Required Notices Required Notices When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? Important Notice from Franciscan Missionaries of You should also know that if you drop or lose your current coverage with Our Lady Health System About Your Prescription Drug Franciscan Missionaries of Our Lady Health System and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may Coverage and Medicare under the FMOLHS Health pay a higher premium (a penalty) to join a Medicare drug plan later. Plan(s) If you go 63 continuous days or longer without creditable prescription drug Please read this notice carefully and keep it where you can find it. This coverage, your monthly premium may go up by at least 1% of the Medicare notice has information about your current prescription drug coverage with base beneficiary premium per month for every month that you did not have that Franciscan Missionaries of Our Lady Health System and about your options under coverage. For example, if you go nineteen months without creditable coverage, Medicare’s prescription drug coverage. You are responsible for providing this your premium may consistently be at least 19% higher than the Medicare base notice to any Medicare eligible dependents covered under the Health Plan. This beneficiary premium. You may have to pay this higher premium (a penalty) as long information can help you decide whether or not you want to join a Medicare drug as you have Medicare prescription drug coverage. In addition, you may have to plan. If you are considering joining, you should compare your current coverage, wait until the following October to join. including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information For More Information about This Notice or Your Current about where you can get help to make decisions about your prescription drug Prescription Drug Coverage… coverage is at the end of this notice. Contact the person listed at the end of these notices for further information. There are two important things you need to know about your current coverage NOTE: You’ll get this notice each year. You will also get it before the next and Medicare’s prescription drug coverage: period you can join a Medicare drug plan, and if this coverage through 1. Medicare prescription drug coverage became available in 2006 to Franciscan Missionaries of Our Lady Health System changes. You also may request a copy of this notice at any time. everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO For More Information about Your Options under or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some Medicare Prescription Drug Coverage… plans may also offer more coverage for a higher monthly premium. More detailed information about Medicare plans that offer prescription drug 2. Franciscan Missionaries of Our Lady Health System has determined that coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the prescription drug coverage offered by the FMOLHS Health plan(s) the mail every year from Medicare. You may also be contacted directly by Medicare is, on average for all plan participants, expected to pay out as much as drug plans. standard Medicare prescription drug coverage pays and is therefore For more information about Medicare prescription drug coverage: considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher » Visit www.medicare.gov premium (a penalty) if you later decide to join a Medicare drug plan. » Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help WhenCanYouJoinAMedicare DrugPlan? » Call 1‑800‑MEDICARE (1‑800‑633‑4227). You can join a Medicare drug plan when you first become eligible for Medicare TTY users should call 1‑877‑486‑2048 during a seven‑month initial enrollment period. That period begins three months If you have limited income and resources, extra help paying for Medicare prior to your 65th birthday, includes the month you turn 65, and continues for the prescription drug coverage is available. For information about this extra help, ensuing three months. You may also enroll each year from October 15th through visit Social Security on the web at www.socialsecurity.gov, or call them at December 7th. 1‑800‑772‑1213 (TTY 1‑800‑325‑0778). However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Remember: Keep this Medicare Part D notice. If you decide to join one Enrollment Period (SEP) to join a Medicare drug plan. of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained What Happens To Your Current Coverage If You Decide to creditable coverage and, therefore, whether or not you are required to Join A Medicare Drug Plan? pay a higher premium (a penalty). If you decide to join a Medicare drug plan, your current Franciscan Missionaries of Our Lady Health System coverage will not be Date: January 1, 2023 affected. For most persons covered under the Plan, the Plan will pay prescription Name of Entity/Sender: Franciscan Missionaries of Our Lady Health drug benefits first, and Medicare will determine its payments second. For more System information about this issue of what program pays first and what program pays Contact—Position/Office: Human Resources second, see the Plan’s summary plan description or contact Medicare at the Address: PO Box 83780 telephone number or web address listed herein. Baton Rouge, LA 70884‑3780 If you do decide to join a Medicare drug plan and drop your current Phone Number: 833‑482‑7547 Franciscan Missionaries of Our Lady Health System coverage, be aware that you and your dependents will not be able to get this coverage back. 58 58