Benistar is the nationwide leader in the design, installation, and administration of group retiree medical benefits. We provide retiree benefits for labor unions, city/government entities, educational and religious organizations, and publicly and privately-held companies.
We offer group retiree medical plans that pay for the costs that are recognized but not covered by Medicare parts A and B. Our qualified service professionals will determine which plan is right for your company’s retirees based on a number of factors and unique solutions. Our plans are more cost-effective and practical than traditional individual retiree medical insurance; our prescription drug plans are specifically engineered for groups under Medicare Part D. Benistar collaborates with its national PBM and insurance carrier partners to meet all requirements of CMS regulations related to Medicare Part D.
What is Medicare Part D?
Also called the Medicare prescription drug benefit, Medicare Part D is an optional federal government program that assists Medicare recipients by helping with the financial costs of self-administered prescription drugs through the use of prescription drug insurance premiums. Medicare Part D was originally proposed by President Clinton in 2000, and eventually enacted as part of the Medicare Modernization Act of 2003.
Medicare Part D covers a wide variety of drugs, both generic and brand-name pharmaceuticals. The ‘formulary’ – or list of covered drugs – includes at least two or more drugs in the most popularly prescribed categories and classes. The Medicare Prescription Drug, Improvement, and Modernization Act, enacted in 2003, produced the largest overhaul of Medicare policies in the program’s 38-year history. We utilize Medicare Part D, along with group retiree medical insurance, to get you the best coverage possible.
Notes on Medicare Part D
While this doesn’t happen often, some drugs may not be covered by Medicare Part D. If you believe none of the drugs on your plan’s formulary work for you, you may ask for a waiver or exception for that coverage rule. More often than not, if you have a valid supporting statement to back up your medical exception, that drug can be covered as well.
What if my drug still isn’t covered under Medicare Part D?
We will work with you to determine a generic drug that works just as well as a similar brand-name medication. Some people may believe that generic drugs lack the efficacy of their brand-name counterparts; thankfully, this is not the case. The Food and Drug Administration has strict guidelines on generic drugs, stating that generics are simply copies of brand-names. The generics must match the safety, strength, dosage form, intended use, quality, ROA (route of administration), and the intended use of their brand-name equivalent.
Group Retiree Medical Solutions and Prescription Benefits
Our retiree prescription drug plans are Employer Group Waiver Plans (EGWP), established by Medicare Part D. Our partners work with the Centers for Medicaid and Medicare Services (CMS) to serve as a Medicare Part D Plan Sponsor and also help manage the compliance of CMS regulations regarding Part D plans. Our Benistar EGWP plans offer these advantages for employers and their retirees:
Flat co-pays or coinsurance.
Nationwide Plan Availability.
Fills the Medicare coverage gap (the ‘donut hole’).
With the addition of a non-part D wrap product, groups can take full advantage of the 50% brand-name drug discount provided by the Coverage Gap Discount Program.
Cap your retiree health liability with a fully-insured plan.
Hassle-free and no-rush assistance for your retirees from our experienced customer service team.
Call us today at 1-(800)-236-4782 for more information regarding our unique solutions towards group retiree medical benefits, or take a visit to our contact page.