University of Chicago

Medical Coverage for Retirees Under Age 65
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If you were employed before January 1, 2005, and are at least 55, but not yet 65, when you terminate employment, you are eligible to enroll in the Retiree Medical Plan. If you were employed on or after January 1, 2005, you must also complete 10 years of service to be eligible for the Retiree Medical Plan.

Once you reach age 65, you must enroll in Medicare Part A and Part B and send the Benefits Office a copy of your Medicare card in order for the Benefits Office to adjust your monthly premiums. You pay lower monthly premiums once Medicare becomes your primary coverage.

The University will contact BCBSIL and provide them with your Medicare information.

To find out how to enroll in Medicare and the Retiree Medical Plan, you may review:

• Retiree Medical Plan
• Enrolling in Medicare and the Retiree Medical Program

 Retiree Medical Plan

How It Works

This plan is administered by BlueCross BlueShield of Illinois (BCBSIL). You can visit the eligible licensed provider of your choice. You receive special advantages if you visit certain physicians. If you visit a BCBS PPO provider, your care is considered "in-network," and the plan will cover a higher percentage of your costs. If you do not visit a BCBS PPO provider, your care is considered to be "out-of-network," and the Retiree Medical Plan will pay less than if you saw an in-network provider.

Because BCBSIL negotiates significant discounts with providers who are part of its network, the prevailing fee schedule can be significantly lower as compared with what out-of-network providers may charge for some services. You should check with BCBSIL before receiving care from a provider who is not part of the Plan's network.

To see a list of BCBS providers online, click here.

In-Network Features

• Generally, after you meet the deductible, the plan covers 80% of the cost of covered services based on the prevailing fee schedule, and you pay the rest. The plan covers 100% after you reach the out-of-pocket limit.

Out-of-Network Features

• For 2006, there is an annual deductible of $200 per individual and a $200 per hospital admission.
• Generally, after you meet the deductible, the plan pays 65% of the covered charges based on the BCBS prevailing fee schedule until you reach the annual out-of-pocket limit.
• Certain limits apply, meaning you are responsible for any amount that exceeds the BCBS's prevailing fee schedule.
• You or your physician file claim forms to get reimbursed.

Other Features

• For 2006, there is an annual deductible of $200 per individual.
• For 2006, the out-of-pocket limit is $1,100 per family.
• The maximum cumulative amount the plan will cover per lifetime is $2,000,000.
• Prescription drugs are administered by Caremark. You pay a copayment at the time of purchase.
  • Copayments for a 30-day supply of prescription drugs purchased at a Caremark pharmacy are $8 for generic, $20 for preferred brand-name and $35 for non-preferred brand-name.
  • Copayments for a 90-day supply of prescription drugs purchased through Caremark's mail service are $16 for generic, $40 for preferred brand-name and $70 for non-preferred brand-name.
  • Preferred brand-name refers to prescription drugs that are on a list approved for use and coverage by the medical plan. Non-preferred brand-name are not on the approved list and, therefore, have higher copayments.
• Prescription drugs are not subject to the $200 deductible and do not count towards the $1,100 out-of-pocket limit.

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 Enrolling in the Retiree Medical Program

If you want to enroll in the Retiree Medical Plan, you should contact the Benefits Office at least two months before you retire, and schedule an appointment to see a Benefits Counselor. The counselor will help you complete the appropriate enrollment forms.

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