Empire Medicare related coverage offers Medicare-eligible retirees protection from costly health care by filling the gaps in Medicare coverage.

While Medicare Parts A and B cover hospital and medical care, most benefits are subject to deductibles or coinsurance. This Medicare Supplement plan helps retirees with Medicare Part A and B avoid out-of-pocket costs by reimbursing the deductible and coinsurance amounts.

For example, if you are hospitalized because you need surgery, the plan's hospital coverage combined with Medicare Part A provides benefits for room, board, general nursing, and other hospital services. The plan's medical coverage, with Medicare Part B, provides benefits for physician services and supplies.

Prescription Drug Coverage - Optional Rider
Retiree must purchase the Optional Rider in order to receive the following prescription drug benefit.  For prescription drug costs between $0 and $2,400 retiree pays the following: 
Retail copays: $10 generic/$25 preferred brand/$50 non-preferred brand name and 25% copay for biologicals for 34 day supply. 
Mail order: $20 generic/$50 preferred brand/$100 non-preferred brand name for 90 day supply.  After prescription drug expenses reach $2,400, retiree will be responsible for a 50% coinsurance up to $3,850. 
After retiree reaches $3,850 in out-of-pocket prescription drug costs, retiree will pay either a $2.15 copay for a generic preferred brand drug that is a multi-source drug or $5.35 for all other drugs, or 5% copay per prescription (whichever is greater).

Cost
See rate page for pension deductions.
See the rate page

For More Information
For additional information about the program, please call (800) 767-8672 from 8:30 am - 5:00 pm, Monday through Friday.

Contact the plan at:
Empire BlueCross BlueShield
City of New York Dedicated Service Center
PO Box 1407
Church Street Station
New York, NY 10008-1407
Visit the Plan Web site

Updated to reflect changes to Prescription Drug Benefit effective January 1, 2007.