Retiree Health Program

    If you (and / or your dependents) are eligible for Medicare, you (or your dependents) may enroll in a supplemental insurance plan offered by the State.

    • Advantage 65
    • Advantage 65 + Dental/Vision
    • Advantage 65 – Medical Only
    • Advantage 65 – Medical Only + Dental/Vision

    You can choose from two plans to supplement Medicare: Advantage 65 or Advantage 65 - Medical only. The Dental/Vision Plan is also available with Advantage 65 and Advantage 65 – Medical Only. For retirees who enroll in Advantage 65 or Advantage 65 – Medical Only, Medicare will be the primary payer. Advantage 65 or Advantage 65 – Medical Only will supplement Medicare’s coverage.

    Advantage 65
    This supplemental plan pays secondarily to Medicare, and covers much of what Medicare does not pay at 100%. Generally, with the exception of out-of-country major medical services (specifically described in the member handbook) Advantage 65 will not pay for services denied by Medicare.

    Advantage 65 includes an enhanced Medicare Part D benefit for outpatient prescription drug coverage. New Medicare-eligible participants will be enrolled in Part D coverage.

    Advantage 65 with Dental/Vision
    You can add coverage for certain basic dental and routine vision services to the coverage described above. There is no coverage for prosthetic and complex restorative dental services.

    Advantage 65 – Medical Only
    This supplemental plan provides the same medical benefits as Advantage 65, but does not include outpatient prescription drug coverage. Outpatient prescription drug coverage can be secured through a non-state-sponsored Medicare Part D Plan, or other creditable coverage (such as Tricare, Veterans Benefits, or your spouse’s coverage) in order to avoid a higher Part D premium at a later date.

    If you select Medical-Only, you may not choose Medicare prescription drug coverage through the Retiree Health Benefits Program at a later date.

    Advantage 65 – Medical Only with Dental/Vision
    You can add coverage for certain basic dental and routine vision services to the coverage above. There is no coverage for prosthetic and complex restorative dental services.

    To cover both Medicare eligible and non-Medicare eligible family members, see below, "Households with both non-Medicare eligible and Medicare eligible family members".

    Medicare-Supplement Plans Monthly 2018 Rates Through Anthem Blue Cross / Blue Shield

    • Advantage 65:  $277
    • Advantage 65 + Dental / Vision:  $310
    • Advantage 65 – Medical Only:  $156
    • Advantage 65 – Medical Only + Dental  /Vision:  $189
    • Option II (Medicare Supplemental):  $356
    • Option II + Dental / Vision:  $389

    Medicare-Supplement Plans Monthly 2019 Rates Through Anthem Blue Cross / Blue Shield

    • Advantage 65:  $262
    • Advantage 65 + Dental / Vision:  $294
    • Advantage 65 – Medical Only:  $159
    • Advantage 65 – Medical Only + Dental  /Vision:  $191
    • Option II (Medicare Supplemental):  $355
    • Option II + Dental / Vision:  $387

    For more information on Medicare Rate Notifications, click here.  

  • Non-Medicare eligible plan options

     If you (and / or your dependents) are not eligible for Medicare, you (and / or your dependents) may enroll in the UVA Health Plan.  Retiree or family members in their first 30 months of Medicare coverage due to End Stage Renal Disease (ESRD) may also enroll in the UVA Health Plan.  They are treated as if they are not yet eligible for Medicare since Medicare must be their secondary insurance for the first 30 months.  

    The plan available for non-Medicare eligible retirees is the UVA Health Plan. Retirees and their eligible dependents can enroll in the same UVA Health Plan option in which they were enrolled on their last day as an active state employee (Basic Health, Value Health, or Choice Health). Enrollment in the UVA Dental Plan is only available to retirees (and dependents) enrolled in the UVA Health Plan and must be in the same dental plan option in which they were enrolled on their last day as an active state employee (Basic Dental or Enhanced Dental). Dental Plan enrollment must be completed when enrolling in the health benefits program. Dental enrollment can be added or dropped during the annual enrollment period each year. If dropped, the retiree (and dependents) will not be able to re-enroll at a later date.

    When you (or a non-Medicare eligible dependent) become eligible for Medicare, eligibility for the UVA Health Plan ends. Make sure you (or your dependent) are enrolled in both Medicare Part A and Part B, terminate coverage in the UVA Health Plan, and enroll in Advantage 65 or Advantage 65 – Medical Only (administered by Anthem). The Dental/Vision Plan is also available with Advantage 65 and Advantage 65 – Medical Only.

    Changes do not occur automatically. Contact the HR Solution Center at least 2 months before you (or a dependent) become Medicare eligible. This allows time for the enrollment process and ensures coverage the first day of Medicare eligibility. Applications must be received at the HR Solution Center prior to the date of Medicare eligibility.

  • Households with both non-Medicare eligible and Medicare eligible family members

    This category applies if one or more covered family members are not eligible for Medicare, and one or more covered family members are eligible for Medicare. 

    Households sometimes consist of a mixture of covered family members, some who are eligible for Medicare and others who are not eligible for Medicare.  

    The insurance plans available for Medicare eligible retirees are Advantage 65 and Advantage 65 – Medical Only. The Dental/Vision Plan is also available as an option with Advantage 65 and Advantage 65 – Medical Only.  All non-Medicare eligible family members must enroll in the UVA Health Plan.  

    When you or your family member who was not Medicare eligible becomes eligible for Medicare, eligibility for enrollment in the UVA Health Plan ends. Make sure you or your family member is enrolled in Medicare Part A and Part B, terminates coverage in the UVA Health Plan, and enrolls in Advantage 65 or Advantage 65 – Medical Only. The Dental/Vision Plan is also available as an option with Advantage 65 or Advantage 65 – Medical Only.  These changes do not occur automatically. You must contact the HR Solution Center at least 2 months before you or a family member becomes Medicare eligible. This allows plenty of time for the enrollment process and helps ensure that you or your family member has appropriate health insurance coverage beginning the first day of Medicare coverage. Applications must be received at the HR Solution Center prior to the date of Medicare eligibility. Those not yet eligible for Medicare are eligible for enrollment in the UVA Health Plan.

  • Survivor benefits

    Family members with survivor retirement benefits may enroll in the Retiree Health Benefits Program upon the death of the retiree if they had coverage prior to the retiree's death. They are considered annuitant survivors.

    To continue or apply for coverage, an eligible family member must submit a Retiree Health Benefits Program Enrollment/Waiver Form (available through the Solution Center) within 30 days of the death of the retiree. If an application is not made within that time limit, the right to enroll is forfeited.

    Non-annuitant survivors may continue coverage under the Retiree Health Benefits Program if enrolled at the time of the retiree’s death. To continue coverage, a Retiree Health Benefits Program Enrollment/Waiver Form must be submitted within 30 days of the death of the retiree. Spouses may continue coverage unless they become covered under another health plan, remarry, or die. Dependent children may be covered until the end of the month in which they turn 26.

Getting Started with Medicare

A review of Medicare and its parts, as well as what it does and doesn’t do. Also includes questions to ask for when you are first starting on Medicare, and after you have it set up.

Resources

Current survivors of ORP retirees

HR Solution Center, University of Virginia
AskHR@virginia.edu
434.243.3344

914 Emmet Street
P.O. Box 400127
Charlottesville, VA 22904-4127

Current survivors of VRS retirees

Virginia Retirement System (VRS)
804.649.8059 in Richmond
888.827.3847 outside Richmond

P.O. Box 2500
Richmond, VA 23218-2500
https://www.varetire.org/retirees/insurance/