Medicare Part D

Guide to Medicare Part D

• Reimbursement of the 5% out of pocket expenditures in excess of the catastrophic level.

Medicare Part D
Catastrophic Reimbursement

Who is covered?

Retirees and their eligible spouse/domestic partner who have enrolled in, and purchased, a Medicare Part D Prescription Drug Program and have reached the annual 5% catastrophic coverage threshold are covered. Other dependents are not covered.

What is the benefit?

This benefit will reimburse the 5% out of pocket co-payments incurred in the catastrophic coverage portion of the Medicare Part D plan.

How are benefits obtained?

You must complete a Medicare Part D Reimbursement Claim Form and submit it to the Welfare Fund no later than February 1 in the year following the calendar year in which you incurred the 5% copayment charges, along with the letter and Explanation of Benefits (EOB) received from your Health Insurance carrier.

Note: If you have not reached the catastrophic threshold of your Medicare Part D plan, you do not qualify for the benefit and you should not file a claim form.

At the end of every year, the health plan that you are enrolled in for the Medicare Part D program will send you an Explanation of Benefits (EOB).

Where can I get the Reimbursement Claim Form?

You can obtain the form in any of the following ways:

• by calling the Welfare Fund's hotline, which operates 24 hours a day, seven days a week: 212-539-0539; or
• by calling the Welfare Fund during business hours at 212-539-0500; or
• by downloading the Medicare Part D Reimbursement Claim Form.