2007
Medicare Benefits at a Glance
Refer
to the 2007 NALC Health Benefit
Plan brochure (RI 71-009) for complete details.
Previous brochures
are also available.
When
Medicare is primary payer (Medicare Part B for prescriptions), all
deductibles, coinsurances and copayments are waived, except for
prescription drugs. See the chart below for a brief overview. Rely
on your brochure for benefits when Medicare does not pay.
|
Benefit
|
You
Pay
|
| Hospitalization
(no precertification
required) |
|
Inpatient Medical/Surgical
and Mental Health
|
No deductible
No copayment
|
| Outpatient |
No calendar
year deductible
No coinsurance |
| Physician
Care |
| Inpatient
and Outpatient Medical and Surgical Care |
No deductible
No copayment
No coinsurance |
| Mental
Health and Substance Abuse |
No deductible
No limitations
No copayment
No coinsurance |
| Prescription
Drugs |
| Retail: |
Network Retail
—
Non-network —
|
15% of cost
50% of allowance
No deductible |
| Mail
Order: |
60-day supply —
|
$7 generic
$20 brand
name
No deductible
|
| 90-day supply —
|
$10 generic
$30 brand name
No deductible
|
| Catastrophic |
Nothing |
This is a summary
of some of the features of the NALC Health Benefit Plan. Detailed
information on the benefits for the 2007 NALC Health Benefit plan
can be found in the official brochure. All benefits are subject
to the definitions, limitations, and exclusions set forth in the
official brochure.
|
