*** Retirees affected by the Aetna Medicare Advantage changes in 2019 ***
Directly from the NJSHBP website:
Effective January 1, 2019, the SHBP will no longer offer Medicare Advantage (MA) plans through Horizon’s NJ DIRECT10 (PPO) or NJ DIRECT15 (PPO) plans. Retirees previously enrolled in these plans will be automatically transferred to a corresponding Aetna Medicare Advantage PPO ESA plan. No application is necessary and no other action is required by retirees. Affected members will receive correspondence directly from the plans.
Spouse or Partner with Different Medicare Eligibility than the Member
Retirees enrolled in one of the NJ DIRECT MA plans who have a spouse or partner who is not Medicare-eligible will move to the Aetna MA plan while the spouse/partner and/or any covered children remain in the NJ DIRECT10 or 15 plan.
Similarly, retirees who are not eligible for Medicare but have a spouse or partner who is Medicare-eligible will remain in their NJ DIRECT10 or 15 plan (along with any covered children) while the spouse/partner is transferred to the Aetna MA plan.
These rules will also be in effect for members, spouses, or partners whose Medicare effective date is 1/1/19 or after. Non-Medicare-eligible retirees enrolled in NJ DIRECT 10 or 15 will be transferred automatically to an Aetna MA plan once enrolled in Medicare Parts A and B.
Aetna Medicare Advantage Plans
Medicare Advantage plans, sometimes referred to as “Part C” or “MA plans,” provide Medicare Part A (inpatient hospital insurance) and Medicare Part B (outpatient medical insurance) coverage.
The Aetna MA plans offer access to providers nationwide, with the same benefits in or out of network, and no referrals required.
SHBP Medicare-eligible retirees can enroll in the following Aetna Medicare Advantage plans: Aetna Medicare Advantage PPO ESA 10;* Aetna Medicare Advantage PPO ESA 15; Aetna Medicare Advantage HMO and Aetna Medicare Advantage HMO 1525.
Resources
- Aetna Medicare Advantage website
- Aetna MA Frequently Asked Questions
- SHBP Plan Design Chart copays, coinsurance, and more (for plan year 2018)
- SHBP Plan Design Chart copays, coinsurance, and more (for plan year 2019)
NJFMBA Survivor Information
NJ FMBA Survivor Information Bulletin
Health Benefits
State Health Benefits Program Information for Active Employees
State Health Benefits Program Information for Retirees
Paladina Health Direct Primary Care
Dental Plans — Active Employees
Family Status Changes — Employees
Family Status Changes — Retirees
Health Benefits Coverage Continuation for Overage Children with Disabilities
Health Benefits Coverage — Enrolling as a Retiree
Health Benefits Coverage for Part-Time Employees
Health Benefits Coverage for State Intermittent Employees
Health Benefits Coverage of Children until Age 31 under Chapter 375
Health Benefit Programs and Medicare Parts A and B for Retirees
Health Benefits Retired Coverage Under Chapter 330
Termination of Employment through Resignation, Dismissal, or Layoff
Retirement/Pension Information
New Jersey Division of Pension and Benefits Fact Sheets
PFRS Retirement Benefits by Membership Tier
Disability Retirement Benefits
Withdrawal From the Retirement System
Divorce, Dissolution of a Civil Union, and Your Retirement Benefits
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