Medicare Prescription Drug Coverage
Medicare Secondary Payer Data Collection
If you currently carry one of the Wright State University Medical Insurance Plans, and you and/or your spouse have Medicare Insurance Coverage, as part of the Medicare Secondary Payer (MSP) provisions of the Social Security Act, commonly known as the “MSP Rules,” Anthem Blue Cross Blue Shield requires a Medicare Secondary Payer Employee Status Form to be completed by the employee. For your convenience, this form is available on the Healthcare web page. Please follow the instructions listed on the form.
Health Insurance Portability and Accountability Act of 1996 (HIPPA)
You have certain rights under the federal Health Insurance Portability and Accountability Act of 1996 (HIPPA) related to the confidentiality of your personal health information. Information about these rights, as well as information about how the health plan may use or disclose your medical information for treatment, payment for services, or business operations can be found in the Notice of Privacy Practices. If a use or disclosure is not outlined in the Notice of Privacy Practices, the health plan must obtain your permission before releasing this information. Copies of the notice can be found on the Healthcare web page.
Women's Health and Cancer Rights Act of 1998 (WHCRA)
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For an individual receiving mastectomy-related benefits, coverage will be provided in a manner determined by consultation with the attending physician and patient for:
- All stages of reconstruction of the breast on which the mastectomy was performed
- Surgery and reconstruction of the other breast to produce an asymmetrical appearance
- Treatment of physical complications of the mastectomy, including lymphedema in a manner determined in consultation with the attending physician and the patient
Notification of Grandfathered Status
Wright State University believes its HMO, PPO, HDHP and Traditional Plans to be “grandfathered health plan” under the Patient Protection and Affordable Care Act (the “Affordable Care Act”). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when the law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act. Questions regarding which protections apply and which protections do not apply to a grandfathered health plan, and what might cause a plan to change from a grandfathered health plan status can be directed to Benefits web page or by contacting firstname.lastname@example.org. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform.
You may also contact the U.S. Department of Health and Human Services at www.healthreform.gov.
Outside of the Open Enrollment period, you can make changes within 30 days of experiencing a qualifying life event, such as birth, marriage, divorce, loss in other healthcare coverage, etc.