Retirees Over 65 With Medicare Parts A & B
Blue Cross CompanionCare and Kaiser Senior Advantage Plans
Blue Cross CompanionCare
Effective January 1, 2021 retirees and their dependents enrolled in RSCCD’s
Retiree Health plans who are also enrolled with Medicare A & B will be
transitioning to a medical plan called Companion Care. This is a Blue Cross Medicare
Supplement Plan that RSCCD will be offering through SISC (Self-Insured Schools
of Southern California). Retirees covered under this plan may access medical services with any U.S. provider who accepts Medicare assignment. Members self-refer to any U.S. provider who accepts Medicare assignment and when the medical service is approved by Medicare, and the provider accepts Medicare assignment, the member cost share is zero. Retirees will be able to enroll in CompanionCare year-round with a 60 day advance notice.
Rancho Santiago Companion Care Overview.pdf
What is CompanionCare?
CompanionCare plan is a supplement to Medicare.
How Does CompanionCare Coordinate with Medicare?
The medical provider will submit claims to Medicare for payment and to Anthem Blue Cross for CompanionCare to pay. Medicare pays 80% of allowable charges and CompanionCare will pay for the other 20% of allowable charges.
Where does a member find a provider for CompanionCare?
Any provider that accepts Medicare will accept CompanionCare.
Are there benefits outside of California with CompanionCare?
Yes. Medicare is the primary insurance and as long as the provider accepts Medicare, CompanionCare will pay on allowed charges.
Who can enroll?
This plan may be offered to retirees over 65 with Medicare Parts A & B (see www.medicare.gov for information on Medicare) and retirees under age 65 with Medicare for the disabled. In order to be eligible, the member must be retired and enrolled in both Medicare Part A and Medicare Part B.
Is there dependent coverage?
No. CompanionCare is an individual enrollment. If a spouse/domestic partner is currently enrolled as a retiree health dependent and qualifies for Medicare Parts A & B a they must complete a separate CompanionCare enrollment form for their own contract or maintain coverage with Anthem Blue Cross HMO or PPO Medical.
How does a member enroll?
A CompanionCare enrollment form must be completed and submitted to the District with a copy of the member's Medicare card. If the card is not available, enrollment in CompanionCare will be delayed until the card is received.
Does the member need to enroll in Medicare Part D?
No. SISC will automatically enroll CompanionCare members in Medicare Part D for prescription medications. CompanionCare members already enrolled in non-ASCIP Medicare Part D plan will be automatically disenrolled from those plans.
What happens if member enrolls in a Medicare Part D plan outside of SISC/ASCIP?
The Centers for Medicare and Medicaid Services (CMS) does not allow a member to be enrolled in two Medicare Part D plans. The ASCIP medical and prescription drug benefits will be terminated.
If you're currently enrolled with Costco Mail Order – You will need to update your information online with your new Navitus Medicare Rx Card. When logging onto your online account choose “Navitus Med-D" on the insurance drop down. Costco cannot refill any 2021 prescriptions without it. If your medication is not on their formulary, call the Navitus customer service at 866-270-3877 and they will work with you over the phone to get the authorization.
To pick-up your prescriptions from a Participating Network Pharmacy (such as RiteAid, CVS, etc.)
Present your new Navitus MedicareRx card to the Pharmacy so they can update your Patient Profile. Without it, the pharmacy cannot dispense your medication
Navitus Online Portal –Even if you previously registered on the member website, you need to create a new account and choose “Medicare Rx”.
Companion Care Summary - Updated Deductible.pdf
Companion Care - Benefit Booklet 10-1-20.pdf
Rancho Santiago Companion Care Overview.pptx
Q&A COMPANIONCARE Medicare Supplement Plan.pdf
CompanionCare RX Summary 2020_Plan 9x35.pdf
Kaiser Senior Advantage Plan
Kaiser Senior Advantage Plan Requirements (retirees and/or dependents 65+):
- If you or your dependent are over 65 and you want Kaiser, you will be required to enroll in the Kaiser Senior Advantage Plan.
- Retirees and/or dependents in this plan must be enrolled in Medicare A & B and you must assign your Medicare benefits to Kaiser.
- If your home zip code is outside of the Kaiser Senior Advantage service area, you will not be eligible to enroll.
Frequently Asked Questions
Q. If I'm a retiree over 65 and enroll in Kaiser's Senior Medicare Advantage Plan but my spouse is
under 65, does he/she stay on the regular Kaiser Plan?
A. Yes, but on their 65th birthday they would be moved to the Senior Advantage Plan. Your spouse must also
be enrolled in Medicare Part A & B and assign the benefits to the Kaiser Senior Advantage Plan.
Q. If I am a retiree under 65, but my spouse is over 65, can we both be enrolled in Kaiser?
A. Yes. You would enroll in the regular Kaiser plan and your spouse would need to enroll in the Kaiser Senior
Advantage Plan. He/She must be enrolled in Medicare Part A & B and they must assign their Medicare benefit
to Kaiser. Otherwise, Kaiser coverage terminates for you and your dependent and you will need to enroll in
Anthem Blue Cross HMO or PPO Medical Plans. When you turn 65 you may either elect the Kaiser
Permanente Senior Advantage plan or elect to enroll in Anthem HMO or PPO plan.
Q. If I or my dependent become eligible for Medicare on our 65th birthday and enroll only in Medicare
Part A and not in Part B, can we keep our Kaiser coverage?
A. No, you would need to contact the district's Employee Benefit Office to terminate Kaiser HMO medical and
enroll in Anthem Blue Cross HMO or PPO medical plan.
Q. If I enroll in Kaiser and move from California to another state, am I able to switch to Anthem Blue
A. Yes. Contact the district's Employee Benefit Office prior to relocation for assistance.
If you need additional information, please visit RSCCD's website at www.rsccd.edu/Departments/Benefits
For more information about Kaiser Permanente, please visit www.kp.org