Navigating Your State Health Plan Benefits and Medicare - NC
Navigating Your State Health Plan Benefits and Medicare
Understanding Your State Health Plan Benefits at Retirement 2019
Presentation Overview
? State Health Plan Options ? Understanding Medicare ? Enrollment ? Medicare Advantage & 70/30 ? Plan Comparisons ? Important Information:
? Disability ? Re-Employment ? Your Address
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State Health Plan Options
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State Health Plan Options for Non-Medicare Members
The State Health Plan offers 2 Preferred Provider Organization (PPO) plans for Non-Medicare members:
80/20 PPO Plan
Pays 80% for most in-network services.
70/30 PPO Plan
Pays 70% for most in-network services.
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State Health Plan Options for Non-Medicare Members
The Plan utilizes a third-party administrator or TPA that is responsible for the provider network and processing your medical claims. Our current TPA is Blue Cross and Blue Shield of NC. But
your medical claims are paid by the state, not Blue Cross.
The Plan also utilizes a pharmacy benefit manager or PBM that is responsible for providing a pharmacy network and processing your
pharmacy claims. Our current PBM is CVS Caremark. But your pharmacy claims are paid by the state, not CVS.
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