What are my coverage options?
The Episcopal Church Medical Trust offers these Medicare supplement plans: the Comprehensive Plan, the Plus Plan, and the Premium Plan. Each is available with and without prescription drug benefits.
What is a premium?
A premium is a payment for coverage made to Medicare, an insurance company, or a health care plan. The payment is generally made monthly. If authorized, payments to the Episcopal Church Medical Trust may be automatically deducted from benefit checks.
What is a deductible?
A deductible is the amount you must pay for health care before a plan begins to pay.
Why do I need to pay deductibles?
Deductibles are used so that individuals share the cost of health care.
What is a copayment?
A copayment is the fixed dollar amount you pay for each health care service (for example, a doctor's office visit copayment or a prescription copayment).
Why do I need to pay copayments?
Copayments are used so that individuals share the cost of health care.
What is included under home health care?
- Part-time skilled nursing facility care
- Physical, occupational, and speech therapy
- Services of a home health aide
- Durable medical equipment and medical supplies
What is my primary coverage when I am enrolled in one of the Medicare supplement plans?
Medicare is your primary coverage, and the Medicare supplement plan is your secondary coverage.
Are there networks of physicians or hospitals in the Medicare supplement plans?
No. You may use any doctor or hospital. However, you will save money if your doctors accept Medicare assignment. If a doctor or hospital does not accept assignment, you may be required to pay more, or all, of your expenses.
Are there pharmacy networks in the Medicare supplement plans?
Yes. For prescription drugs, you must use a network pharmacy. Visit Medco to locate participating pharmacies, or call Medco at (800) 841-3361.
If I move to another state or travel within the 50 states for an extended period of time, will I still be eligible to remain in a Medicare supplement plan?
Your coverage remains intact if you move to another state. You are covered when you travel within the 50 states and most United States territories.
What kind of coverage will I have in a foreign country?
Under most circumstances, Medicare does not cover health care services performed outside the United States. The Episcopal Church Medical Trust travel plan rider covers health care costs associated with medically necessary treatment for an accidental injury or acute illness you may incur while you or a covered dependent is traveling outside the United States.
What is a formulary?
A formulary is a list of commonly prescribed medications. The prescription drugs on the list are selected based on clinical effectiveness and opportunities to help contain your plan's costs. Formulary lists are subject to periodic review and modification by the health plan.
What is a brand-name drug?
The brand name is the product name under which a drug is advertised and sold. The brand name is protected by trademark.
What is a generic drug?
A generic drug is one that, by law, must have the same active ingredients as the brand-name drug it replaces. Generic drugs typically cost less than brand-name drugs. According to the FDA, generic drugs are just as safe and effective as brand-name drugs. The FDA regulates generic drugs to ensure that they meet rigid standards of quality.