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Please keep in mind that you will need to satisfy 2012 deductibles and out of pocket amounts. Also, if you are enrolling in the Pfizer medical plan for the first time, you now have vision coverage and should have received a UHC Visioncare ID card. Please be sure you are using your new medical, prescription drug and vision care ID cards each time you visit your doctor or have a prescription filled. In most cases, use of your 2011 ID card, or not presenting an ID card at all because you are using the same pharmacy or doctor will result a benefit problem. If you received new ID cards please discard your old ones. If based on the communication materials you received from Pfizer in October you feel you should have received new ID cards but did not, please contact hrSource at 1-866-4SOURCE (1-866-476-8723). Last, for many retirees the 2012 medical plan is new. hrSource is available Monday – Friday from 8:30 a.m. to Midnight, Eastern time to assist you with any questions you may have regarding your new plans or invoicing. |
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Lipitor will continue to be included on the Pfizer 100% drug listing. It is important however that your provider indicate "no generic substitutions" or "brand only" on your prescription. Many pharmacies automatically substitute a generic drug when filling prescriptions without these indications. Prescriptions filled for generic versions of Lipitor will be subject to your plan's co-insurance provisions. |
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You will receive new ID cards if you are a legacy-Pfizer retiree and you changed your medical option or option administrator for 2012 or if you are a legacy-Wyeth retiree. Please remember to continue to use your current ID card for services received through December 31, 2011. You can then begin using your new ID card on January 1, 2012. |
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High cholesterol is one of the prime risk factors for heart attacks, heart disease and stroke. That's why it's important to know your cholesterol levels — through a routine physical with a simple blood test. High cholesterol can be lowered and controlled by diet and physical activity, and if necessary medication.. Schedule an appointment with your doctor to get tested and to discuss a health routine that's right for you. Remember, your annual physical is covered at 100 percent under the Pfizer Medical Plan.
To learn more about cholesterol, visit www.nhlbi.nih.gov. |
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Yes, flu and pneumonia immunizations is covered at 100 percent. |
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The enrollment period for 2012 health care benefits is October 13 – 28, 2011. Look for more information in the late September issue of PLUS in print. |
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You may qualify for lower medical and prescription drug contributions if you are single and your income for 2010 was less than $16,335 or if you are married and your combined income was less than $22,065. These income thresholds are updated each calendar year.
You may apply from now through August 15, 2011, if your income for 2010 was lower than the thresholds described above. You may obt ain an application at www.hrSourcebenefits.pfizer.com and click on Reference Library located in the Health & Insurance tab. Or, you may contact hrSource at 1-866-4 SOURCE (1-866-476-8723) and follow the prompts for Medical, Dental, Life Insurance and Billing, Monday through Friday between 8:30 a.m. and midnight Eastern time to speak with a hrSource Benefits Specialist.
For more information, click here.
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Congratulations on your upcoming birthday! Now that you are approaching age 65 and will be eligible for Medicare, it's time to review your medical coverage while taking steps to enjoy the best health possible.
- Contact the Social Security Administration four to five months before reaching age 65 to learn more about Medicare. To receive the maximum benefits available, you must enroll in Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) as soon as you are eligible. You may visit www.ssa.gov or call the Social Security Administration at 1-800-772-1213 from 7:00 a.m. to 7:00 p.m. Eastern time, Monday through Friday. Whether or not you actually enroll, as soon as you are eligible, the Pfizer Retiree Medical Plan assumes you have received the Medicare benefits available for any health care treatment and will begin to reduce its benefits by the amount Medicare paid or could have paid for the same expense.
- If you are presently enrolled for medical benefits through Pfizer, you will receive a Personal Fact Sheet in the mail about 30 days before your 65th birthday. Follow the instructions to make a new election into a Pfizer retiree medical plan option that coordinates with Medicare by the first of the month in which you turn 65. If no election is made, you will be defaulted into the Medicare Carve Out option under the Pfizer Retiree Medical Plan. See "How the Plan Integrates with Medicare" for more information about your options.
Be aware that if you elect to participate in a Medicare Part D program, you cannot submit your prescription drug claims for additional consideration through the Pfizer healthcare plans. Your new plan election will result in a change to your monthly contribution requirement. Based on the timing of your election, this change may not occur during the month of your birthday. If this is the case, an adjustment will be made to the following month's invoice.
Also, remember to take advantage of preventive services now eligible for coverage at 100% when billed with a routine screening/preventive care diagnosis. This includes routine lab and diagnostic radiology testing, bone density testing and tests to support cardiovascular health just to name a few. Please contact United Healthcare directly to learn more about these services.
If you are not presently enrolled for medical benefits through Pfizer and would like to enroll in a Pfizer retiree medical plan option that coordinates with Medicare, you may do so by contacting hrSource and providing proof of continuous coverage for the period your coverage was not through Pfizer.
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If you would like your monthly contributions to be automatically deducted from your personal bank account, rather than writing a check each month, you may sign up for Fidelity's Automatic Bank Withdrawal Service. If you currently have this service with Ceridian or SHPS, you must set up Automatic Bank Withdrawal with Fidelity by Friday, April 29, 2011, for automatic deductions to continue without interruption when Fidelity begins administering the billing process in June. You will need to provide your account type (e.g., checking or savings account), bank name, account number and bank routing number. To sign up, either 1) Go to NetBenefits at www.hrSourcebenefits.pfizer.com > click Health & Insurance tab > select Payment Method and then Update > change your payment method to ABW for Automatic Bank Withdrawal, or 2) Contact hrSource at 1-866-4 SOURCE (1-866-476-8723). Note that if you are a Pharmacia retiree presently enrolled for Automatic Bank Withdrawal service, you also must contact SHPS to stop deductions through SHPS. No action is required to stop deductions through Ceridian.
Fidelity recently sent you a letter in the mail with more detailed information and instructions for making contribution payments starting with your June invoice. If you have any questions after reviewing your instruction letter, please call hrSource.
Going forward, to enroll in Automatic Bank Withdrawal Service, do so by the 4th of the prior month for the change to take effect with your next invoice (e.g., sign up by September 4 and the change will take effect for October).
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To change your address, call hrSource at 1-866-4 SOURCE (1-866-476-8723). At the medical, dental, life insurance and billing prompt, you will be connected to a benefits specialist who will help you make this change. |
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You now have the ability to drop and/or delay enrollment in the Pfizer Retiree Medical Plan and re-enroll in Pfizer-sponsored coverage at a later date, provided you can supply proof of continuous coverage during the time you were not enrolled in the Pfizer plan. Previously, only pre-65 retirees had this option and in addition it was a one-time provision. However, effective January 1, 2011, this option applies to post-65 retirees as well, and it is no longer a one-time provision, as long as you were enrolled in the Pfizer Retiree Medical Plan as of December 31, 2010. Your other coverage can be provided through another employer’s plan, a spouse’s plan or any other private coverage, such as a Medigap plan but it must be continuous.
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The annual limit for preventive care services has been removed from the harmonized retiree medical plan for 2011. In 2010 annual physicals were covered once per year at 100% with a $500 annual limit. Beginning in 2011, annual physicals are covered once per year at 100% with no annual limit. In the July 2010 issue of PLUS in print, we outlined other preventive care services covered by Pfizer. You can review this list here.
Please note, this applies for those covered under the Pfizer Retiree Medical Plan; therefore, this is not applicable for Warner-Lambert Pre-92 and American Optical retirees. |
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You can expect your retiree medical coverage invoice at the end of December. Please note, this is the invoice for your January coverage and, therefore, reflects the contributions required in 2011. |
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• Medical ID cards will be mailed to retirees who make a change in their medical option.
• Vision ID cards will be mailed to all U.S. retirees enrolled in medical Coverage through UnitedHealthcare.
• An invoice for your contributions for retiree medical benefits for the month of January will be mailed. |
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When you log onto www.hrSourcebenefits.pfizer.com to make your 2011 annual enrollment elections, beginning on October 26, you will need your Social Security number or Customer ID and your Fidelity PIN (6-12 digits). |
Yes, if you choose to, you and your spouse may each have individual coverage instead of family coverage. You may only make this change during annual enrollment. Please note that if you each elect individual coverage, you will each need to satisfy the individual deductible and out-of-pocket maximum. In addition, only one of you may cover any eligible dependent children. |
Each month, you receive a bill for the month following. For example, in July you are billed for August. You have until the due date on the bill to submit payment. If payment is not received by the due date there is a grace period allowed but payment must be made in full by that date or benefits will be terminated.
You can simplify this process by enrolling in automatic bank withdraw (ABW). To do this, you will need to call your billing vendor and request the information for enrollment into ABW. All retirees, except legacy-Pharmacia retirees, will need to contact Ceridian Benefit Services at 1-877-616-3645. Legacy-Pharmacia retirees need to contact SHPS at 1-800-301-7556. |
You can find a complete list of covered preventive care services in the Pfizer Retiree Medical Plan Summary Plan Description. You may download the Summary Plan Description on www.hrSourcebenefits.pfizer.com or request a copy by calling hrSource. A few examples of preventive care services covered at 100% include:
Routine adult physical exams and related diagnostic screenings and immunizations, up to a $500 annual maximum per person.
- Colonoscopy
- Sigmoidoscopy
- Mammogram
- Pap smear (papnet and thin prep)
- Immunizations
- Prostate specific antigen (PSA)
- Well woman exam
- Hearing exam
- Bone density test
It is important to note that your doctor must code your services as preventive care in order for the services to be covered at 100% through UnitedHealthcare. Contact UnitedHealthcare for more information on preventive care services.
Please note, annual maximums are currently in place for the preventive care benefits. Due to Health Care Reform, plan modifications will be made to certain benefits, effective January 1, 2011. Plan updates will be sent to you in the fall. |
You will need to call hrSource at 1-866-4 SOURCE (1-866-476-8723) to change your address. At the medical, dental, life insurance and billing prompt, you will be connected to a benefits specialist who will help you make this change. |
The Medicare Carve Out option determines what the Pfizer Retiree Medical Plan would pay for a covered service if Medicare were not the primary insurer. The Pfizer plan then pays the difference, if any, between what Medicare has paid and what the Pfizer plan would have paid. Examples where the Medicare Carve Out option covers services beyond those covered by Medicare include:
- Preventive care services, including an annual routine physical exam
- Hearing exams and hearing aids
- Most chiropractic services
- Most immunizations
- Private duty nursing
- Services incurred outside the U.S.
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The deductible is the amount you must pay each year before the Plan begins to reimburse you for covered services. Once you reach the deductible, the Plan will reimburse you at a rate of 80% of covered services. The out-of-pocket maximum is the most you will be required to pay for covered healthcare services in one calendar year (not including the deductible). Take a look at the example below.
Brian is a recent retiree who is in the pre-65 Retiree PPO and has individual coverage. His deductible is $700 and his maximum out-of-pocket limit is $5,000 (for care received from in-network providers). Brian had some chronic medical issues last year, which added up to $38,200 in total charges for the calendar year. Brian paid $5,700 toward the cost of those healthcare bills and the Plan paid $32,500, as outlined below.
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