What you need to know if you are traveling outside the US.

Are you planning to travel outside the US? Then you should be aware of how your health insurance works during foreign travel.

Empire Plan coverage is available worldwide, primarily in the form of reimbursement. If Medicare is your primary insurance, you should be aware that Medicare does not provide coverage outside the United States (with a few exceptions).

If you require medical care while abroad, the American Embassy can usually provide names of reliable, English-speaking doctors. After receiving medical services, ask for copies of your medical records in English, if possible. Keep a receipt when you pay your bill. When you get home, submit the records to the appropriate Empire Plan administrator. The Plan administrators will reimburse you directly for covered expenses. If you are Medicare primary, remember that Medicare does not provide coverage outside the United States. If no other coverage is in effect, The Empire Plan is primary until you return.

The above paragraph was excerpted from the publication, On the Road with the Empire Plan. The publication  is a must read for all New York State retirees who travel out of New York, both in the United States and internationally.

Click the buttons below to download the New York State publications or to learn more about Medicare and foreign travel.


 

 

 

Thanks to member Ed Nostrand for sharing the information about Medicare and foreign travel.

Urgent Message Regarding Health Insurance

NYSUT sent out a notice earlier this year regarding the NYSHIP dependent eligibility audit. The  Audit was directed strictly to those members with family Empire Plan coverage and who obtain their health coverage through school districts or local
governments.

April 15, 2016, was the deadline for participants to submit verifying dependent information to the plan for the purpose of coverage. It was reported yesterday that as of 04/14/16, 26,000 Empire Plan participants had not submitted their dependent verification information. If this information is not submitted, dependents will be removed from coverage, and most would lose coverage retroactive to 01/01/16.

Local leaders encourage their members to review the dependent verification packet they received in February and comply with the request as soon as possible. If participating members have questions, members can call HMS Solutions (the NYSHIP dependent verification vendor) 1-855-893-8477.

Update on Social Security and Medicare

The AFT as issued a bulletin from on recent changes to Social Security and Medicare that all retirees, and soon to be retirees, should be aware of.


2016 Changes Announced for Social Security and Medicare

The Social Security Administration and Centers for Medicare and Medicaid Services recently announced changes in Social Security and Medicare benefits effective January 1, 2016. This bulletin provides some of the key changes for review and use by local leaders and active and retired members.   More detailed information can be found at www.ssa.gov. Continue reading

Good News for North Carolina Residents …

NYSUT reported this morning that United Healthcare (UHC) and the 
Carolinas Health Care System (CHS) have reached a contractual agreement, 
resulting in the return of all CHS physicians to The Empire Plan 
network. The effective date will be retroactive to March 1, 2015, 
ensuring that Empire Plan enrollees and dependents do not experience any 
interruption in their network benefits for services received from CHS 
providers. Any questions regarding CHS providers or claims should be 
directed to UHC by calling The Empire Plan at 1-877-7-NYSHIP 
(1-877-769-7447); press or say 1 for the Medical Program 

Medicare “Doc Fix” Bill Passes in the Senate

This week, the Senate passed the Medicare Access and CHIP Reauthorization Act of 2015 to repeal the Sustainable Growth Rate (SGR) formula that determines Medicare physician payments and extend the Children’s Health Insurance Program (CHIP) for two years. Congress has acted 17 times to temporarily prevent drastic payment cuts resulting from use of the SGR formula. The “doc fix” bill replaces the SGR with alternative, value-driven payment strategies. This is good news for people with Medicare, who need to know their doctors will be there when they need them. 

The bill also permanently funds the Qualified Individual (QI) program that helps low-income Medicare beneficiaries afford Part B premiums. While the Senate considered an amendment to the bill to permanently repeal the Medicare therapy caps, this measure was not successful. Instead, the therapy caps exceptions process will be extended for two years. When this exceptions process expires, Congress must again act to ensure that people with Medicare are able to retain access to needed therapy services.

Also extended for two years is federal funding for community-based organizations, including State Health Insurance Assistance Programs (SHIPs), Area Agencies on Aging (AAAs) and others, to find and enroll vulnerable Medicare beneficiaries in low-income assistance programs. Like the therapy cap exceptions process, it will be paramount for Congress to ensure this funding continues beyond the two-year extension included in the final bill. 

The legislation will now go to the President, and he is expected to sign it into law. 

Click here to read the final bill.