While Medicare is the primary payor for your medical expenses, the Supplemental Medicare Benefit is designed to reimburse you for your annual deductible and Patient’s Portion under Medicare. When you receive treatment or services for a medical expense covered by Medicare, submit your claim and your Medicare Explanation of Benefits to the Fund Office for reimbursement of your Medicare annual deductible and/or Patient’s Portion.
If your spouse and/or dependents are not covered by Medicare, they will remain covered as dependents of retirees not eligible for Medicare (see here) under this Plan.
The Plan’s annual deductible does not apply to Medicare-eligible retirees.
Medicare Parts A & B
The Plan assumes you are enrolled for Medicare Parts A and B if you are age 65 and will not pay for any expenses that are covered under Medicare Parts A and B even if you are not actually enrolled. That is why it is essential that you apply for Medicare Parts A and B at least three months before you reach age 65 to assure continued coverage.
The Plan pays your Medicare deductibles and your Patient’s Portion.
This Plan does not pay the Medicare Part B premium for Participants.
Medicare Part D
The EWTF Plan provides prescription benefits to Retirees. The Plan’s actuary has determined that the benefits provided under the Plan exceed the Medicare Part D prescription coverage for Medicare eligible participants. The Plan therefore receives a subsidy from the Centers for Medicare and Medicaid Services (CMS) for providing these benefits. If you or a covered dependent enrolls in a separate Medicare Part D program, you or your dependent will permanently lose your prescription benefits with EWTF.
What’s Not Covered
- This plan does not pay the Medicare Part B premiums.
- This Plan does not cover any expenses that Medicare does not cover.
While you’re enrolled in Medicare, the Plan will continue to provide hearing, dental, vision and death benefits for you. The Plan will also continue to provide prescription drug benefits for you provided that you have not enrolled in the Medicare Part D prescription program.
This Plan does not cover expenses that Medicare does not cover except dental and vision benefits.