2021 Retiree Benefits
Retired Employee Medicare Plans
Advantage Plans
AvMed Medicare Access HMO-POS (Miami-Dade and Broward) New Plan
- No referral to see specialists
- Initial Coverage Limit – $4,500
- Primary Care Physician required
- Primary Care Physician co-pay $0
- Specialist Office visit no referral needed – $10
- Rx Tier 1 and 2 – $0 co-pay; Tier 3 and 4 set co-pay; Tier 5 co-insurance
- Rx mail away available
- Transportation allowance – up to 8 one-way trips
- $10,000 Point-of-Service Benefit for out-of-network care
AvMed Medicare Choice HMO (Miami-Dade and Broward)
- Increase in the Initial Coverage Limit – $4,500
- Increase in Hearing Aid allowance – $1,200
- Increase in Healthyperks Rewards – up to $125 for healthy behaviors
AvMed Medicare Circle HMO (Miami-Dade and Broward)
- Decrease in Maximum Out-of-Pocket – $2,500
- Increase in the Initial Coverage Limit – $6,000
- Increase in Hearing Aid allowance – $1,500
- Increase in Eyewear allowance – $350 (Miami-Dade); $350 (Broward)
- Increase in Transportation allowance – unlimited trips
- Increase in Healthyperks Rewards – up to $125 for healthy behaviors
- Over the Counter allowance – $50 monthly
AvMed Medicare Premium Saver HMO (Broward) New Plan
- Primary Care Physician required
- Primary Care Physician co-pay $0
- Specialist Office visit referral needed – $25
- Rx Tier 1 and 2 – $0 co-pay; Tier 3 and 4 set co-pay; Tier 5 co-insurance
- Rx mail away available
- Part B Premium Reimbursement up to $100 per month
Leon Medicares (Miami-Dade)
- Decreased Maximum Out of Pocket amount to $1,000
- Increase in Tier 3 90-supply drug copay at preferred pharmacies
- New virtual doctor visits (telehealth) added at $0 copay
- New Acupuncture benefit added with $0 copay
- New home delivered Meal benefit for members with End Stage Renal Disease
Humana Zero Premium HMO
(contact Humana directly for a list of participating Counties)
- Addition of Medicare-covered Acupuncture
- Increase in the Initial Coverage Limit
- Increase in Catastrophic Coverage Limit
- Includes Extra Benefits such as SilverSneakers and Go365 rewards program
Humana Passive PPO
- Decrease in Premium
- Addition of Routine Chiropractic Coverage
- Addition of Routine Podiatry Coverage
- Addition of Routine Hearing Coverage & Hearing Aid Allowance
- Addition of Routine Vision Coverage & Vision Allowance
- Addition of Wig Coverage
- Addition of Medicare-covered Acupuncture
- Decrease in Outpatient Hospital Diagnostic co-pay
- Decrease in Coverage Gap co-insurances
- Increase in Initial Coverage Limit – $4,130
- Increase in Part D True Out-of-Pocket (TROOP)
- Increase in coverage for In-Network Virtual Visits
- Increase in Catastrophic Coverage co-pays
- Increase in Urgent Care co-pay
Humana National Traditional PPO
· Decrease in Premium
UnitedHealthcare (UHC) Differential PPO
- Increase in Initial Coverage Limit
- Increase in Catastrophic Coverage limit
UnitedHealthcare (UHC) Passive PPO
- Increase in Initial Coverage Limit
- Increase in Catastrophic Coverage limit
UNITEDHEALTHCARE (UHC) MEDICARE SUPPLEMENT PLANS (DOES NOT INCLUDE MEDICARE PART D):
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Both plan design and premiums are pending approval by the Centers for Medicare and Medicaid Services (CMS)
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Freedom of choosing physicians of your choice
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Plan F will only continue to be offered to anyone who became a Medicare recipient prior to 1/1/2020
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Rates are based on the applicant’s date of birth, place of residence and tobacco usage
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Supplements Medicare coverage
NOTE: Pre-65 Medicare recipients are not eligible for the Supplement plans.
UNITEDHEALTHCARE (UHC) PHARMACY PLANS (MEDICARE PART D ONLY):
UHC continues to offer Prescription Drug Plans (PDP). Participants currently enrolled in a PDP only may enroll in any of the School Board sponsored Medicare Group Healthcare plans. The following PDP plans are being offered for the 2021 plan year:
- UHC 4-Tier low option tier 1 gap only coverage
- UHC 4-Tier high option full gap coverage
- UHC 5-Tier Formulary Standard Coverage in Gap
You must contact the Medicare healthcare company directly for assistance with your enrollment. Proof of Medicare enrollment in both parts A & B must be provided at the time of enrollment.
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AvMed Medicare Access HMO-POS (Miami-Dade County Only; Broward County Only) AvMed Medicare Choice HMO: AvMed Medicare Circle HMO: AvMed Medicare Premium Saver (Broward County Only) |
Enrollment Telephone Number: 1-800-835-6137 (TTY 711) Post enrollment for Member Engagement Center: 1-800-782-8633 (TTY 711) |
| Leon Medicare Advantage Plan | 1-866-266-8917 (TTY 711); 8 am – 8 pm, 7 days a week |
| Humana Zero Premium HMO (Miami-Dade, Broward and Palm Beach Counties), Humana Passive PPO and Humana Traditional PPO |
Enrollment Telephone number: 1-800-824-8242 Mon – Fri, 8 am – 8 pm EST (TTY 711) Post enrollment: 1-866-396-8810 Mon – Fri, 8 am – 9 pm EST (TTY 711) |
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UnitedHealthcare (UHC): Medicare Advantage Plans Medicare Supplement Plans Prescription Drug Plans (PDP) |
Enrollment Call Center: 1-877-870-7923 Customer Service: Medicare Advantage and PDP: 1-888-867-5548 Medicare Supplement: 1-800-523-5800 8 am – 8 pm (EST), 7 days a week |
Enrollment
Your Benefits
FAQ's
Rates
Office of Risk and Benefits Management
1501 N.E. 2nd Avenue, Suite 335
Miami, Florida 33132
Mon - Fri, 8 a.m. to 4:30 p.m. ET
www.dadeschools.net
305-995-7129
FBMC Service Center
Mon - Fri, 7 a.m. to 7 p.m. ET
1-855-MDC-PS4U (1-855-632-7748)