Skip to main content
[an error occurred while processing this directive]

2018 Benefits for The Dartmouth College Medicare Supplement (DCMS) Plan

The DCMS Plan is available to qualifying Dartmouth College Medicare eligible retirees age 65+, and members who are Medicare eligible due to disability.   

2018 DCMS plan costs

Beginning January 1, 2018 the monthly DCMS premium rate will be $536.05 per covered member per month. This change will be reflected in the monthly statement you receive mid-January for your January 2018 benefits.  If you do not owe Dartmouth College for the cost of your retiree medical plan for either yourself or your covered dependent(s), you will not receive an invoice from Dartmouth.

The deductible, copayments, and coinsurance will remain the same for 2018.  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. See below for details: 

Dartmouth College Medicare Supplemental (DCMS)

Medical Coverage

Administered by Cigna

Deductible $250
Coinsurance 20% (up to an additional$200)
Medical out of pocket maximum $450
  

Pharmacy Coverage

Administered by SilverScript (PDP)

Retail Pharmacy Copayments Generic Preferred Brand Non-Preferred Brand
30 day supply $5 $25 $40
60 day supply $10 $50 $80
90 day supply $15 $75 $120
Mail Order Pharmacy Copayments Generic Preferred Brand Non-Preferred Band
90 day supply $10 $50 $80
Pharmacy out of pocket maximum $450
 

Medical & Pharmacy combined out of pocket maximum

$900

 
 

SilverScript Copayment 

A Copayment is a flat dollar amount that you pay out of pocket for each covered drug you purchase. The amount you pay out of your pocket for your prescription drugs will be determined by the table above, according to the tier (Generic, Preferred Brand or Non-Preferred Brand) 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, or refer to the 2018 SilverScript Abridged Formulary. Please read the annual enrollment materials sent to you from SilverScript for details about your plan. You can find additional information at mycaremark.com. 

More Information

 

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 DCMS plan.  The DCMS plan will pay second after Medicare 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

Top of page

 

Plan Details

As stated above, the Medicare Supplement Plan will pay second after Medicare Parts A & B.  These expenses are subject to a $250 deductible, followed by a 20% coinsurance, with a maximum of up to $200, for 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 flat *tiered copayment for each prescription drug purchase, until you've met the annual $450 out of pocket maximum. 

 Retail Pharmacy

* 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:

 

SilverScript Open Enrollment documents 

Top of page

 

 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.

Top of page

 

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.   

Top of page 

 

Helpful Medicare Summaries & Links

 
Top of Page

 

Who 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: 1-855-469-4619 
  • 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:

Top of page

Last Updated: 1/8/18