As communicated in January 2014, the current Pfizer Retiree Medical plan options offered to Medicare-eligible retirees and their Medicare-eligible dependents are changing to Pfizer-sponsored Medicare Advantage plans in 2015. As part of this change, Pfizer has selected UnitedHealthcare® (UHC) as the insurance company who will provide and administer these Pfizer-sponsored plans.
Under the Pfizer-sponsored UnitedHealthcare® (UHC) Group Medicare Advantage plans, you will have broad access to doctors and providers – generally any doctor or provider who accepts Medicare – and will receive quality health care that is expected to lower your out-of-pocket costs. While rising health care costs will cause monthly contributions to increase in 2015 and in future years, we expect that the costs will generally be lower under the new Pfizer-sponsored Medicare Advantage plans than they otherwise would have been under the current Pfizer Retiree Medical plans.
In addition, the new Medicare Advantage plans will replace the benefits currently provided to you by your Medicare Part A and Part B coverage. As a result, all of your medical coverage will be provided under a single plan – one of the Pfizer-sponsored UHC Group Medicare Advantage plans. This means you will only need to provide a single medical ID card when you receive medical services, and you will no longer be subject to separate Medicare and Pfizer plan deductibles, helping to further reduce your out-of-pocket costs. Note that this change will not impact your prescription drug coverage through CVS Caremark.
In this letter, you will find:
An overview of the new Pfizer-sponsored UHC Group Medicare Advantage plans, including a summary of how the plans will work
A timeline of what to expect in the coming months, including when additional information about the new Medicare Advantage plans will be provided, and when meetings will be scheduled so that you can learn more about this change
As always, Pfizer is committed to keeping you informed about the new plans so you can make educated choices for yourselves and your families.
Overview of the New Pfizer-Sponsored UHC Group Medicare Advantage Plans
Medicare-eligible retirees and their covered Medicare-eligible dependents will have the choice between the Pfizer Medicare Advantage Base Plan and the Pfizer Medicare Advantage Buy-up Plan ï¿½ both of which will be provided by UHC. The Pfizer Medicare Advantage Base and the Pfizer Medicare Advantage Buy-up options are primarily copay-based plans. This means that you will only be responsible for paying a flat dollar copay when you receive most covered services. Following is a high-level summary of the key provisions of these new plans:
2015 Medical Coverage
Pfizer Medicare Advantage Base Plan
Pfizer Medicare Advantage Buy-up Plan
$100 per Individual
Annual Out-of-Pocket Maximum**
$3,400 per Individual
$2,400 per Individual
Office Visit (Specialist)
Lab / X-ray
$20 per procedure/test
$10 per procedure/test
PT/OT/Speech Therapy Visit
Hospital Inpatient Stay
$500 per admission
$350 per admission
Hospital Outpatient Stay
$350 per admission
$250 per admission
Emergency Room Visit
Urgent Care Visit
Durable Medical Equipment
You pay a 20% coinsurance
You pay a 20% coinsurance
* Deductible only applies to inpatient and outpatient services and the purchase or rental of durable medical equipment. Refer to additional plan details that will be sent in the fall for information about other covered services that may be subject to the deductible.
** Includes the deductible.
Prescription Drug Coverage
Prescription drug coverage will continue to be administered by CVS Caremark. While coverage for Pfizer brand and Greenstone generic drugs will continue at 100%, the per-prescription minimum and maximum copay will increase for 2015 (see details below). This coverage is part of both the Pfizer Medicare Advantage Base Plan and the Pfizer Medicare Advantage Buy up Plan. Alternatively, the Prescription Drug-Only option will also continue to be available.
2015 Prescription Drug Coverage
Pfizer Drugs (including Greenstone Generics): Covered at 100%
Non-Pfizer Drugs: You pay 20% with $10 minimum/$125 maximum copay* for a 30-day supply (Pfizer pays 80%)
Prescription Drug Out-of-Pocket Maximum
$3,500 per Individual / $5,500 per Family
* If the total cost of the prescription is less than the minimum copay, you continue to pay the lesser of the minimum copay and the cost of the prescription.
Vision benefits are not changing and will continue to be included as part of your retiree medical coverage and administered by EyeMed Vision Care. Note that vision coverage is not available under the Prescription Drug-Only Plan. Please see the FAQs for more information.
What to Expect over the Next Few Months
Watch for more information and events during the next few months, leading up to the Annual Enrollment period (Oct. 14 to Oct. 31, 2014), when you will need to make your election for 2015 medical coverage.
What to Watch For
A letter requesting information we may need from you to enroll you and/or your Medicare-eligible dependent in a Medicare Advantage plan (and instructions on how to provide the information):
Health Insurance Claim Number (HICN)
Street address (if you currently have a P.O. Box listed in the Fidelity recordkeeping system)
You will only receive this request if your HICN information is not already on file with Fidelity, the recordkeeper, or if your mailing address is listed as a P.O. Box.
An invitation to in-person meetings or teleconferences on the Medicare Advantage plans (note that you will only receive the invitation if you are age 64 or older or are otherwise eligible for Medicare)
Retiree enrollment package including the RetireePLUS Annual Enrollment Newsletter, the UHC Hello Simplicity Medicare Advantage Plan Guide (if you are age 64 or older or are otherwise eligible for Medicare), and other enrollment information
Informational meetings and teleconferences will be held with more details on the new Medicare Advantage plans
Week of Oct. 9, 2014
Personal Fact Sheets (PFS), which will reflect your coverage options and the associated 2015 monthly contribution
Oct. 14 ï¿½ 31, 2014
Annual Enrollment for 2015 health and insurance benefits (this year, in response to retiree feedback, we have extended the enrollment period to provide more time to make your election)
UHC Welcome Guide, new medical plan ID cards from UHC (please continue to use your current prescription drug ID Card from Caremark and your current vision ID card from EyeMed) and Confirmation of Enrollment letter
For more information about the transition to Pfizer-sponsored UHC Group Medicare Advantage plans for Medicare-eligible retirees and their Medicare-eligible dependents, refer to the January 2014 Medicare Advantage communication, which is available on www.pfizerplus.com.
For questions about the new Medicare Advantage plans, you can visit the UHC website at UHCRetiree.com/pfizer or call the UHC Pfizer-dedicated toll-free number at 1-866-868-0329, TTY 711 from 8:00 a.m. – 8:00 p.m. in your local U.S. time zone, 7 days a week. You may also call the Pfizer Benefits Center at 1-877-208-0950. Representatives are available Monday through Friday from 8:30 a.m. to midnight, Eastern time.
Note that information contained in the Plus Newsletter as well as the Pfizer Plus Website does not apply to the following retiree groups: Aetna International, AH Robins, American Optical, Warner Lambert ESP, Warner-Lambert Parke-Davis OCAW Union, Warner Lambert pre-1992 or Wyeth Change in Control.
If you are a legacy retiree that is part of one of these groups, please contact Pfizer Benefits Center at 1-877-208-0950 for questions about your Pfizer health coverage.