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The Dartmouth College Medicare Supplement (DCMS) Plan

Click here FlexOnline Logo  to access the Dartmouth benefits enrollment system, review your elections and enroll in your 2016 Dartmouth retiree benefits.

2016 RETIREE MEDICAL BENEFITS  

The DCMS Plan is available to qualifying Dartmouth College Medicare eligible retirees age 65+, and members who are Medicare eligible due to disability.  Please find below, a brief summary of the benefit changes for the 2016 plan year.

2016 DCMS plan premium

There will be a 9% increase in the DCMS premium rate for 2016 for covered members. Beginning January 1, 2016 the DCMS plan premium will be $439.58 per member per month. This change will be reflected in the monthly statement you receive mid-January for your January 2016 benefits. Those whose plans are fully subsidized and do not owe a household balance will not receive a monthly statement.  

SilverScript® Prescription Drug Cost Share - New

To continue offering affordable prescription drug coverage, the out of pocket cost share will change from the current 30% coinsurance to a flat *copayment structure for Generic, Preferred Brand and Non-Preferred Brand drugs. This means that beginning January 1, 2016 when you go to the pharmacy to purchase your prescription drugs, the amount you pay out of your pocket will be determined by the table below, according to the tier your specific drug falls into.  To find out if your drug is on the formulary (list of Medicare Part D covered prescription drugs), or about any restrictions, please call SilverScript Customer Care  at 1‑866‑693‑4621. Please read the annual enrollment materials sent to you from SilverScript for details about your plan. You can find additional information at dartmouth.silverscript.com.

Retail Pharnacy Generic Preferred Brand Non-Preferred Brand
1-30 day supply $5 $25 $40
31-60 day supply $10 $50 $80
61-90 day supply $15 $75 $120
Mail OrderGenericPreferred BrandNon-Preferred Brand
1-90 day supply $10 $50 $80

* A Copayment is a flat dollar amount that you pay out of pocket for each covered drug you purchase.

No Change to Out of Pocket Maximum

There will be no change to the annual DCMS out of pocket maximum. The annual out of pocket maximum per member for covered services is $900.  This includes up to $450 toward medical costs and up to $450 toward prescription drug costs each year. This will not change for 2016.

 

More Information

Eligibility & Medicare
Medicare
SilverScript (Dartmouth's Medicare Part D Plan)
Plan Details and Summaries
Costs
Changing Your Election
Whom to Contact
Helpful Medicare Summaries

 

Eligibility & Medicare

In order to be eligible for the Dartmouth College Medicare Supplement (DCMS) Plan, you must  meet the minimum qualifications for the DCMS plan, and be enrolled in Medicare Part A and Part B, according to the rules outlined by the Social Security Administration.  You should not enroll in a separate Medicare Part D if you want to be covered on the on the DCMS plan.  The DCMS plan will supplement Parts A & B and provides Medicare Part D prescription drug coverage as well.

For additional information on Medicare, you should visit  Medicare.gov or the Social Security Administration website or contact your local Social Security Office.  You can find your local office by visiting the Social Security Administration office locator website

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Plan Details

As stated above, the Medicare Supplement Plan will supplement Medicare Parts A & B.  These expenses are subject to a $250 deductible, followed by a 20% coinsurance to a maximum of $200, a total out-of-pocket expense of $450 for your medical services for the year.

The Medicare Part D plan offered through Dartmouth College includes a *tiered copayment for each prescription drug purchase, until you've met the annual $450 out of pocket maximum. 

Retail Pharnacy Generic Preferred Brand Non-Preferred Brand
1-30 day supply $5 $25 $40
31-60 day supply $10 $50 $80
61-90 day supply $15 $75 $120
Mail OrderGenericPreferred BrandNon-Preferred Brand
1-90 day supply $10 $50 $80

* A Copayments is a flat dollar amount that you pay out of pocket for each covered drug you purchase.

Further detail is available in the following resources:

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             Active Employees becoming Medicare eligible

If you are not a retiree and are eligible for Medicare (ex. because you are turning 65 or due to a disability), you should contact the Benefits Office for more information about coverage.

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Changing Your Election 

If you would like to change your election in the Dartmouth College Medicare Supplement (DCMS) Plan, you may do so during Open Enrollment or any time during the year if you have a qualify event.  You can do so by notifying the Benefits Office in writing within 30 days of your qualifying event.   

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Helpful Medicare Summaries & Links

2016 Medicare & You booklet
Who Pays First (Medicare Coordination of Benefits Summary)
Higher Income Beneficiary Rules (IRMAA premiums)
IRMAA Premium Reimbursement Form 
Medicare Extra Help program
TriCare for Life

 
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Whom to Contact

For questions on Medicare, please visit either Medicare.gov or the Social Security Administration website or contact your local Social Security Office. You can find your local office by visiting the Social Security Administration office locator website.

For questions about the DCMS Plan, you may contact Cigna Health Insurance:

  • Toll-free phone number: 1-800-469-4619 
  • Send claims to:  P.O. Box 182223, Chattanooga, TN 37422-7223
  • Website: http://www.MyCigna.com/

If you would like to make changes to your coverage or have questions on your eligibility for the DCMS plan, you should contact the Benefits Office:

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Last Updated: 2/12/16