The following information about the DuPont benefit plans has been prepared to answer questions about plan provisions and pricing and is not intended to be a complete summary of the Plans. To the greatest extent possible, non-technical language has been used to explain some of the Plans' provisions. While DuPont intends to continue the benefits and/or policies described in this communication, the Company reserves the right to change, modify or discontinue these plans or policies at its discretion at any time. In the event of a discrepancy between this communication and the Plan document, the Plan document will govern.
Official Medicare Publication "Frequently Asked Questions About Retiree Prescription Drug Coverage & The New Medicare Prescriptions Drug Coverage (10/05/2005)
DuPont Frequently Asked Questions - Medicare and DuPont Retiree Prescription Drug Coverage (10/10/2005)
General (10/10/2005)
1. Will DuPont still offer retiree prescription drug coverage in 2006?
(10/10/2005)
Yes. Medicare-eligible retirees will have a choice of taking Medical Plus Prescription or Medical Only coverage. As announced in January 2004, the DuPont medical plan will offer medical and prescription drug coverage on a secondary basis to Medicare. Please refer to the October and November 2005 retiree benefit communications (mailed to retirees’ homes and available on the DuPont retiree website at www.retiree.dupont.com) for further details.
2. Will the DuPont prescription stop loss protection still apply if I elect Medical Plus Prescription coverage? (10/10/2005)
Yes. For 2006, the DuPont prescription drug benefit individual stop loss (out of pocket maximum) is $1,500, including the $250 deductible. The individual stop loss applies to each covered person. Once you reach the individual stop loss, the Plan pays 100% of the discounted price of your covered medications for the remainder of the year.
3. Why am I receiving prescription benefit offers from other companies?
(10/10/2005)
Medicare Part D is marketed and administered by several different companies in each state. It differs from traditional Medicare Parts A and B which are centrally designed and administered by Medicare. Since Medicare is encouraging local plans to compete for enrollees, you will receive marketing materials from several different plans in your area. Note that if you wish to continue your DuPont prescription drug coverage, you cannot enroll in one of the public Medicare Part D plans.
4. Is the DuPont prescription drug plan my best coverage option?
(10/10/2005)
Only you can decide which Medicare Part D plan best meets your needs. Compare the DuPont prescription drug coverage, premium, and out-of-pocket costs (including stop loss protection) with those of the other public Medicare Part D plans in your area to decide which plan is best for you.
5. Why would I choose a public Medicare Part D plan instead of DuPont prescription drug coverage? (10/10/2005)
Some retirees may prefer the coverage, premium, and out-of-pocket costs of a public Medicare Part D plan. Public Part D plans will be available for a lower premium, but they may have different coverage and benefits than the DuPont plan. Each individual must select the plan that is best for him/her.
6. What are the 2006 premiums for the DuPont Medical Plus Prescription coverage? (10/10/2005)
Premium information will be communicated to retirees in a November home mailing. You will have the premium information before you can begin signing up for any Medicare Part D plan. (Public Medicare Part D plans may enroll new members between November 15, 2005 and May 15, 2006.)
7. Why is DuPont adding a $250 deductible to the prescription drug coverage? (10/10/2005)
The standard Medicare Part D benefit, designed by Medicare, includes a $250 deductible. DuPont added the $250 deductible to the prescription drug coverage to align with the Medicare Part D design.
8. I called Medco to ask about the DuPont prescription drug coverage and they called it an “enhanced PDP”. What does that mean? (10/10/2005)
The term “enhanced PDP” (where PDP stands for Prescription Drug Plan) is an industry term for a Medicare Part D plan that provides a benefit exceeding the standard Medicare requirement. For the DuPont prescription program, our plan combines Medicare Part D coverage with secondary coverage from DuPont.
9. Who can I go for more information regarding the new Medicare prescription drug program? (10/10/2005)
- For questions about financial assistance, drug plans offered in your area, and Medicare eligibility, contact Medicare at 1-800-MEDICARE
(1-800-633-4227), www.medicare.gov
- For questions about formularies, covered medications, prescription costs, deductibles, coinsurance, and stop-loss, contact Medco at
1-800-572-8695, http://www.medcohealth.com/
- After November 15th, for questions about the enrollment process, deductions and premiums, contact DuPont Connection at
1-800-775-5955
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Medical Plan Choices (10/10/2005)
10. Why doesn’t DuPont offer a prescription only option, without medical coverage? (10/10/2005)
One of the principles of DuPont health care is to provide secondary, catastrophic financial coverage to retirees. Prescription drug costs do not tend to be catastrophic in nature; therefore, DuPont does not provide prescription-only coverage. Retirees who desire only prescription drug coverage have a choice of competitive plans available from private companies.
11. Will retirees have to re-enroll every year? (10/10/2005)
No. Medicare-eligible retirees will have flexibility to reduce their medical coverage at any time throughout the year. Note that beginning in 2007, retirees will not be allowed to switch back from Medical-Only to Medical Plus Prescription coverage. Also, a decision to elect No Coverage from DuPont is permanent and irrevocable*, meaning you cannot re-enter the plan once you leave it.
*Exception: If you decline medical coverage while participating in another company’s group plan (such as another active employee medical plan) you may re-enroll in DuPont retiree medical and prescription coverage upon losing eligibility for the other group plan.
12. How do I make my medical plan election? (10/10/2005)
Refer to the checklist on page 4 of the October home mailing titled “Important Benefit Information Regarding Your DuPont Medical Coverage.” First, gather information about the drugs you take. Second, review the various Medicare Part D plans available in your area. Third, compare the public Medicare Part D plans with the DuPont prescription drug program. Finally, choose the plan that works best for you and your family. If you want to keep Medical Plus Prescription, do nothing - you will automatically be enrolled. If you want to switch to Medical Only or No Coverage, call DuPont Connection at
1-800-775-5955 between November 15, 2005 and December 31, 2005 for your change to be effective on January 1, 2006.
13. If I elect the Medical Only option for 2006 and enroll in a public Medicare Part D plan, can I opt back into the Medical Plus Prescription option in future years? (10/10/2005)
For 2006 only, DuPont will relax the rules that normally pertain to declining coverage and will allow retirees who elected Medical Only the opportunity to re-enroll in Medical Plus Prescription prior to December 29, 2006. After that date, your decision to accept Medical Only coverage will be considered permanent and irrevocable. (Exception: If you declined coverage due to the fact that you were covered by another company’s group plan, such as your spouse’s active employee coverage, and later lose eligibility in the other plan, you will be permitted to re-enroll in DuPont coverage.)
14. What coverage will I have if, as a retiree, I am not eligible for Medicare coverage but my spouse or dependent are eligible for Medicare benefits? (10/10/2005)
If you are a pre-Medicare retiree participating in the DuPont medical plan, your coverage includes both medical and prescription drug coverage. The Medical Only (without prescription) option is only available to Medicare-eligible retirees, for whom the federal government provides primary prescription drug coverage. Your premium from DuPont will reflect the fact that your spouse has primary coverage through Medicare. Note that, in order to be covered as your dependent, your spouse cannot enroll in a public Medicare prescription drug plan. He/she will be automatically enrolled in the DuPont Medicare Part D plan.
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Public Medicare Part D Plans (10/10/2005)
15. Where can I get information on all of the public Medicare Part D plans available in my area? (10/10/2005)
Medicare can provide you with information on the public Medicare Part D plans in your state. Their Internet site, www.medicare.gov, contains comparison tools and information. If you prefer, you may call Medicare at
1-800-MEDICARE. Once you have compared the public Part D plans, consider whether you wish to enroll in a public Part D plan or continue your DuPont prescription drug benefits.
Further information regarding the medical plan options will be mailed to you in early November. Please do not call DuPont Connection to make your choices until after November 15th.
16. Can I enroll in both DuPont Medical Plus Prescription and another Medicare Part D plan? (10/10/2005)
No. Medicare does not allow you to be enrolled in two Medicare Part D plans at the same time.
If you, the DuPont retiree, enroll in a Medicare Part D plan offered in your area, you and your covered dependents will be switched to the DuPont Medical Only coverage option. You should call DuPont Connection as soon as you enroll in another Medicare Part D plan to request the change from Medical Plus Prescription to Medical Only so that your premiums and coverage can be changed the first of the following month.
If you are enrolled in the Medical Plus Prescription option and your covered dependent enrolls in a public Medicare Part D plan, he/she will be dropped from DuPont medical and prescription coverage*. You will continue to have Medical Plus Prescription coverage for yourself and your other covered dependents.
*Once dropped from DuPont coverage, your dependent cannot be added back onto your DuPont coverage unless he/she loses eligibility for coverage under another company’s group plan. A decision to voluntarily end coverage in another Medicare plan or a loss of coverage due to non-payment of premiums is not considered a loss of eligibility. Please contact DuPont Connection for details regarding declination rules.
17. If I enroll in another Medicare Part D plan, do I need to notify DuPont Connection?(10/10/2005)
Yes. Call DuPont Connection at 1-800-775-5955 and inform them that you wish to switch to Medical Only coverage. If you call before January 1, 2006, your DuPont coverage and premiums will be changed to reflect Medical Only coverage effective January 1, 2006. Otherwise, your premiums will be adjusted the first of the month following your call. It is important that you call to inform DuPont Connection of the change as soon as you enroll in another Medicare Part D Plan. You must not use your DuPont prescription drug card once your other Medicare Part D Plan becomes effective.
18. If I elect the Medical Only option and enroll in a public Medicare Part D plan, will DuPont contribute toward the premium I need to pay for the public Part D plan? (10/10/2005)
No. DuPont only contributes toward the DuPont benefit.
19. What happens if my Medicare-eligible spouse enrolls in a public Medicare Part D plan when I have Medical Plus Prescription with DuPont? (10/10/2005)
If your spouse enrolls in another Medicare Part D plan, your spouse will be dropped from your DuPont medical and prescription coverage*. You will continue to have Medical Plus Prescription coverage for yourself and any of your other covered dependents. Medicare does not permit individuals to be enrolled in two Part D plans simultaneously and considers the most recent enrollment to be the only valid one; that’s why your spouse will be dropped from DuPont coverage (medical and prescription). *Once dropped from DuPont coverage, your dependent cannot be added back onto your DuPont coverage unless he/she loses eligibility for coverage under another company’s group plan. A decision to voluntarily end coverage in another Medicare plan or a loss of coverage due to non-payment of premiums is not considered a loss of eligibility. Please contact DuPont Connection for details regarding declination rules.
20. If I enroll in a public Medicare Part D plan (and take Medical Only coverage through DuPont) will Medco transfer my mail order prescription to my new carrier? (10/10/2005)
Yes. As long as refills remain, you may call Medco Member Services to request that your prescription be transferred to another pharmacy. One of Medco's pharmacists will work with the pharmacist at the retail pharmacy (or another PBM) to transfer your prescription.
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Public Medicare Advantage Plans (10/10/2005)
21. I am enrolling in a public Medicare Advantage plan that includes Medicare Part D prescription drug coverage. If I elect to receive No Coverage from DuPont, and later change my mind, can I get back in to the DuPont medical plan? (10/10/2005)
No. A decision to completely decline DuPont medical coverage is permanent and irrevocable.
22. If I enroll in a public Medicare Advantage plan that does not provide prescription drug coverage, can I stay in the Medical Plus Prescription option? (10/10/2005)
Yes. Note, however, that your Medicare Advantage benefit will be primary to your DuPont medical coverage, just as Medicare Parts A and B are primary to DuPont medical coverage. For prescriptions, you would use the DuPont YOURx prescription card.
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Formulary – The List of Preferred Drugs (10/10/2005)
23. Does the DuPont prescription drug plan use a formulary? (10/10/2005)
Yes. DuPont uses a Medco formulary, which is a listing preferred drugs, but the DuPont plan does not require that you use a formulary medication. The same benefit applies whether you use a formulary or non-formulary medication.
24. Who determines what drugs are on the formulary? (10/10/2005)
Medco has a Pharmacy and Therapeutics Committee that reviews various drugs and identifies which drugs are “preferred” based on quality, effectiveness, and cost.
Prescriptions Filled Outside the U.S. and its territories for Medicare-Eligible Participants
25. I currently live outside the U.S. Will the prescriptions I fill overseas be covered? (10/10/2005)
No. The DuPont retiree medical plan provides prescription drug coverage that integrates Medicare Part D coverage with secondary DuPont prescription coverage in a single plan. Medicare Part D does not provide coverage outside to individuals living outside of the U.S. and its territories; therefore, DuPont cannot provide prescription coverage since our plan includes a Medicare Part D component.
26. I live in the U.S. and frequently travel to other countries. If I need an urgent medication while traveling overseas, will it be covered? Will the plan cover a maintenance medication purchased outside the U.S. if I runout? (10/10/2005)
If you are traveling and become ill, your short-term urgent medication will be covered. In this situation, you will have to pay the full cost (rather than paying just your coinsurance) when you fill your prescription. You can file a claim with Medco. You will be responsible for paying the difference between what the Plan would pay for a prescription filled at an in-network pharmacy and what the out-of-network pharmacy charged for your prescription.
Maintenance* and non-urgent medications filled outside the U.S. and its territories will not be covered. If you take a prescription drug on a regular basis and you are going on a trip, be sure to check your supply of the drug before you leave. When possible, take along all the medication you will need. You may be able to order your prescription drugs ahead of time through the mail-order service.
*Consider calling Medco before you depart on your trip and request an early refill to accommodate your travel plans.
27. I purchase some of my medications through the mail from Canada. Are these medications covered? (10/10/2005)
No. At the present time, purchasing drugs from another country by mail is illegal.
DuPont Frequently Asked Questions - Medicare and DuPont Retiree Prescription Drug Coverage (05/19/2005)
