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October 16, 2024<\/strong><\/p>\n You may have recently received two pieces of mail from the Retirement Office. The first is an Information Verification Form for 2024. It requires you to provide\u00a0updated information to the Retirement Office. If you are receiving a monthly benefit from the Retirement System, this form must be filled out, signed, dated and returned to the Retirement Office. Failure to return the completed form will result in the suspension of your benefit payment until such time as the form is completed and returned. Therefore\u00a0it is very important\u00a0that you comply with this request.If you receive a monthly benefit and did not receive the form you should contact the Retirement Office at (313) 224-5891.<\/p>\n August 13, 2024<\/strong><\/p>\n On August 8, 2024, the Michigan Court of Appeals finally issued their decision in the County\u2019s appeal of the Disability Healthcare coverage grievance. They rejected the Couty’s arguments and affirmed the lower court ruling. The County can request that the Court of Appeals reconsider the decision but since it was a published decision the chances of the Court of Appeals allowing a Motion to Reconsider are very small and should be denied. On June 13, 2024 there was an arbitration hearing to clarify certain issues in the arbitrators decision. Briefs were filed last week and hopefully we will get a decision by Labor Day. The arbitrator did comment that he was dismayed that this issue is taking so long to be resolved. Our attorneys are considering to file a Mandamus Order to force the County to follow the court order and arbitrator’s award but have to weigh that against just prolonging the procedure by doing so.<\/p>\n As I have stated in past meetings the Medicare eligible increases that we have been receiving pursuant to the Settlement agreement will end in 2025. We will continue to receive the stipend but with no additional increases. I had a meeting with a representative from the County Executive\u2019s Office regarding the continuation of the increases beyond 2025. In our discussions he said that the County is looking at enhancing the current pension benefits being offered to active employees in an effort to assist in recruitment and retention of active employees. As such he seemed supportive of including our request in the package that might be sent to the Wayne County Commission. He requested that we have discussions with Alicia Bell, Chairperson of the Wayne County Commission to get support from her regarding our request. I have sent a detailed letter to her with a cc to the rest of the Wayne County Commissioners and hope to hear from her soon. I also requested an increase for the Non Medicare stipend as that has remained unchanged since 2015.<\/p>\n I have been told that many retirees that have an account with Empower for either your Defined Contribution account or your Deferred Compensation account do not have a designated beneficiary on file. If you have an account with Empower please be sure you have a beneficiary listed and make sure it is up to date. If you have questions you should contact Kandie Anglin at (248) 840-0655.<\/p>\n There is an election for a retiree representative to the Retirement Board. It is a four year term beginning January 1, 2025. You must be a retiree (not a beneficiary of a retiree) and a resident of Wayne County, and not be an Airport Authority retiree. You must pick up petitions from the Retirement Office and obtain at least 50 signatures of eligible retirees. Bettye Misuraca is up for re-election and is running for a new four year term.<\/p>\n There is legislation in Lansing that would remove the 1,000 hour limitation on retirees who come back to work for the County. Currently if you work more than 1,000 hours your pension would be suspended until you no longer worked for the County. Under the proposed legislation you would continue to get both your pension and wages from the County. People that are opposed to this change feel it is \u201cdouble dipping\u201d and shouldn\u2019t be allowed.<\/p>\n There is current legislation that requires a pension fund to be 100% funded before any pension increases can be granted to retired members unless negotiated through collective bargaining.<\/p>\n July 10, 2024<\/strong><\/p>\n Wayne County has switched to a new payroll system and the July benefit is the first retiree payment processed with the new software system. There have been a few problems with the new program: 1) The County cannot send DDA notices via email so they are currently sending paper DDA statements through the US mail to all retirees who have direct deposit; 2) The benefit deduction tables and tax tables may not be 100% correct so that taxes withheld and benefit deductions (healthcare, dental, life insurance etc.) may not be 100% correct; 3) the 129 retirees that still receive a paper check may have issues cashing or depositing their check due to some checks missing the MICR\u00a0 code normally printed on the bottom of the check. If you are one of those individuals you should cal Andrea Pennington in the Retirement Office at (313) 224-2774 or Jim Magee at (313) 224-2821. They should be able to assist you.<\/p>\n We had two guest speakers at the July meeting. Sakia Scruggs Nixon, sister of Adrianne Scruggs, who is running for 3rd Circuit Court Judge for Wayne County and Carol Soucheck runnung for 9th District Wayne Couty Commissioner. Both Adrianne Scruggs and Carol Soucheck have been screened and endorsed by the AFSCME PEOPLE Committee screening committee.<\/p>\n Hugh Macdonald did some research and procured a copy of the County’s mirrored retiree BCBSM Medicare Advantage Plan<\/a> (MAPD) which is made available to mirrored retirees age 65 and above. The County does not offer retirees a Medicare Supplemental Plan. You can enroll in the County’s MADP or select a plan of your own from any other healthcare provider. However once you qualify to elect the Couty’s MAPD you can always enroll in the plan at a later date.<\/p>\n May 15, 202<\/strong><\/p>\n At our last meeting we had two guest speakers. The first was Sandra Bucciero, Fraud Guard Director, from the Register of Deeds Office. She spoke on the issue of Deed Fraud and how to protect yourself. She stated that the most often properties affected were homes with no mortgage or homes that no one is living in. Fraudsters create counterfeit Quit Claim Deeds and put the property in their name and then take control of your property.\u00a0 The Wayne County Register of Deeds, Bernard Youngblood, has established a fraud guard service which is free to Wayne County residents. If you are registered, they will send you a notification of any changes made to your deed. We have attached a copy of the flyer<\/a> she provided us at the meeting on how to register for the service and if you have a complaint. If you own a home you might want to look into this free service.<\/p>\n We also had Sherry Searcy, widow of Bryant Searcy, who was murdered in the Wayne County Jail. She has established the Bryant Searcy Scholarship Foundation and is holding its 2nd annual Scholarship Banquet and Fund Raiser on June 25, 2024. Sub-Chapter 38 donated $100 towards the scholarship Fund at its May meeting and we have provided the flyer<\/a> regarding the banquet and fundraiser for any interested members.<\/p>\n We are hoping to meet with the County Executive or his representative and members of the Wayne County Commission to see if we can get support to extend the possible increases to the Medicare healthcare stipend paid to Wayne County retirees who are not in the “Mirrored Retiree Group” as the Settlement agreement which provides for the increases will reach its maximum amount in 2025 if an increase is paid in 2025.<\/p>\n Finally, just a reminder that the Blue Cross Blue Shield of Michigan Medicare Advantage Plan will still be available in 2025 with a slight increase in premiums from 2024. The current premium is $11.20 and it is guaranteed not to increase by more than 10% for 2025. If you might be interested in this Plan, you can contact Mark Mueller, TRM & Associates, at (313) 963-1135 for additional information.<\/p>\n February 25, 2024<\/strong><\/p>\n At our next General Membership Meeting we will have a guest speaker, Sheriff Raphael Washington, who will speak on senior citizen scams and what to watch out for and who to contact if you become a victim.<\/p>\n At a recent Labor Coalition meeting the Unions said the County has stated that they are not open to offering the BCBSM Advantage Plan to mirrored retirees as a healthcare option as it would increase the Counties costs. We are hoping to talk to other County officials to get a better understanding of the Counties position and any additional costs they may incur.<\/p>\n The County has recently discovered that it was providing a Medicare Eligible stipend to beneficiaries of retirees who did not provide continued healthcare benefits for their survivor(s) and was attempting to recover any over payments. The Subchapter filed a grievance and in resolution the County has agreed that it will only attempt to recover any remaining balances in their MERS account rather than the total of any overpayments.<\/p>\n December 20, 2023<\/strong><\/p>\n Just a reminder that the Retiree Medicare stipend will increase to $140.72 or $145.72 effective January 2023. If you get a monthly reimbursement from your stipend account for your Medicare Part B premiums you must file a new reimbursement form with MERS\/Alerus requesting the recurring reimbursement. If you need a reimbursement request form you can download it from our forms page. You need to fill out the form and sent it to Alerus along with a copy of your new Social Security statement showing what your new benefit will be as well as the deduction for Medicare Part B premiums..<\/p>\n We are still working with the Labor Coalition to see if they can negotiate an option for Medicare eligible retirees to opt into the Blue Cross Blue Shield of Michigan Medicare Advantage Plan which has a monthly premium of $11.20 per month and is accepted by all doctors and hospitals, with the exception of only a few, that accept Medicare.<\/p>\n We wish everyone a Merry Christmas, Happy Hanukkah, Happy Kwanzaa, Happy Holidays and a Happy New Year and hope that the new year brings good health and prosperity. Looking forward to seeing everyone in the New Year.<\/p>\n November 24, 2023<\/strong><\/p>\n Hopefully everyone had a Happy Thanksgiving. At our November meeting we had a speaker from TMR & Associates give a presentation on the BCBSM (Blue Cross Blue Shield of Michigan) Medicare Advantage Plan. A copy of the presentation can be viewed by clicking this option<\/a>. The premium is $11.20 per month and you can enroll by contacting TMR & Associates at (313) 963-1135. The stipend for Medicare Eligible Retirees will be increased to $140.72 or $145.72 effective January 1, 2024. The results of our officer elections maintain the current Board Member swith the exception of Jerry Smith (who stepped down) being replaced by Gerard Grysko. The next meeting of the Sub-Chapter will be held on December 12, 2023.<\/p>\n October 15, 2023<\/strong><\/p>\n The next meeting of Sub-Chapter 38 will be held on Tuesday, November 14, 2023 at UAW Hall 182 located at 35603 Plymouth Road, Livonia, MI. The meeting will begin at 1:00 pm with a light lunch served before the meeting starting at 12:30 pm.<\/p>\n Unfortunately the representative was not able to attend our October meeting but will be available to speak to our members regarding the Open Enrollment for the BCBSM Medicare Advantage Plan effective January 1, 2024. The premium will remain at $11.20 per month for 2024. If you are in a Medicare Advantage Plan with higher premiums or you are in a Medicare Supplemental Plan and are looking to get information on the Medicare Advantage Plan, this will be your opportunity to get information on this very affordable healthcare alternative.<\/p>\n The Executive Board was re-elected at our October meeting and will be sworn in at the November meeting. Gerard Grysko was elected to a 3-year term as our newest trustee replacing Jerry Smith. Thanks to Jerry for his long service as a trustee.<\/p>\n September 26, 2023<\/strong><\/p>\n The next meeting of Sub-Chapter 38 will be held on Tuesday, October 10, 2023 at UAW Hall 182 located at 35603 Plymouth Road, Livonia, MI. The meeting will begin at 1:00 pm with a light lunch served before the meeting starting at 12:30 pm.<\/p>\n We will be holding elections for all Executive Board positions and one (1) Trustee position. The current Executive Board has been nominated for re-election with the exception of Jerry Smith. Nominations will also be taken from the floor for any of the Executive Board positions.<\/p>\n We will also have a speaker regarding the Open Enrollment for the BCBSM Medicare Advantage Plan effective January 1, 2024. The premium will remain at $11.20 per month for 2024. If you are in a Medicare Advantage Plan with higher premiums or you are in a Medicare Supplemental Plan and are looking to get information on the Medicare Advantage Plan, this will be your opportunity.<\/p>\n Looking forward to seeing you there.<\/p>\n August 13, 2023<\/strong><\/p>\n At the September 12, 2023 meeting representatives from Empower and Titan Wealth Advisors who handle the Defined Contribution Plan and Deferred Compensation Plan will be making a presentation regarding these two programs. If you have any questions regarding how to access your funds, change your investment options. update your beneficiary(s) or any other issues, you should definitely attend this meeting. They will also be providing lunch for the meeting.<\/p>\n We will also be selecting 12 delegates to the Chapter 255 meeting to be held on October 13 and 14 at UAW Hall 182 located at 35603 Plymouth Road, Livonia, MI (the same place our monthly meetings are held). The membership has approved paying for up to 20 members to attend the convention.<\/p>\n There are still over 800 retirees who have not returned the Signature Verification form. They will have 60 days from the date of the second notice that was recently sent out to complete and return the form. Failure to return the form will result in the suspension of their monthly benefit until such time as the completed form has been returned.<\/p>\n July 19, 2023<\/strong><\/p>\n The Wayne County Retirement Board has sent out an Information Verification Form that must be completed by all retirees receiving a monthly benefit. Many retirees have not completed this form. The Retirement Office is sending out a second notification and if it is not completed and returned to the Retirement Office within 60 days, your monthly benefit will be suspended until such time as the completed form is received. It is important that you complete and return the form as soon as possible.<\/p>\n Titan Wealth Advisors and Empower, the two companies that administer the Couty’s Defined Contribution Plan and the Deferred Compensation Plan will be making a presentation at our September meeting. They will be able to explain what investments are available to you, how the programs work, how and when funds must be withdrawn from you account(s), the tax liability and who your beneficiary(s) are. If you participant in either or both of these Plans it is recommended that you attend this session. They will also be providing a luncheon from Thomas’s Restaurant before the meeting.<\/p>\n May 10, 2023<\/strong><\/p>\n It has come to our attention that many retirees that are over age 65, receiving Medicare and have a Health Care Stipend paid monthly by the County, have large balances that have not been spent. The money can only be used for healthcare expenses and can be accessed for recurring monthly expenses or individual healthcare expenses.<\/p>\n If you do not know if your have a Stipend Fund account, don’t know how much you have in your account or don’t know how to access your account please contact Ron Yee (wcsc-38@att.net) or Hugh Macdonald (hmacdonald67@comcast.net) for assistance.<\/p>\n March 14, 2023<\/strong><\/p>\n 2023\u00a0\u00a0\u00a0 retirees born after 1945-1959\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 25% max allowed under Tier 1<\/p>\n 2024\u00a0\u00a0\u00a0 retirees born after 1945-1963\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 50% max allowed under Tier 1<\/p>\n 2025\u00a0\u00a0\u00a0 retirees born after 1945-1967\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 75% max allowed under Tier 1<\/p>\n 2026\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 100% max allowed under Tier 1<\/p>\n Current Tier 1 maximums:\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Single \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 $56,961<\/p>\n Joint\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 $113,922<\/p>\n Under the current law:<\/p>\n Tax Payers born from January 1, 1946 \u2013 December 31, 1952 the deduction is $20,00 for Single and $40,000 for Married filing Jointly.<\/p>\n Tax Payers born from January 1, 1953 \u2013 January 1, 1956 may be eligible for up to $20,000 for Single and $40,000 for Married filing Jointly.<\/p>\n If the amount you can deduct under current law is better than under the new law you can use the one that provides the better deduction.<\/p>\n Also it is my understanding that since the new law won\u2019t take effect until 2024, the first year 2023 rate becomes null and void and we will start with a 50% of the Tier 1 rates.<\/p>\n Police, Fire, County Correction Officers and State Police will get 100% in the first year.<\/p>\n February 14, 2023<\/strong><\/p>\n If you enrolled in the new BCBSM Medicare Advantage Plan you can now pay your monthly premiums through an automatic deduction from your savings or checking account. You can print the form from our web site located at www.wcsubchapter38.com. Click on “Forms<\/strong>”\u00a0at the top of the page; click on “BCBSM Auto-Payment<\/strong> Form<\/strong>“, Print Form, complete it and send it in. If you wish to make one payment for the year, when you receive the next bill just write a check for the $11.20 premium times the remaining months left in the year and your account will be credited for the remainder of the year.<\/p>\n January 16, 2023<\/strong><\/p>\n There will be a dinner honoring former Subchapter 38 President, Henry Lykes, held on January 28, 2023. It will be held at UAW Hall 182, located at 35603 Plymouth Road, Livonia, MI 48150. There will be a reception at 4:30 with a dinner and program beginning at 5:30 pm. Tickets are $25.00 per person and can be obtained by contacting Julie Bauman at jbauman2947@wowway.com or (313)429-3479.<\/p>\n December 22, 2022<\/strong><\/p>\n The ballots for the Retirement Board Retiree Commissioner have been counted and the results are Hugh Macdonald 651; Ronald Yee 676; Spoiled\/Voided 55. Therefore Ronald Yee has been elected to a 4 year term on the Retirement Board effective January 1, 2023.<\/p>\n November 8, 2022<\/strong><\/p>\n TRM has provided this link (www.tmrandassoc.com) to the Subchapter to review the new Wayne County BCBS Healthcare Plan that will be replacing the AM Wins healthcare effective January 1, 2023. Click on the “Menu Icon 3 bars in upper right corner) and then select Wayne County Retirees. It will then provide links to sign up for an Educational Meeting, provide a powerpoint presentation, benefit summary, group prescription drug formulary and enrollment center.<\/p>\n October 25, 2022<\/strong><\/p>\n Here is an update from the County on the new Medicare Eligible Retiree Healthcare that will be replacing the AmWINS Healthcare Plan effective January 1, 2023.<\/p>\n “We’re finalizing the dates for the on-site meeting as I type.\u00a0 Most of them will be the week of Nov 14 at various community college campuses in Wayne County plus one in Oakland County and one in Washtenaw County.\u00a0 There will also be two webinars set up on the afternoon of Nov 21 and the morning of Nov 22. \u00a0There will be enrollers available at each site as well for those that want to go ahead and make the change.\u00a0 A letter will be going out with the meeting schedule and we’ll email everyone for whom we have email addresses the same information. \u00a0<\/em><\/p>\n Information about the plans \/ enrollment kits will be mailed in the first week of November so retirees will have them in their hands by the week of the presentations.”<\/em><\/p>\n August 16, 2022<\/strong><\/p>\n If you have questions concerning your life insurance coverage from the County, you can contact the Benefits & Disability Administration Division at (313) 224-5157 or email address benefits@waynecounty.com.<\/strong><\/p>\n Also if you need to contact your local Union<\/a> to discuss changes in retiree benefits, especially for “Mirrored Retirees” you can view a list of names and contacts by clicking on the highlighted “Union”.<\/p>\n July 12, 2022<\/strong><\/p>\n Due to circumstances, the Executive Board recommended and the General Membership approved a change to the posted meeting schedule at the July 12, 2022 meeting. The General Membership meeting has been changed from Tuesday, August 9, 2022 to Tuesday, August 16, 2022. It will still be held at the UAW Hall 182 located at 35603 Plymouth Road, Livonia, MI 48150<\/p>\n June 2, 2022<\/strong><\/p>\n May 23, 2022<\/strong><\/p>\n Information regarding Free COVID 19 Test Kits<\/p>\n Every home in the U.S. is eligible to order a 3rd round of free at-home tests. Order yours today.<\/p>\n Order Free At-Home Tests<\/a><\/p>\n Need help placing an order for your at-\u2060home tests? If you need a COVID-\u206019 test now, are looking for another type of COVID-\u206019 test, or need more tests than covidtests.gov provides, the resources below are available.<\/p>\n<\/div>\n At-\u2060home tests are available for sale around the U.S. Check with local retailers and pharmacies to see where at-\u2060home tests are available.<\/p>\n<\/div>\n If you have health insurance through an employer or Marketplace, your insurance will pay you back for 8 at-\u2060home tests each month for each person on your plan.<\/p>\n Learn more about insurance reimbursement<\/a><\/p>\n<\/div>\n No-cost antigen and PCR COVID-\u206019 tests are available to everyone in the U.S., including the uninsured, at more than 20,000 sites nationwide.<\/p>\n Find resources in your state<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n The tests available for order:<\/p>\n Read more frequently asked questions<\/a><\/p>\n<\/div>\n<\/div>\n<\/section>\n Starting January 15, most people with a health plan can go online, or to a pharmacy or store to purchase an at-home over-the-counter COVID-19 diagnostic test authorized by the U.S. Food and Drug Administration (FDA) at no cost, either through reimbursement or free of charge through their insurance. This applies whether you purchased your health plan on your own or whether you get health insurance through your job.<\/p>\n The test will either be free directly at the point of sale, if your health plan provides for direct coverage, or by reimbursement if you are charged for your test. Be sure to keep your receipt if you need to submit a claim to your insurance company for reimbursement. If your plan has set up a network of preferred providers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers outside that network. Insurance companies are required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12).<\/p>\n The Biden-Harris Administration is strongly incentivizing health plans and insurers to set up a network of convenient locations across the country such as pharmacies or retailers where people with private health coverage will be able to order online or walk in and pick up at-home over-the-counter COVID-19 tests for free, rather than going through the process of having to submit claims for reimbursement.\u00a0 Consumers can find out from their plan or insurer if it provides direct coverage of over-the-counter COVID-19 tests through such a program or whether they will need to submit a claim for reimbursement. If you are charged for your test after January 15, keep your receipt and submit a claim to your insurance company for reimbursement.<\/p>\n If you purchase an over-the-counter COVID-19 test from a pharmacy, store, or online retailer and are charged for your test, keep your receipt and submit a claim to your insurance company for reimbursement. If your plan has not set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, you will be reimbursed the amount of the cost of the test.\u00a0For example, if you buy a two-pack of tests for $34, the plan or insurer would reimburse $34.<\/p>\n If your plan has set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers if you buy them outside of that network. Your plan is required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12).\u00a0 Save your receipt(s) to submit to your plan for reimbursement at a rate of at least $12 per individual test (or the cost of the test, if less than $12).<\/p>\n If a plan or insurer sets up a network of\u00a0convenient options such as pharmacies or retailers, including online retailers,\u00a0in which individuals on their plans can get their tests\u2019 cost covered up front (at the point of sale), then it is permitted to limit the per test reimbursement amount for retailers outside of that network. Specifically, if a plan or insurer establishes this type of direct coverage option, then the plan or insurer is permitted to limit the reimbursement for tests purchased outside of their network to $12 per test (or the actual price of the test, if less). Many commercially available at-home tests run about $12 or less per test.<\/p>\n If the plan or insurer does not set up a process through which individuals can obtain test with no upfront costs, then the plan and insurer must reimburse in the full cost of the test, even if the test costs more than $12. For example, if an individual buys a two-pack for $34, and the plan or insurer has not set up a system to cover costs upfront, then the plan or insurer would have to reimburse the $34 instead of $24.<\/p>\n Consumers can visit stores online or in-person. The Biden-Harris Administration is also strongly incentivizing health plans and insurers to set up a network of convenient options across the country like pharmacies or retailers, including online retailers, where people can get COVID-19 tests for free at the point of sale, rather than having to submit claims for reimbursement.\u00a0Consumers can find out from their plan or insurer if it is providing direct coverage of over-the-counter COVID-19 tests through such a network of preferred pharmacies or retailers.<\/p>\n Health plans and insurers are strongly incentivized to set up a network of convenient options across the country, such as pharmacies and retailers, where people will be able to order online or walk in and pick up\u00a0at-home over-the-counter\u00a0COVID-19 tests for free rather than going through the process of having to submit claims for reimbursement.\u00a0 Consumers can find out from their plan or insurer if it is providing direct coverage of over-the-counter COVID-19 tests through such a network of preferred pharmacies or retailers.<\/p>\n You can also access free testing in the community. A list of community-based testing sites can be found\u00a0here<\/a>.\u00a0COVID-19 tests are also available without cost-sharing to covered individuals when administered by a health care provider like a nurse, doctor, or pharmacist, without limitation.<\/p>\n The Biden-Harris Administration is purchasing 500 million over-the-counter at-home tests to be distributed for free to all Americans who want them, with the initial delivery starting in January 2022. There will be a website where Americans can request at-home tests for home delivery\u2014for free. More information on this federal program is expected soon.<\/p>\n People without insurance can also get free at-home test from some community health centers.<\/p>\n In addition, the U.S. Department of Health and Human Services (HHS) is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. The program is intended to ensure COVID-19 tests are made available to populations and settings in need of testing, especially populations at greatest risk from adverse outcomes related to COVID-19. As of December 21, 2021, all Health Resources and Services Administration (HRSA) -supported health centers (including look-alikes) and Medicare-certified rural health clinics are eligible to participate in the program after completing the on-boarding process. More information about this program is\u00a0here<\/a>.<\/p>\n HHS also has established more than 10,000 free community-based pharmacy testing sites around the country.\u00a0 To respond to the Omicron surge, the Department of Health and Human Services (HHS) and the Federal Emergency Management Agency (FEMA) are creating surge testing sites in states across the nation.<\/p>\n Additional information about testing resources for people without insurance are available here: https:\/\/www.hhs.gov\/coronavirus\/covid-19-care-uninsured-individuals\/index.html.<\/p>\n Plans and insurers are required to cover at-home over-the-counter COVID-19 tests purchased on or after January 15, 2022. Plans or issuers may, but are not required by federal law to, provide such coverage for at-home over-the-counter COVID-19 tests purchased before January 15. Contact your health plan to inquire about getting reimbursed for tests purchased before January 15, 2022.\u00a0 Some states may have existing requirements related to coverage of at-home over-the-counter COVID-19 tests.<\/p>\n Your plan is required to provide reimbursement for 8 tests per month for each individual on the plan, regardless of whether the tests are bought all at once or at separate times throughout the month.<\/p>\n If your plan has set up a network of\u00a0convenient options such as pharmacies and retailers,\u00a0in which individuals can get their tests\u2019 cost covered up front (at the point of sale) then the plan is permitted to limit the reimbursement for tests purchased outside of their network to $12 per test (or the actual price of the test, if less than $12). If more than one test is purchased or ordered at a time, such as a package with two tests in it, then the insurer would reimburse up to $12 for each of the tests purchased at that time.<\/p>\n If you are charged for your test, keep your receipt and submit a claim to your health plan for reimbursement. You can find out directly from\u00a0 your plan how to submit reimbursement claims. They are not allowed to design their reimbursement process in a way that unduly delays your reimbursement. You will not need a prescription or a note from your provider.<\/p>\n Health plans are encouraged to provide prompt reimbursement for claims for at-home tests, and consumers can find out directly from their plan how their claims process works and ask questions about reimbursement timing.<\/p>\n The Biden-Harris Administration is strongly incentivizing plans to offer at-home over-the-counter COVID-19 tests through preferred pharmacies, retailers and online and mail-order programs without up-front out-of-pocket costs to you. Consumers can find out from their plan if it is providing such direct coverage of over-the-counter COVID-19 tests. You will not need to seek reimbursement later for tests received through such a program.<\/p>\n Health plans must cover 8 individual at-home over-the-counter COVID-19 tests per person enrolled in the plan per month. That means a family of four can get 32 tests per month for free.<\/p>\n Note that tests may be packaged individually or with multiple tests in one package (for example, two tests packaged in one box). Plans are required to cover 8 tests per covered individual per month, regardless of how they are packaged and distributed.<\/p>\n There is generally no limit on the number of COVID-19 diagnostic tests, including at-home tests, that must be covered when ordered or administered by a health care provider.<\/p>\n Plans are not required to provide coverage of testing (including an at-home over-the-counter COVID-19 test) that is for employment purposes.<\/p>\n HHS is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. You can learn more about this program\u00a0here<\/a>. HHS also has established more than 10,000 free community-based pharmacy testing sites around the country.\u00a0 To respond to the Omicron surge, HHS and FEMA are creating surge testing sites in states across the nation.\u00a0 The Biden-Harris Administration is purchasing 500 million at-home, over-the-counter tests to be distributed for free to Americans who want them, with the initial delivery starting in January 2022. There will be a website where all Americans can request at-home tests for home delivery\u2014for free. More information on this federal program is expected soon.<\/p>\n For people covered by original fee-for-service Medicare, Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People with Medicare can access one lab performed test without cost sharing per patient per year without an order. At this time original Medicare cannot pay for at-home tests through this program. Medicare Advantage plans may offer coverage and payment for at-home over-the-counter COVID-19 tests, so consumers covered by Medicare Advantage should check with their plan.<\/p>\n In accordance with the American Rescue Plan, State Medicaid and CHIP programs are required to cover FDA-authorized at-home COVID-19 tests.\u00a0 People with Medicaid or CHIP coverage should contact their state Medicaid or CHIP agency for information regarding the specifics of coverage for at-home COVID-19 tests, as coverage rules may vary by state.<\/p>\n ###<\/p>\n Page Last Modified:<\/p>\n 01\/12\/2022 04:32 PM<\/p>\n\n
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