Retiree Health Care FAQs
General
Deductible
A deductible is a set dollar amount that enrollees must pay out-of-pocket toward certain health care services before insurance starts to pay.
Coverage Options
You and your family are all eligible for the MSU Medicare Advantage Plan with Humana.
You and your family are all eligible for the MSU Non-Medicare Plan with Personify Health.
Your family is eligible for the MSU Transition Plan. Once enrolled in that plan, Humana will cover any individuals on Medicare in the MSU Medicare Advantage Plan with Humana and those not yet eligible for Medicare in the MSU Non-Medicare Plan with Personify Health.
Coverage for Spouse or Other Eligible Individual
Yes, that is correct. You do not need to complete the affidavit for your spouse/OEI.
For those that are Medicare eligible, please be advised that you can only be enrolled in one Medicare Advantage plan at a time. If you enroll yourself or your spouse/OEI in the MSU Medicare Advantage Plan and that is the last Medicare Advantage plan of enrollment, the previous Medicare Advantage provider will disenroll you and/or your spouse/OEI from that plan too. The same applies for Part D , Medicare Prescription Drug, plans too.
Enrollment & Insurance Cards
You will receive an enrollment kit from Humana or Personify Health to review health and prescription drug benefits and coverage to decide if you want to continue your healthcare and prescription drug coverage with MSU. You will receive this information if you are retiring or have a change in Medicare eligibility. MSU will also send you information and an enrollment form that you must complete to keep your healthcare and prescription drug coverage.
Please note, if you do not take action within 30 days of your new benefits eligibility date, your coverage will be terminated and you will not be able to enroll again until you have a qualifying life event (QLE) or the next MSU open enrollment.
Upon completion of your enrollment at MSU, Humana or Personify Health will send a new Medical insurance card. MSU recommends enrolling as soon as possible in the new plan and, when possible, within 45 days of your change in status at MSU for the best experience. You will receive one card that may be used for both medical services and prescription drugs. This one card is all that is needed for services. You no longer need to show your Medicare card at appointments; however, we suggest you keep the card and put it in a safe place at home.
No. You cannot enroll in both the MSU Medicare Advantage Plan and any other Medicare Advantage or Part D plan. This means that if you enroll in another Medicare Advantage plan, after enrolling in the MSU Medicare Advantage Plan, you’ll be automatically disenrolled from the MSU retiree health plan.
Prescription Drug Plan
No, both the MSU Medicare Advantage Plan and the MSU Non-Medicare plans cover both healthcare and prescription drug coverage through one plan.
The prescription drug plan allows MSU and retirees to take advantage of better pricing and governmental assistance programs while providing a high-quality, affordable pharmacy benefit to retirees at the same time.
Dental Insurance
Both the MSU Medicare Advantage Plan and the MSU Non-Medicare Plan combine health and prescription coverage. Dental coverage is not impacted and will continue to be offered through Aetna Dental and Delta Dental consistent with current practice.
MSU Medicare Advantage Plan
The MSU Medicare Advantage Plan is administered by Humana. Humana has a long history in providing Commercial and Medicare Advantage health plans. They offered their first private Medicare Advantage plans in 1985. Humana Medicare Advantage plans include a full spectrum of integrated, senior-focused care management programs designed specifically to meet seniors' needs. They also have a comprehensive suite of health management programs designed to address the entire continuum of health needs for MSU's retiree population.
There is not an MSU premium associated with the MSU Medicare Advantage Plan for retirees with full university contribution as follows:
Retired Support Staff Hired Before July 1, 2002
Retired Faculty Hired Before July 1, 2005
For retirees that are not fully vested, the premium associated will be based on the vesting contribution level consistent with current practice. Please see the Retiree Open Enrollment Benefits Guide located on our website at Benefit Summaries & Brochures for monthly plan premium rates.
Note: For retirees enrolled in the MSU Medicare Advantage Plan, as the process exists currently, Medicare will continue to charge you a Medicare Part B premium. Existing Part B costs, including Late Enrollment Penalty (LEP) or Income Related Monthly Adjustment Amount (IRMAA) fees will apply consistently with current practice.
In addition, since the MSU Medicare Advantage Plan includes Medicare Part D (prescription drug coverage), for most people a Medicare Part D cost does not apply. However, as with Part B, Medicare Part D Late Enrollment Penalty (LEP) or Income Related Monthly Adjustment Amount (IRMAA) fees may apply. For more information on costs for Medicare Parts B and D, please see the links below:
The MSU Medicare Advantage Plan, which also provides prescription drug coverage, has a $192 deductible per member each calendar year for some combined in and out-of-network services. This is an individual plan so a family deductible does not apply. The plan does not have a deductible for the Part D prescription drug benefits.
The Humana MSU Non-Medicare PPO plan, which also provides prescription drug coverage has an in-network deductible of $100 individual/$200 family. The out-of-network deductible is $500 individual/$1,000 family. The plan does not have a deductible for the prescription drug benefits.
This plan is a Passive Preferred Provider Organization (PPO), which means your benefit levels are the same for in-network and out-of-network providers. Individuals on this plan can use any provider in the country who accepts Medicare and agrees to bill Humana.
Offering retiree health care and prescription drug benefits combines Medicare A, B, and D together in one convenient plan. Humana will process all claims which minimizes coordination of benefits (COB) with the Centers for Medicare and Medicaid Services (CMS).
MSU requires Medicare eligible individuals to enroll in Medicare, when eligible, and sign up for Part B. Once you receive a card, you will need to provide the Medicare Beneficiary Identifier (MBI) to MSU. The MBI is a unique identifier that is not based on a social security number. This number is used for billing, eligibility verification, and claims processing with healthcare providers, pharmacies, and Medicare.
When searching for a provider, you may call the Humana Customer Care team for assistance at 800-273-2509, Monday through Friday, 8 am to 8 pm EST. If you prefer self-service, you may also search online using the Physician Finder tool. With this tool, you will find nearby doctors, hospitals, pharmacies, and other healthcare providers in the Humana network. You can get phone numbers, addresses and maps, customize your search by specialty and see the distance from your home or work.
There are several ways to access the Find Care tool. You can visit Physician Search - Humana or visit the “Tools & Resources” page from your Humana MSU landing page.
Once you access the tool, you can login to the Humana portal OR "Search as a guest".
Yes, members may call Humana Customer Care at 800-273-2509 (TTY: 711).
Although most health care providers will submit claims to Humana, members can file claims directly. You can download a claim form from the Humana Website.
CMS is a federal agency in the US Department of Health and Human Services (HHS). They administer the Medicare program and work in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. The MSU Group Medicare Advantage Plan is a Medicare Advantage and Prescription Drug (MAPD) plan, and CMS requires that all MAPD plan designs and informational materials go through an approval process with CMS before they may be released to the public. The process is in place to protect consumers from fraud and abuse in the health care marketplace.
MSU Non-Medicare Plan
The MSU Non-Medicare Plan is administered by Personify Health (PH). PH is a Health Plan Administrator (HPA) for employers with self-funded employee benefits. As an HPA, Personify Health helps your employer administer your health plan by processing member claims, answering questions, and performing other functions related to health benefits.
There is not an MSU premium associated with the MSU Non-Medicare Plan for retirees with full university contribution as follows:
Retired Support Staff Hired Before July 1, 2002
Retired Faculty Hired Before July 1, 2005
For retirees that are not fully vested, the premium associated will be based on the vesting contribution level consistent with current practice. Please see the Retiree Open Enrollment Benefits Guide located on our website at Benefit Summaries & Brochures for monthly plan premium rates.
The MSU Non-Medicare Plan, which also provides prescription drug coverage, has an in-network deductible of $100/individual or $200/family. The out-of-network deductible is $ 500/individual or $1,000/family. The plan does not have a deductible for prescription drug benefits.
The plan is a Preferred Provider Organization (PPO) and members receive a higher level of benefits if being treated by an in-network provider.
When searching for a provider, please go to https://aetna.com/asa. Additional information on finding a provider can be found on the Aetna flyer.
Alternatively, you may call the Personify Health Customer Care team for assistance at 855-469-1245.
First, it is important that you notify MSU and Personify Health as soon as possible with address changes. If you reside in a state that is outside of the Aetna network service area, and give notification of your change in state residence, covered members will be placed in an indemnity plan and have the same benefit level whether seeking services in-network or out-of-network.
Additional Questions?
MSU Medicare Advantage Plan Information
MSU Non-Medicare Plan Information
Contact MSU Human Resources at 517-353-4434, toll free at 800-353-4434 or email SolutionsCenter@hr.msu.edu.
