benefits, Benefits

PASBF Medicare and Other Benefits

Below you will find information about the benefits available through IGRC and PASBF. This includes Medicare, Medicare Part D, and more. To learn more, simply click on the + sign on the right side of the box you want to read- the information will then drop down for you to read.

IGRC Medicare Supplement
This is the only benefit where vesting rules apply. All other benefits are for all retired clergy and spouses from the Illinois Great Rivers Conference no matter the number of years served.

PASBF donates $1.5 million for the purchase of the Medicare Supplement for retired clergy and spouses who qualify. The plan is similar to a Medicare Plan F.  There is no prescription coverage in this supplement.  Retirees and spouses must purchase their own Medicare Part D Plan.

There are NO Deductibles or Co-Pays in our plan. Retirees and spouses should have no out of pocket expenses on all covered expenses.

General rule of thumb for IGRC Supplement Plan, if Medicare covers it, our supplement will cover it. If you are ever in doubt, always have the doctor’s office call to ensure coverage.

Expenses are listed below for the plan:

 

Covered Medical Expenses

 Retired Clergy

Spouse/Surviving Spouse
Premiums

$35/ month

$70/ month
Deductibles

$0

$0
Co-Pays

$0

$0

Click here for the Vesting Rules.

If you have any questions, please contact Rev. Keith Anderson at 217-529-3221.

Medicare Tips
Below are several Instruction Sheets and Tips for using Medicare.  If you have still have questions, call PASBF at 217-529-3221 or Senior Health Insurance Service (SHIP) at (800) 252-8966.

How to Use Medicare’s Website Interpreting Plan SummariesReducing Prescription Drug Costs When To Switch Part D Plans2020 Medicare Part D Schedule of Benefits PASBF Medicare Part D Benefit

 

 

 

Reducing Prescription Drug Costs

Reducing your prescription drug costs.

We all know that, even with insurance, prescription drugs can take a huge bite out of a monthly budget.  Here are several ideas for how you can reduce this expense:

1. Switch from Name Brand Drugs to Generics. Be sure to talk with your doctor before changing any medications!
2. Increase the Dosage and Cut the Medication in one-half. For example, if you are taking 50 mg of medication, see if the doctor will write a script for 100 mg tablets and have you cut them in half. This will decrease your co-pays in half. Note that this will not work for all medications. Be sure to check with your doctor first!
3. Check with your pharmacy (or other pharmacies in your area) to see if any of your drugs are offered on their discount lists.  Many large pharmacies continue to expand their listings. Examples are Wal-Mart, Meijer, Kroger, K-Mart, Sam’s Club, and others. There may be a small membership fee, but the savings should offset any fee to join a club.
Please note that if you use this option, the cost of these drugs are outside of your Part D plan and the cost will NOT apply towards the donut hole and catastrophic levels. For drugs that are covered through your plan, but fall into your gap or donut hole period, ask your pharmacy if there are any other discounts during the gap.  Often, Part D plan providers make special arrangements with pharmacies as additional benefits for their insured.

Still need assistance? Here are 7 places to contact for help with prescription drug costs:

1. Illinois CaresRX: This is a state subsidy available to Illinois residents that qualify.  This plan works with Part D Coverage plans to lower co-pays, and covers 75% in the gap and pays for the premium cost. For those who qualify they can switch to one of the selected drug plans mid-year as soon as the state approves the application and switching plans.
The SHAP program can assist with the applications
To qualify for IllinoisCares Rx, you must meet the following criteria
  • Be enrolled in Medicare
  • Be a current Illinois resident
  • Have annual income levels (including all income, but not counting any assets)
    • Singles – $21,780
    • Married – $29,420
2.  Pharmaceutical Manufacturer Programs: Many drug manufacturers have programs to discount or cover the cost of medications for those within a certain income level. Contact the Pharmaceutical Manufacturer to request any information.
3.  Veterans Administration: If you served in the military, you may qualify for a significant reduction. Contact the VA for details and qualifications.
4.   Patriot Prescriptions: This organization, located in Normal, IL, provides 20% – 80% discount on many drugs manufactured in the USA through Canadian pharmacies.  They provide personalized service to people anywhere. To contact Patriot Prescriptions call 309-454-3000.
5. Bureau of Prescription Health: This service seeks low or no cost drugs from drug manufacturers during the donut hole.  The income qualifications for this program are a bit higher than normal, so even if you are turned down for other assistance, it is worth looking into. For more information call 573-996-3333.
6. Prescription Assistance and Discount Programs Chart: There are about 10 internet sites which provide a variety of information sources. Some are discount programs, and others provide drugs from pharmaceutical manufacturers as no cost for those who qualify. For a copy of the chart, contact Illinois SHIP at 800-548-9034.
7. Preachers’ Aid Society and Benefit Fund
PASBF has budgeted money to assist those whose drug costs have caused a hardship. Note that one of the questions on the application is if you have tried other methods to reduce your drug costs. Applications can be found at www.pasbf.org or by calling 217-529-3221.
How to Use Medicare.gov

How to use Medicare.gov

1)  Go to www.medicare.gov

2) Under Find Plans at the top, click on “Compare Drug and Health Insurance Plans”

3) Enter Your Zip Code and click “Find Plans”

4) Under Step 1 0f 4: Enter Information

– How do you get your Medicare coverage? – Enter “I don’t know”.
– Do you get help from Medicare or your state to pay your Medicare prescription drug costs? – Enter “I don’t know”.
– Click on “Continue to Plan Results”
5) Under Step 2 of 4: Enter Your Drugs
– Enter the name of your drug and click on Find My Drug
– Click on Dosages, Number, and Frequency
– Once you enter your drugs My Drug Profile  is creating showing:
Drug List ID: 0123456789
Password Date: 10/10/2011 (the date you are entering the drugs)
Zip Code: 01234
NOTE: Save this information! If at a later date, you want to review additional plans, Click on Retrieve My Saved Drug List, and you can review your drugs without the need to re-enter them. To retrieve this information, you will need to complete the first three screens to reach Step 2 of 4: Enter Your Drugs.
– When all your drugs are entered click on My Drug List is Complete
6) Under Step 3 of 4: Select Your Pharmacies
– Select Your Pharmacy. You do not have to click on any Pharmacies; however, it is wise to select the pharmacies you use most often.
– If your pharmacy is not shown, increase the number of miles from your Zip Code by clicking on the arrow
– Click Add Pharmacy
– You can add up to 2 Pharmacies at a time
– Click on Continue to Plan Results
7) Under Step 4 of 4: Refine Your Results
– In Summary of Your Search Results click on Prescription Drug Plans with Original Medicare
– Click on Continue to Plan Results
8) Under Plan Results
– The Plans are listed with Lowest Annual Retail Cost first
– The annual cost includes all premiums, deductibles, co-pays, and co-insurance
– Click on the Name of the Plan
– Your Plan Details are shown
– Scroll down to find:
  • Fixed Cost
  • Estimated Annual Drug Cost
  • What You Pay
  • Estimated Monthly Drug Costs
  • Drug Coverage Information
  • Pharmacy and Mail Order Information
  • Drug List
– To look at other plans click on Return to Previous Page
9) To Sign-Up for a Plan – we recommend that you enroll by phone although you can enroll online
-You may sign-up online – click on Enroll to the right of the plan
– To enroll by phone – Call the phone number listed. Call the Non-member number to sign-up
Enrollment Steps for Medicare Part D

Enrollment steps for Medicare Part D drug plans

Enrollment Procedure:

Enrollment by phone is recommended. The call takes approximately 20-30 minutes.
  • The phone number to enroll can be found under the name of the plan you have chosen.
  • During the enrollment process, be sure to:
    1. Confirm Plan Name
    2. Confirm all costs: premiums, deductibles, co-pays, co-insurance
    3. Ask for a confirmation number and note the date of the phone call
IMPORTANT: It is recommended that you do NOT have the premium COST deducted from your Social Security check.
  • Choose to pay your premium from one of these options:
    1. Automatic withdrawal from your bank account
    2. Automatic credit card payment
    3. Receive bills monthly and pay by check
Watch for Your Drug Plan Packet and Member Card:
A couple of weeks after enrollment or prior to January 1, the packet will arrive by mail. If you do not have it by January 1, call the drug plan.
Your package should include:
1.      Member Card to Present to Your Pharmacy
2.      Formulary Listing of the Drugs the Plan Covers
3.      Outline of Coverage
4.      Appeals Process
5.      Other Explanations and Benefits
Watch for Important Questionnaire that REQUIRES YOUR RESPONSE
You will receive a Questionnaire from your Drug Company after you enroll or shortly after the first of the year. It may be included with the Part D packet or in a separate mailing.
Carefully read the choices and respond correctly by indicating you DO NOT have creditable employer drug coverage. This may be worded in various ways. You MUST return this response to the drug plan.
Information Sheet from the Conference Office:
The Benefits Office will be mailing a letter with statements regarding “creditable drug coverage and the end date for the IGRC group drug coverage.” If needed, this letter provides you with important proof that there will be no penalty charge as long as you have enrolled by December 7. You may or may not be asked to send a copy of this letter to your drug company.
  • It is IMPORTANT to keep this letter on file indefinitely.
  • Use it if a Part D Drug plan wants proof after your enrollment, that you were covered by qualified creditable drug coverage prior to January 1, 2012. Wait to be asked to send a copy of the letter.
  • At some point, the drug plan may request proof of the date your creditable drug “employer” coverage ended. This information sheet will provide the response they need.
  • Keep the original sheet. If requested, send a copy to the drug plan.
If Problems Arise
If, during the year, your prescription plan does not seem to be running smoothly and you do not receive satisfactory answers from your drug plan, contact the SHIP program closest to you. For locations, call 800-546-9034.
Switching to Another Drug Plan in Future Years
To switch from one drug plan to another in future years, please refer to the “How to Reduce Your Drug Costs” section about the specific and unique steps to do this.
Interpreting Plan Summaries

Interpreting the plan summaries

When you click on a plan name, several important items can be found:
Top Right Hand Corner
  • Contains your Zip Code, Drug List Number, and Password Date.
  • These items are useful if you go to Medicare.gov.  Using these three pieces of information, you can retrieve your drug information.
 The Plan Name and Plan Code Number are near the Center of the Page
  • You will need both the Plan Name and Plan Code Number to enroll in the plan.
  • Contact Information for the Plan is located to the right of the name.
  • To Enroll, you will call the Non-Member Phone Number.
The Overall Plan Rating is to the right of the phone numbers
  • The higher number of stars the better the rating.
  • However, you cannot tell why a particular plan received a higher or lower rating. You can be confident in all the plans since they have been approved by Medicare.
Under the Plan Name are the Fixed Costs of the plan
  • The Monthly Plan Premium and any Annual Drug Deductibles are listed.
    •  Monthly Plan Premium – the amount you will pay each month for the plan whether you use the plan or not.
    • Annual Drug Deductible – the amount you will pay out of pocket before the plan benefits begin. The premium does not count toward the deductible; only the actual cost of the drug(s) counts.
    • These costs will not change during the year
    • Each plan will have its own premium and deductible charges.

Estimated Annual Drug Costs

  • Located under the Fixed Costs.
  • Your decision making begins here. Select the plan that meets your needs at the lowest annual cost.  You should take into consideration the total annual out-of-pocket cost for each pharmacy that you selected and mail order (if available). The cost includes all premiums, deductibles, co-pays, and co-insurance.
  • By clicking on the pharmacy name, the cost details at that particular pharmacy will appear.

Drug Cost and Plan Coverage are listed for each drug

  • First column lists the full cost of the drug
  • Second column is the refill frequency
  • The rest of the columns show your out-of-pocket expense for each drug:
  • If the plan has a Deductible, the next column shows you paying the full amount of the drug until you reach the deductible amount:
    • Initial Coverage Level – shows what you pay when the plan is in full effect
    • Coverage Gap – shows what you pay when you are in the donut hole/coverage gap. This column is included whether you reach the donut hole or not. For a definition of the donut hole, click here.
    • Catastrophic Coverage – shows the amount you pay when you have reached the far side of the donut hole.
     Estimated Monthly Drug Costs
    • A bar graph depicts your monthly cost for that plan
    • If there is a deductible, you will notice a decrease in the expenses once the deductible is fully met
    • If you reach the donut hole, you will see an increase in the monthly cost in the middle of the year
    • If you reach catastrophic coverage, you will see a decrease in the monthly expenses as you leave the coverage gap
     Drug Coverage Information
    • Each drug is listed along with its Tier (Formulary Status), Prior Authorization, Quantity Limits, and STEP Therapy
    • If a drug has a Quantity Limit, click on YES for more details
    • Ideally, you want to have all of your medications to be Tier 1 drugs as these are the least expensive drugs
      • Each plan determines its own Formulary List, therefore, the same drug can be different tier levels depending upon the plan
       Drug List
      • The list of the medications that you typed in are listed along with their quantity and frequency
Hearing Aid and Dental Loans
 Dental Loan

Deductible: $500 paid by participant.  Send bill for the balance to PASBF

Interest Rate: 1% Simple Interest

Term: Up to 5 years

Maximum Loan Amount: $5,000 per person

Dental Loan Summary

Dental Plan and EnrollmentInstructions and Payment Form

Preachers’ Aid and Ampliphon

Go to PASBF – Amplifon webpage.

PASBF has teamed up with Amplifon to bring discounts on over 2,000 hearing aids. And, through July 2017, Amplifon will give you a FREE hearing test at one of their clinics. Call 855-508-5462 to schedule an appointment. Go to Amplifon brochure with gift certificate.

Ampliphon does offer a 1-year, interest free loan for hearing aids. You may use their service or you the loan option from PASBF – details to the right.

PASBF Hearing Aid Loan

Deductible: $500 paid by participant.  Send bill for the balance to PASBF

Interest Rate: 1% Simple Interest

Term: Up to 5 years

Maximum Loan Amount: $5,000 per person

Hearing Aid Program FlyerHearing Test CouponHearing Aid Program SummaryInstructions and Enrollment Form

What is the Medicare Part D Donut Hole?

What is the donut hole in Medicare Part D plans?

The donut hole or coverage gap occurs when the total cost for your drugs – including all deductibles, co-pays, and the amount the plan pays – reach a certain amount. During the gap, or donut hole, there is no prescription drug coverage and you will pay the entire cost of the drugs until you hit the upper limit and Catastrophic Coverage begins. All Medicare Part D plans have the same donut hole and the plan tracks the expense.  You do not have to.
2012 limits: Donut hole begins when total drug costs reach $2930 and ends when total drug costs reach $6,657.50.
Financial Assistance + Financial Planning
We are here to help our retired clergy, to serve those who served us.  If a retired clergy member or surviving spouse is struggling with finances, we offer a variety of resources to assist. For more information, please contact Keith Anderson at 217-529-3221.

To learn more about PASBF’s Finaincal Planning services, click here.

Fellowship Groups
To learn more about Fellowship Groups, click here!
Death Benefits
Click here for the 2020 CPP Benefits.  If you are unsure if you qualify for the CPP benefits in retirement, call Wespath at 800-851-2201.
Virgin Pulse
PASBF pays for the first pedometer and all benefits to retirees and spouses from the IGRC. You need your own email to sign-up. Click here for instructions and begin to earn money with every step you take.
Clergy Assistance Program
All retirees and spouses can take advantage of the Clergy Assistance Program (CAPS) because PASBF pays for all of the fees. There are several ministries under CAPS including 1) counseling, 2) legal consultation, 3) financial consultation, 4) identity theft, 5) elder care, 6) nutrition, and 7) exercise. Click here for a copy of the CAP Brochure..
Questions?

Still need help?

If you still need help….
Call SHIP (Senior Health Insurance Program): 1-800-548-9034 OR go to their website:  www.insurance.illinois.gov

They have sites in senior centers and other facilities throughout the state.

Attend one of our Medicare D counseling meetings.

Give us a call at 217-529-2308 and we’ll put you on the appointment schedule!