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Rockwood School District

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Medicare Advantage Plan

Plan Contact Information

Enrollment

Lynda Bott
Aetna Account Executive
314-506-1966

Krisinda Chadwell
Aetna Account Executive
314-348-7214

Claims

Call 1-800-533-0367.

When you call, please have your ID number from your Aetna card ready.

An individual becomes eligible for Medicare part A on the 1st of the month in which they turn 65. If the birthday occurs on the 1st of the month, he or she would be eligible for Medicare on the 1st day of the previous month.

Enrollment in Medicare Part B does not happen automatically. To elect Medicare Part B, please contact Social Security directly. If you are already 65, Medicare will begin to pay primary after you retire or your spouse (who is the primary account holder) retires. If you are eligible to be covered under Medicare Part B but have not elected Medicare part B, Cigna will automatically pay as secondary. Rockwood does not reduce the premium for those on Medicare Part B. If you purchase an individual Medicare supplement policy and continue your Cigna policy, Medicare will be primary.

Aetna High Plan and Aetna Low Plan

Once a retiree becomes eligible for Medicare, the Cigna medical plans pay secondary to Medicare Part B, so it is important the retiree enrolls in Part B. Because of this, the District partners with Aetna to provide alternative insurance options that closely mirror the plan design of the Rockwood plan at a much-reduced premium.

There are two Medicare Advantage plans to choose from, the High Plan and the Low Plan. Please see the Overview of Coverage and Premiums in the retiree benefit guide for more information or contact Aetna for a summary plan document.

To enroll in one of the Aetna Advantage Plans for RSD Retirees, you will need to enroll in Medicare A and B. This plan includes Part D coverage so you cannot enroll in a separate Part D plan. You will waive your Cigna coverage. For this reason, you will need to contact our local Aetna Account Executive, Lynda Bott, to enroll in the Advantage plan and contact the RSD Benefits office at benefits@rsdmo.org to waive your Cigna coverage. You can start this process up to 3 months prior to your 65th birthday.

Retirees should contact RSD Benefits at least one month prior to their birthdate with the notification that they are starting a Medicare plan as of the first of the month of their birthday.

Plan Options

2023 Plan Name High Plan (Aetna Medicare HMO CVTY) Low Plan (Aetna Medicare PPO CVTY)
Plan Monthly Cost $247.53 Per Month** $14 Per Month**
Deductible $0 $500
Out of Pocket Max $3,000 $3,400
Inpatient Hospital $150/Day (1-5) $200/Day (1-5)
Skilled Nursing Facility $0/Day (1-20); $40/Day (21-60); $0/Day (61-100) $20/Day (1-20); $178/Day (21-100)
Outpatient Services/Surgery $200 visit $150 visit
PCP/Specialist Visits $15/$25 Copay $20/$30 Copay
Diagnostic Radiology 20% $120
Ambulance $100 $120
Telehealth/Telemedicine $15/25 $20/30
Lab $0 $0
X-Ray $0 $0
Urgent Care $25 $50
ER $25 $120
Emergency Services Covered whether in or out of network Covered whether in or out of network

Other Items

2023 Plan Name High Plan (Aetna Medicare HMO CVTY) Low Plan (Aetna Medicare PPO CVTY)
ResourcesRX (standard) $10/$35/$55/25% $10/$35/$55/25%
Retail 90-Day Supply 2x Copay Tier 1,2,3 (Tier 4 N/A) 2x Copay Tier 1,2,3 (Tier 4 N/A)
Gap (Donut Hole-you will continue to pay the same amount for covered drugs throughout the Coverage GAP)
 
$4,660-$7,400 $4,660-$7,400
Gap Coverage Full Coverage (pay Rx copay only) Full Coverage (pay Rx copay only)
Vision Eyewear reimbursement $100 every 12 months $265 every 12 months
Hearing aid reimbursement $500 every 12 months $2,500 every 12 months
Teladoc $0 $0
Resourses for Living $0 cost to member EAP (Employee Assistance Program) $0 cost to member EAP (Employee Assistance Program)
Silver Sneakers Free Fitness Program Free Fitness Program
Meals NA Covered up to 14 meals following an inpatient stay
Wigs NA $0
Compression Stockings NA $0
Dental Value-EPO $750 max benefit each year, $0 deductible/0% coinsurance Premier-EPO $1,000 max benefit each year, $0 deductible/0% coinsurance, $25 deductible, 50% coinsurance
Annual 2023 Cost $2,970.36 $168