We’re sorry we didn’t build in enough time in the ACERA 2021 Virtual Health and Wellness Fair to answer all of your questions for our healthcare carriers. You all are a curious bunch with some excellent questions, and we won’t make that mistake again!
Below are the answers we’ve received so far from our carriers and have compiled.
Why can’t I use the Via Benefits HRA for dental?
The funds in your Via Benefits Health Reimbursement Account (HRA) are Monthly Medical Allowance funds that ACERA’s Board of Retirement has reserved as a subsidy to help pay for the cost of your medical plan through ACERA. The MMA can only be used for medical expenses. Separately, the Board of Retirement has also reserved funds to fully subsidize your monthly dental plan costs (if you’re eligible by having at least 10 years of ACERA service credit or a service-connected disability retirement). This means that if you’re eligible for the subsidy, you pay zero out-of-pocket for your dental plan premiums. The subsidy rules are set up to provide a robust subsidy while maintaining the sustainability of the reserve fund. ACERA provides a higher level of healthcare benefits to retirees than any county in California.
I have a college student enrolled as my dependent. If she gets a job with benefits, can I drop her during the year? I’m paying for her medical, dental, and vision now. We both have Kaiser Permanente.
Yes, if your dependent gets a job with benefits, you may drop them during the year from Medical, Dental, and/or Vision coverage.
What is the cheapest way to choose medical benefits, since it seems like a lot will come out of the small retirement check.
Consult your annual Retiree Enrollment Guide for the costs of each healthcare plan. There are charts in the guide that do the math for you and show you what your out-of-pocket expenses will be for the monthly plan premiums.
If you get another job with benefits, do you still have to pay for benefits through your retirement check?
No, if you get a job with benefits you may drop your medical coverage. If you have less than 10 years of ACERA service credit and are receiving a service retirement, you may drop the dental and vision coverage. However, if you have over 10 years of ACERA service credit, you may drop your dependents from dental and vision coverage, but you will remain on the dental and vision as 1-party. But there will be $0 out of pocket premium costs for you because ACERA subsidizes the premium costs for all retirees with 10+ years of ACERA service credit or a service-connected disability retirements.
What age can you get your Social Security check and receive your retirement check from your place of work?
The minimum age for collecting Social Security benefits is 62. Visit the Social Security website for more information on requirements to receive benefits.
See ACERA’s page on Verifying Your Retirement Eligibility for more information on the minimum requirements to start to receive pension benefits from ACERA.
Where do I find the current healthcare plans I’m enrolled in in my ACERA account?
Log into your ACERA account. Then click on Insurance Deduction in the menu.
My mother is in an Assisted Living Home and can not get to many appointments. Is there any program that travels to these locations that I can get her into?
For dental appointments, members can conduct virtual dental appointments through Delta Dental. Log in to your Delta Dental account to sign up.
For transportation to medical appointments, contact your insurance carrier’s customer service by calling the number on your medical ID card or by contacting your primary care physician. You may request that a case worker be assigned to assist you regarding the availability of shuttle transportation programs if that service is available through your insurance carrier or primary care physician. Otherwise, you can Google “medical transportation services” in your location for companies that provide this service.
What are the typical hearing aid benefits in MediGap programs?
Medigap plans don’t typically cover hearing aids. Via Benefits does offer a hearing aid benefit called iHEAR.
Is the Humana reimbursement process the same as Wellcare Part D?
The process to be reimbursed from the HRA is the same for each carrier, no difference. There are differences between requesting premium reimbursements automatically or recurring.
I live out of state in Las Vegas, NV. Will a Via Benefits certified Benefits Adviser assist me in deciding between a Medicare Advantage Plan or keeping my existing health care plan, i.e., help me compare between the two plans?
Absolutely, we are here to help, whatever state you live in. Contact Via Benefits at 1-888-427-8730 for help with Medicare plans and for help with non-Medicare plans, call 1-844-353-0770.
My husband is on COBRA. I want to compare his plan to Via Benefits plans. He won’t be on Medicare until July 31, 2022 next year. His COBRA ends July 17, 2022. Should I look now or wait until he does not have COBRA?
You cannot enroll into a Medicare plan until you are closer to your Medicare effective date, but you can certainly go online (my.viabenefits.com/acera) to shop and compare different plans.
Where do we get information on Medicare Parts C & D?
Medicare Part C is a federal program that allows you to receive your Part A and B Medicare benefits through a Medicare Advantage or other Medicare-approved insurance plans. Medicare Part D is your Prescription Drug plans. You can get more information on ACERA’s How Medicare Works page, or contact Via Benefits and they can help you review your prescription drug plan options.
When does the Silver&Fit program start?
February 1, 2022
Can I register for Silver&Fit ahead of time?
No. The plan is not available until February 1, 2022, and the file that contains the membership data will not be available until then, so there’s no way to register ahead of time.
How do I search for gyms participating in Silver&Fit?
- Go to SilverandFit.com.
- Register to use the site.
- Select a participating fitness center and choose a Home Fitness Kit.
- Print out your Silver&Fit card, take it to the fitness center, and start exercising.
Is Silver&Fit free?
Yes, for now; there’s no cost for the 2022 plan year. However, ACERA will review the utilization level during 2022 and determine if we will continue to offer the plan in 2023 and forward. If the Board of retirement decides to continue the program for 2023, there will be an estimated $2.65 per-member per-month increase in the premium for all Kaiser Permanente Senior Advantage Members. If this is a benefit you feel you want, please take advantage of the benefit early.
Can Orange Theory or other gyms be included in the Silver&Fit program if they’re not already on the list?
If there is a gym you are interested in and it is not already apart of the program you can petition Silver and fit to reach out to the gym and they will work with the gym to see if they are willing to participate.
Are dental benefits available for Kaiser Senior Advantage users?
Kaiser Permanente does not offer dental coverage, but ACERA members can enroll in dental coverage through Delta Dental. ACERA members who retired with 10 or more years of service credit or a service connected disability retirement have their full monthly dental premium covered by ACERA.
Where can I find the link for the Kaiser Permanente open office hours the first week of open enrollment? Is there a phone number I can call instead of using the link?
Review the open office hours flyer for the link to sign up.
I’m in the process of relocating to Southern California (or any of Kaiser Permanente’s service areas outside of Northern California. How do I sign up for a Kaiser Permanente plan and how do I find doctors?
ACERA’s group contract is only for the California region, if you are moving to Southern California, you will complete a group Kaiser Permanente Senior Advantage plan enrollment form and at the top of the form write “Inter Regional coverage.” This will allow for your Medicare to be used in both regions. Once you have enrolled in the Southern Ca region, go on KP.org and search doctors. Regarding the other regions, you will enroll in the Individual Senior Advantage plan in that region, and once you are enrolled, you will reach out to Via Benefits to access your Health Reimbursement Account if you’re eligible for ACERA’s Monthly Medical Allowance subsidy.
Is there any reason that I should not stay with my Kaiser Permanente Senior Advantage Plan?
Your group Senior Advantage plan provides you with complete coverage, very enhanced benefits including a free gym membership, and an optical hardware allowance. It may be to your advantage to maintain your the ACERA-sponsored group plan offering as the group plans are often richer than plans in the market place.
I use my husband’s KP medical insurance, not the ACERA’s / Alameda County’s. Can I join all those benefits that County retirees use?
Different employers and groups like ACERA negotiate different sets of benefits when contracting with Kaiser Permanente to provide a medical coverage plan. Your husband’s Kaiser plan may offer a different set of benefits that Kaiser Permanente’s group plan. The way to take advantage of the offerings from ACERA’s Kaiser Permanente plan is to enroll in it through ACERA.
Open enrollment is your annual opportunity to join the ACERA’s plans if this is something you are interested in doing. This is the perfect time to discuss with staff how to enroll in the plan through ACERA.
Does Kaiser have any plans to open facilities in the Redding, CA area?
Unfortunately, not at this time.
I am a Kaiser member and turn 65 in August. I want to enroll in Kaiser Permanente Senior Advantage. When do I enroll?
You will begin with enrolling in Medicare Part’s A & B 90 days before your 65th birthday. Once you have enrolled in your Medicare benefits, you should receive a group enrollment packet in the mail to enroll in the Kaiser Permanente Senior Advantage plan at that time. If you have not received your enrollment kit, please make sure to reach out to the ACERA team and they will make sure you receive your kit.
The Kaiser Permanente plan includes eye exams. Which plan between Kaiser and VSP would help me purchase my eye glasses and frames?
Both plans provide a frame ware allowance to purchase glasses and also provide eye exams, so you have the option to have two pairs glasses. The Kaiser plan the benefit is available for use every 24 months. Review the Retiree Enrollment Guide for a summary of VSP benefits.
Is chiropractic care covered under ACERA’s Kaiser plans?
ACERA’s plan does not include chiropractic care at this time however, Medicare in general offers a limited benefit (spinal manipulation) based on a referral from your primary care physician.
I have more than one VSP plan (3 in this case). Under the plans, I am eligible for glasses annually. Why is it that whenever I try to order a second pair, VSP will not pay for my frames, and my request is denied?
Contact VSP at 1-800-877- 7195 and they will go over in detail with you how each plan works and what you are entitled to under these 3 plans.
In the buy-up plan for lenses that are progressive and tinted, is it $25 for each feature, or one $25 for both together?
There is a $25 copay for premium or custom progressive lenses. There is a $0 copay for the tints.
Is Costco considered in or out of network for VSP?
Costco is in-network for ACERA. If you are ever in question if a retail chain is in-network, log in to your VSP account and search for in-network retail chains under your plan. Or you can call 1-800-877-7198 and they would be happy to help.
Under the buy-up plan, there is an allowance of $110 for frames. Will the additional discount of 20% be applied if the frame cost if higher than the allowance?
Under the Buy-up Plan there is a $110 frame allowance for Costco. For any out of pocket costs under this frame allowance or any frame allowance, you will receive a 20% discount.
Can I get use the VSP plan for glasses and frames above what Kaiser covers at the Kaiser eye glass clinic?
Yes, if you go to Kaiser eye glass clinic, you can use your VSP plan towards lenses and frames. Please be advised this will be considered an out-of-network claim, and you will receive the reimbursement allowance amounts listed under your plan, which are lower than if you choose to go to a in-network provider. After your visit, you may take your receipt and proceed with a Claim For Reimbursement for any amounts you are entitled to. It is recommended to call VSP at 1-800-877-7195 to see what you will be entitled to under reimbursement prior to going.
Will you accept an invoice from a foreign country for out-of-network reimbursement?
Yes, VSP will accept an itemized invoice from a foreign country for out-of-network reimbursement.
Where can I find the list of in-network frame and optician providers?
Login into your VSP account and do a search for in-network providers.
I have the buy-up plan this year, and I got my eyeglass in August 2021. If I switch to the base plan for next year, can I get my eyeglass in August 2022 or do I have to wait until August 2023?
Contact ACERA on whether the plans start anew, at the beginning of the year or if the plan is going to pick up where things left off.
Are there other glasses providers outside of retail chains?
Login into your VSP account and do a search for a full list of in-network providers.
Is TruHearing included in VSP? How do we add it?
Under your VSP benefit you are entitled to great savings discounts with TruHearing. When shopping with TruHearing, just mention you are a VSP member to receive your discount.
How do you sign up for the VSP buy-up plan?
During ACERA’s open enrollment period, follow the instructions starting on page 5 of your Retiree Enrollment Guide to change vision plans.
What is the cost of the VSP buy-up plan per month?
For ACERA members with at least 10 years of service credit, the self-only premium for the buy-up plan is $14.26 per month, with a $3.97 subsidy, resulting in a $10.29 monthly out-of-pocket cost. Compare this to the cost of the base plan, which is $3.97 with a $3.97 subsidy, resulting in a $0 monthly out-of-pocket cost. For more cost scenarios, visit www.acera.org/vision.
I’ve used Costco before, and I didn’t have to do anything for my prescription. I just needed to pay my co-pay, which is not covered. Do I need to do anything else, like submit a claim form?
Costco is a in-network provider under your benefit with ACERA, so you do not have to do a Claim for Reimbursement. Just visit a Costco store, and they can pull up your VSP benefit in their system for you to use right there.
How do I Iog on to the VSP website the first time? What is my username?
When you go to the VSP website for the first time to create an account, you will create your own username and password at that time. Initially you are asked to provide a member number or the last 4 digits of your social security number, first and last name, and date of birth.
Does the eyeconic web store provide reading glasses?
Yes, and you can use your benefit towards prescription reading glasses.
If I have a medigap plan, is my eye exam already paid by Medicare?
This question can be best answered by your Medicare provider.
Do I need to sign up for SmileWay during every open enrollment?
No. Your election will stay with you on the PPO plan as long as you are enrolled on the PPO plan. You do not have to re-enroll every open enrollment for SmileWay. Note: DeltaCare USA plan does not offer SmileWay Wellness Benefits.
Is there someone who can walk me through questions about dental coverage over the phone?
Yes. DeltaCare USA members can call 1-800-422-4234. Delta Dental PPO members can call 1-888-335-8227.
I noticed that orthodontia is not covered on page 18 of ACERA’s Retiree Enrollment Guide. Is this correct? I heard something different in the Health Fair presentation.
Orthodontia is not covered on the Delta Dental PPO plan. Orthodontia for adults and children is covered on the DeltaCare USA plan with a referral from your general practitioner.