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MIT Employee Benefits

PLAN RATES

The Medicare supplemental health plans offered by MIT are designed to bridge the gap between what Medicare coverage provides (80% after Part B deductible is paid) and any remaining balance(s) owed by you for covered services. This means that after Medicare pays for a covered service, MIT's plan will pick up any remaining costs left over that were not paid by Medicare (20%).

In most cases you are either covered in full or are required to pay a small copayment. There are no deductibles associated with the plans and preventive services (PDF) approved by Medicare are covered in full with no copayment at all. You pay the costs of services that Medicare or the MIT supplemental health plan does not cover. For detailed coverage information on each of these plans, refer to the 2013 Medicare Supplemental Plans Comparison Chart.

IMPORTANT NOTE: As of January 1, 2012 the Managed Blue for Seniors and Tufts Medicare Complement plans were no longer available to new enrollees. This means that you will not be able to enroll in either of these plans during Open Enrollment. Members who are already enrolled in either of these plans can continue enrollment in 2013. If you are staying in the same plan in 2013 and do not want to make any changes, no action is required on your part— you will automatically continue to be enrolled in that same Medicare supplemental plan in 2013.

For information regarding your MIT-sponsored Medicare Part D Prescription Drug Plan, which is administered by Express Scripts, visit http://hrweb.mit.edu/benefits/retirees/prescriptions.

For information regarding Medicare, visit www.medicare.gov.

Medex

The Medex plan is offered by MIT and administered by Blue Cross Blue Shield of Massachusetts. This supplemental plan provides additional coverage to your Medicare hospital insurance (Part A) and Medicare medical insurance (Part B). Medex will provide benefits when services are covered by Medicare and offered by a provider who has a payment agreement with Blue Cross Blue Shield.

Please note:

• You do not need to choose a Primary Care Provider (PCP).
• You do not need a referral to see a specialist.
• There are no copayments required on your part.
• The only copayments associated with this medical plan are copayments for services received in a skilled nursing facility.
• This plan includes medical coverage only – your Medicare Part D prescription drug coverage is separate from your medical plan. MIT will continue to sponsor your prescription drug coverage and Express Scripts will administer the plan. This prescription drug coverage goes hand in hand with MIT's medical coverage. If you opt out of MIT's prescription coverage, you will no longer have medical coverage through MIT and will therefore need to find new medical insurance. Call the MIT Benefits Office at 1-855-253-6151 if you are considering opting out. Learn more about your Part D prescription drug coverage through Medicare.

To be eligible for the Medex plan, you must:

• Have and maintain Medicare Parts A (hospital) and B (medical) and Medicare must be your primary insurance (Medex would be secondary to Medicare).
• Live in the U.S. or its territories. Medicare usually does not provide benefits for services received outside the U.S. or its territories.

What You Should Know

• You can continue using your current Medex medical ID card in 2013 that you were using in 2012. No new medical ID cards will be mailed to you (unless you are enrolling in Medex for the first time).
• You'll be enrolled automatically in the Medicare Part D Prescription Drug Plan, unless you choose to opt out (you'll also be opting out of medical if you choose to opt out of the prescription drug plan).

For more information regarding your prescription drug coverage visit http://hrweb.mit.edu/benefits/retirees/prescriptions.

Your local Social Security administration office should be able to answer any Medicare questions, or you can check the Medicare Web site at www.medicare.gov.

For more information on Medex, see the Medex Summary of Benefits (PDF).

Tufts Medicare Preferred

The Tufts Medicare Preferred Plan is offered by MIT and administered by Tufts Health Plan. The plan is available for Massachusetts residents who live in certain counties. This supplemental plan provides additional coverage to your Medicare hospital insurance (Part A) and Medicare medical insurance (Part B).

To be eligible for the Tufts Medicare Preferred Plan, you must:

• Choose a Primary Care Provider (PCP) who will manage your care and provide referrals to see network specialists when necessary.
• Have and maintain Medicare Parts A and B and Medicare must be your primary insurance (Tufts would be secondary to Medicare).
• Live in the Tufts Health Plan service area, and you cannot be away from the service area for more than 90 consecutive days. The service area includes the following counties in the state of Massachusetts: Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester. There are towns in Bristol and Plymouth counties that are excluded from the service area, which can be found in the Tufts Medicare Preferred Summary of Benefits (PDF). No coverage is available outside of the service area, except in an emergency or urgent care situation.

This plan includes medical coverage only – your Medicare Part D prescription drug coverage is separate from your medical plan. MIT will continue to sponsor your prescription drug coverage and Express Scripts will administer the plan. This prescription drug coverage goes hand in hand with MIT's medical coverage. If you opt out of MIT's prescription coverage, you will no longer have medical coverage through MIT and will therefore need to find new medical insurance. Call the MIT Benefits Office at 1-855-253-6151 if you are considering opting out. Learn more about your Part D prescription drug coverage through Medicare.

What You Should Know

• You must choose a PCP from the Tufts Health Plan network service area.
• You must obtain a referral from your PCP to see a network specialist.
• In most cases the medical services you receive, if covered by Medicare, are covered with a $10 copayment for visits with your PCP and $15 for visits to see a specialist.
• You will receive a new medical ID card from Tufts Health Plan (PDF) and a new prescription drug ID card from Express Scripts (PDF).
• You'll be enrolled automatically in the Medicare Part D Prescription Drug Plan unless you choose to opt out.

For more detailed information regarding your medical plan refer to the Tufts Medicare Preferred Summary of Benefits (PDF).

Your local Social Security administration office should be able to answer any Medicare questions, or you can check the Medicare web site at www.medicare.gov.

Managed Blue for Seniors

If you are currently a participant you may continue your coverage. This plan is not open to new enrollees.

The Managed Blue for Seniors plan is offered by MIT and administered by Blue Cross Blue Shield of Massachusetts. This supplemental plan provides additional coverage to your Medicare hospital insurance (Part A) and Medicare medical insurance (Part B). Under the Managed Blue for Seniors medical plan, you choose a Primary Care Provider (PCP) who will manage your care and provide referrals to see network specialists when necessary.

To be eligible for Managed Blue for Seniors, you must:

• Have and maintain Medicare Parts A and B and Medicare must be your primary insurance (Managed Blue would be secondary to Medicare).
• Live in the Blue Cross Blue Shield service area, and you cannot be away from the service area for more than 90 consecutive days. The Managed Blue for Seniors service area includes all cities and towns in Massachusetts. No coverage is available outside of the service area, except in an emergency or urgent care situation. 

Your prescription drug plan will be Medicare Part D. MIT will continue to sponsor your coverage and Express Scripts will administer the plan. This prescription drug coverage goes hand in hand with MIT's medical coverage. If you opt out of MIT's prescription coverage, you will no longer have medical coverage through MIT and will therefore need to find new medical insurance. Call the MIT Benefits Office at 1-855-253-6151 if you are considering opting out. Learn more about your Part D prescription drug coverage through Medicare.

For more information on Managed Blue, see the Managed Blue for Seniors Summary of Benefits (PDF).

What You Should Know

• Enrollment in this plan is no longer an option. This means that unless you were already enrolled in the plan in 2012, you will not be able to enroll in this plan during open enrollment.
• You must choose a PCP from the Blue Cross Blue Shield HMO Blue network.
• You must obtain a referral from your PCP to see a network specialist.
• In most cases, the medical services you receive are covered either in full or with just a $10 copayment.
• You'll be enrolled automatically in the Medicare Part D Prescription Drug Plan unless you choose to opt out.

For more information regarding your prescription drug coverage visit http://hrweb.mit.edu/benefits/retirees/prescriptions.

Your local Social Security administration office should be able to answer any Medicare questions, or you can check the Medicare web site at www.medicare.gov.

Tufts Medicare Complement Plan

If you are currently a participant you may continue your coverage. This plan is not open to new enrollees.

The Tufts Medicare Complement Plan is offered by MIT and administered by Tufts Health Plan. This supplemental plan provides additional coverage to your Medicare hospital insurance (Part A) and Medicare medical insurance (Part B). Under the Tufts plan, you choose a Primary Care Provider (PCP) who will manage your care and provide referrals to see network specialists when necessary.

To be eligible for the Tufts Medicare Complement Plan:

• You must have and maintain Medicare Parts A and B and Medicare must be your primary insurance (Tufts would be secondary to Medicare). 
• Live in the Tufts Health Plan service area, and you cannot be away from the service area for more than 90 consecutive days. The service area includes an extensive network of providers throughout Massachusetts, Rhode Island and southern New Hampshire. No coverage is available outside of the service area, except in an emergency or urgent care situation.

This plan includes medical coverage only – your prescription drug coverage is separate from your medical plan and will be Part D coverage through Medicare. MIT will continue to sponsor your coverage and Express Scripts will administer the plan. This prescription drug coverage goes hand in hand with MIT's medical coverage. If you opt out of MIT's prescription coverage, you will no longer have medical coverage through MIT and will therefore need to find new medical insurance. Call the MIT Benefits Office at 1-855-253-6151 if you are considering opting out. Learn more about your Part D prescription drug coverage through Medicare.

What You Should Know

• Enrollment in this plan is no longer an option. This means that unless you were already enrolled in the plan in 2012, you will not be able to enroll in this plan during open enrollment.
• You must choose a PCP from the Tufts Health Plan network.
• You must obtain a referral from your PCP to see a network specialist.
• In most cases, the medical services you receive are covered either in full or with just a $10 copayment.
• You'll be enrolled automatically in the Medicare Part D Prescription Drug Plan unless you choose to opt out.

For more detailed information regarding your medical plan, refer to the Tufts Medicare Complement Summary of Benefits(PDF).

For more information regarding your prescription drug coverage, visit http://hrweb.mit.edu/benefits/retirees/prescriptions.

Your local Social Security administration office should be able to answer any Medicare questions, or you can check the Medicare web site at www.medicare.gov.

Retirees Over Age 65 — Grandfathered Group

You qualify for grandfathered eligibility if, on July 1, 1995, you were: 1) retired from MIT and were eligible for retiree health insurance benefits; or 2) actively employed by MIT and had attained at least age 65 on that date — or age 55 with at least 10 years of retirement-plan-eligible service. If you qualify for grandfathered eligibility, MIT pays the full cost of Blue Cross and Blue Shield's MEDEX Supplement and subsidizes the other Medicare Supplement Plans up to the cost of MEDEX.