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If you retired under the Wyeth benefit plans, please contact the hrSource Center at
1-866-4 SOURCE (1-866-476-8723) for benefit information and support. Information is also available by visiting www.hrSourcebenefits.pfizer.com. |
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Below are some Frequently Asked Questions we receive through the site.
- Call hrSource at 1-866-4
SOURCE (1-866-476-8723).
- When asked if you are an active colleague
or on leave of absence, reply “NO.”
- When asked if you
are a retiree, reply “YES.”
- Select the menu prompt for “Medical,
Dental, Life insurance or Billing” to continue with your request.
- Provide your Social Security number or Customer ID.
- Follow the
prompts to create or change your PIN.
- Exit the phone system.
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What will you need for medical, dental, life insurance or billing questions?
SS#
or Customer ID + Fidelity PIN
What will you need for savings and pension plan questions, or account access?
SS# or Customer ID + Fidelity PIN
What will you need for a Change of Address?
Call hrSource to change your address. At the prompt, identify yourself as a retiree
and select the option for "Medical, Dental, Life Insurance or Billing." Follow
the prompts to change your mailing address.
What will you need to report a Death?
No PIN is required.
What will you need for
Stock Options?
No PIN is required.
What will you need for Forms?
No PIN is required.
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Who administers the Pfizer Prescription Drug Program?
Caremark is the
administrator for the Prescription Drug Program for Pfizer, Pharmacia
and Upjohn, Monsanto and Nutra-Sweet/Searle. The Warner-Lambert Drug
Program for Pre-’92 and American Optical retirees is administered by Aetna.
How do I use the prescription card?
You simply present your prescription
card at a participating network pharmacy when you pick up your prescription.
The pharmacy will apply the appropriate benefit.
What is the co-pay/co-insurance for prescriptions?
The coinsurance for the prescription drug program is 20% of total cost for all covered prescription drugs with a $5 minimum charge per 30-day supply not to exceed $100 per 30-day supply. The Warner-Lambert Drug Program for the Pre-’92 Plan has a 90% coinsurance and the American Optical Plan has a coinsurance of 80%.
What pharmacies accept the card?
Participating network pharmacies
include national chains such as CVS, Rite Aid, Eckerd, Drug Fair, Walgreen's
and many others. For more information, refer to your pharmacy card
or contact your vendor directly.
Are there any pharmacies that will not accept the card?
Yes, there
may be pharmacies that do not participate in your prescription plan.
If you have a prescription filled at a non-participating pharmacy you
will need to pay the cost of the prescription at the pharmacy and file
a claim for reimbursement. Claim forms can be obtained at the individual
vendor's website or by calling the vendor directly.
Are Pfizer drug costs covered at 100%?
Yes, the cost for all Pfizer manufactured prescription drugs is covered at 100%.
Can a pharmacy suggest that I accept a generic drug?
Sometimes the
pharmacy may offer a generic drug when the brand name is not readily
available. You may choose not to accept a generic by ensuring that
your doctor checks the "do not substitute" box at the bottom
of your written prescription. If the doctor does not make this indication,
you can advise the pharmacist that you do not want the generic version
of your prescription at the time they fill your prescription.
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I continue to hear a lot in the news about Medicare Part D, which
went into effect in 2006. Don't I get drug coverage through Pfizer?
Yes. The retirees enrolled in the Pfizer-sponsored retiree medical
coverage for 2006 have prescription drug coverage. You are covered
100% for Pfizer drugs and pay only your share of the cost (your "co-insurance" or
co-payment) for your non-Pfizer prescription drugs at the time of purchase.
How does Pfizer's coverage compare to what is available through Medicare
Part D?
The Centers for Medicare and Medicaid Services consider the
drug coverage provided under the Pfizer-sponsored retiree medical coverage
to be "creditable." That means that Pfizer drug coverage
is considered to be at least as generous as the standard Medicare prescription
drug coverage.
Do the problems that some seniors are having getting drugs through
Medicare Part D coverage effect how I get my drugs?
No. Some of the
problems seniors are having are related primarily to enrollment in
Medicare Part D and the problems the program had experienced earlier
this year with benefits information and eligibility. Since the vast
majority of Pfizer retirees are enrolled in the Pfizer-sponsored retiree
medical coverage, they are not affected by these problems.
What should I do if I am having a problem getting my prescription
drugs or with my pharmacy card?
If you are having any problems getting
your prescription drugs, you should contact hrSource at
1-866-4-SOURCE
(1-866-476-8723) and select the prompt for your medical plan.
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When do I become eligible for Medicare?
You become eligible for Medicare
when you turn age 65. You may also become eligible for Medicare if
you become disabled before age 65. You can find additional information
on Medicare eligibility at www.medicare.gov or by calling 1-800-MEDICARE
(1-800-633-4227). TTY users may call 1-877-486-2048.
I turn 65 later this year. How and when will I receive information
about Medicare?
You should contact your local Medicare office at least
90 days in advance of turning 65 in order to receive information on
Medicare and enrolling in Medicare benefits. You will receive information
regarding your Pfizer retiree medical coverage, and the impact of Medicare,
approximately 30 days before you turn 65. Please call hrSource at 1-866-4
SOURCE (1-866- 476-8723) if you do not receive this information.
I've been told that Medicare becomes my primary medical insurer when
I turn 65. What happens to my Pfizer-sponsored coverage?
When you turn 65, Medicare becomes your primary insurer. What
that means is that Medicare will be responsible for reimbursing you
first for any eligible medical expenses.
Your Pfizer-sponsored coverage will reimburse you after Medicare, depending on the provisions and coverage limits provided by the plan in which you are enrolled. Consult your pre-enrollment brochures or call hrSource at 1-866-4 SOURCE (1-866-476-8723) for more information.
What happens when my spouse is under age 65 and I'm 65 or over and
Medicare eligible?
It sometimes happens that one person is Medicare
eligible and one is not yet eligible. If you are age 65 or older, Medicare
will be your primary coverage and your Pfizer sponsored retiree medical
plan will be your secondary coverage. If your spouse is under age 65,
your Pfizer sponsored retiree medical plan will be his/her primary
coverage until he/she reaches age 65.
Please note that the person under age 65 may be enrolled in a different
plan with different plan rules.
I am a surviving spouse and will be turning 65 in a few months. Will
my benefits continue?
As long as you continue to be eligible under
the rules of the Plan in which you are enrolled, your benefits will
continue. If you are required to enroll in a different plan due to
your turning age 65, information will be mailed to you approximately
30 days in advance of age 65. If you do not receive this information
or have any questions on your coverage after age 65 please contact
hrSource at 1-866-4 SOURCE (1-866-476-8723).
I won't turn 65 for a few years. How can I find out what my Pfizer-sponsored
coverage options are when I become Medicare eligible?
Because Pfizer may change the provisions of its plans at anytime, it may not be a good idea to look at current plan provisions if you will not become Medicare eligible for a few years. However, it is a good idea to ask for that information approximately 30 days before you turn 65 or when you become Medicare eligible. You can find information in the Pfizer Retiree Medical Plan Summary Plan Description (SPD),
available in the reference library on www.hrSourcebenefits.pfizer.com or by calling hrSource at 1-866-4 SOURCE
(1-866-476-8723).
I know I have very good prescription drug coverage through my Pfizer-sponsored
plan. Do I need to also enroll in Medicare Part D?
Only you can decide, based on your personal circumstances, whether Part D coverage is right for you. However, because Pfizer-sponsored plans provide excellent prescription drug coverage that is considered “creditable” and cover Pfizer drugs at 100%, most retirees would not benefit from having additional drug coverage through Part D. Also, keep in mind that if you enroll in Part D coverage, you will be paying an additional cost for prescription drug coverage that you already have through your Pfizer-sponsored plan.
Medicare EOB (Explanation of Benefits) statements are now sent quarterly
instead of monthly, so it takes us much longer to get reimbursed for
expenses that Medicare does not cover or only covers partially. Is
there anything that can be done?
Yes. You can call Medicare directly
and request the EOB at any time. To do so, you'll need to call
1-800-MEDICARE
(1-800-633-4227). TTY users may call 1-877-486-2048. You should also
be aware of Medicare crossover. Medicare crossover is the process for
determining the respective responsibilities of two or more health plans
that have some financial responsibility for a medical claim. This is
also called "coordination of benefits." With Medicare crossover,
claims are processed by both health plans without your direct intervention.
All retirees enrolled in UnitedHealthcare coverage are automatically
eligible for Medicare crossover. Retirees who are covered under Aetna
can call and request to be enrolled for Medicare crossover. It does
not cost you anything to enroll.
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In the news every day you hear about the skyrocketing costs of healthcare
in the U.S. These escalating costs have a direct affect on healthcare
costs for both active employees and retirees in all types of plans.
Here are some of the factors that affect what you pay for health insurance.
Uninsured Americans — Society pays some portion of the cost
to treat uninsured citizens. The millions of Americans who do not have
health insurance typically don't get routine physical exams or take
advantage of preventative health screenings. Over time, chronic conditions
like heart disease, diabetes or asthma, if left undiagnosed or untreated,
will cost dramatically more to treat than if they were managed earlier
with better primary care.
Unhealthy Lifestyle Choices — Poor food choices, smoking and
little or no exercise can lead to chronic health conditions. As conditions
like these materialize, the costs to treat them are assumed by everyone.
A recent Emory University study concluded that a small number of illnesses—many
of them preventable—account for most of the health care spending
increase over the past 20 years. Conditions like heart disease, pulmonary
conditions, cancer and hypertension account for roughly one-third of
that increase. Helping to prevent them by choosing to live healthier
lifestyles would reduce healthcare costs overall and have a positive
impact on our economy.
Inappropriate Utilization — Many health insurers are experiencing
higher levels of usage of medical services and health care for the
people they insure. Of course, if there is a medical need, you should
take care of it. The issue is whether the patient is getting the appropriate
type of care—the right care at the right time. Preventive care
and early treatment may result in higher costs initially, but generally
results in lower costs over time.
Aging Population — With 76 million baby-boomers reaching age
60 in 2006, the largest wave of "older Americans" will enter
those years in their lives where they will have greater healthcare
needs. This demographic fact alone has a tremendous effect on overall
healthcare costs.
Medical/Technological Advances — Every day new tests, new technologies,
new equipment and new medical advances are available to us. With those
advancements, however, come more expensive treatments and services.
It's no surprise that businesses have growing concerns over how to
manage the rising costs of offering healthcare benefits to employees
and retirees. Pfizer reviews our healthcare plan costs and coverage
options annually. To help keep contribution rates manageable, we may
add a health care coverage option, for example, that has lower contributions,
but would require higher out-of-pocket costs at the time care is received.
While Pfizer doesn't have much control over rising healthcare costs,
by offering you more choices, we work hard to give you a little more
control over yours.
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At the Retiree Benefits and Health Information Fairs that were held in February and March 2010, we received a number of questions regarding the changes to the Pfizer Retiree Medical Plan that took effect on January 1, 2010, as well as how the new benefits work. Here, we’ve answered the most frequently asked questions from the live and webcast benefits presentations and question and answer sessions. We hope the information in this document helps answer some of your questions. Please keep in mind the fairs were attended by retirees from all of our legacy companies (Pfizer, Warner-Lambert, Pharmacia and Upjohn, Nutrasweet/Searle and Monsanto) and the medical plan changes retirees experienced from 2009 to 2010 were different based on your legacy company. We are committed to continuing to provide you with information that helps you understand your medical coverage, plan for your medical expenses and evaluate your coverage options.
Please note that during the information fairs and through the webcast submissions, we received a number of specific questions about retirees’ contributions to the cost of medical coverage. Refer to the current special edition of PLUS in print, which provides much more detail about the cost of coverage for each of the legacy retiree groups as well as additional information regarding your coverage. You can view the current and previous issues of PLUS in print on PLUS online.
Why did Pfizer make changes to retiree medical coverage?
As of January 1, 2010, we harmonized the legacy retiree medical plans into a new retiree medical program with the goal of providing competitive retiree benefits that were sustainable for both Pfizer and our retirees for the future.
Do you expect the new plan and cost structure will change in the future (for example, as Healthcare Reform becomes effective)?
We believe that the new Pfizer Retiree Medical Plan will be a plan that continues to be affordable and sustainable for Pfizer and our retirees for the future. At this point, we do not anticipate making significant changes to the new retiree medical plan as a result of the recently signed Healthcare Reform legislation. When we have more information on the impact of Healthcare Reform on the Pfizer Retiree Medical Plan, we will communicate that information to you.
Why is there one medical plan option for retirees under age 65, but two medical plan options for retirees age 65 and over?
The coverage options available to retirees were selected in an effort to keep the Pfizer Retiree Medical Plan affordable for retirees and for Pfizer. Once retirees reach age 65, Medicare becomes their primary coverage. Some retirees may find that Medicare Parts A and B meet their needs; therefore, we offer the “Prescription Only” option as a means of providing retirees with the option of only receiving prescription drug benefits through Pfizer-sponsored coverage and medical coverage through Medicare. Pfizer also offers a “Medicare Carve Out” option for those retirees age 65 and over who would like Pfizer-sponsored medical coverage that supplements the coverage provided by Medicare Parts A and B.
When retirees reach age 65 and become eligible for Medicare, the Pfizer Retiree Medical Plan provides coverage that is secondary to Medicare through the “Medicare Carve Out” option. Why don’t contributions go down more significantly when retirees turn 65?
The way contributions are structured is heavily influenced by the subsidy that each legacy company established for its retirees; therefore, what happens to the contribution when a retiree reaches age 65 depends on the legacy company structure. Keep in mind, a significant portion of the cost of coverage for retirees age 65 and over is the prescription drug benefit, which is the same prescription drug benefit that is offered to retirees under age 65. Refer to the current issue of PLUS in print for more details about your cost of coverage.
Why is the cost of covering a retiree and a spouse substantially more than the cost of covering only the retiree?
In determining contribution amounts, Pfizer first recognizes the retiree by providing a greater subsidy to the retiree than is provided to spouses and dependents.
Once retirees reach age 65 and become Medicare eligible, they will be eligible under the “Medicare Carve Out” option. At this point, they cannot drop Pfizer coverage and re-enroll at a later date. Can they, however, switch between the “Medicare Carve Out” and “Prescription Only” options from year to year?
Yes, you can make changes in the option you elect each year during the annual enrollment period. The option to move between plans remains available to you each year as long as you do not drop coverage entirely. Also, if both you and your spouse are Pfizer retirees you can switch from family to individual coverage during annual enrollment (see question 10 for more information).
Where is information about services covered and not covered by Medicare available?
Medicare Part A pays some of the cost for hospitalization, skilled nursing facilities and home health services. Medicare Part B pays for doctors’ fees, most outpatient hospital services and certain related services. For more information on services covered and not covered by Medicare, refer to the “Medicare & You” handbook on www.medicare.gov or call 1-800-633-4227.
How does the Medicare Carve Out option work? What services does it cover that are not covered by Medicare?
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 (see question 11 for more information on preventive care services)
- Hearing exams and hearing aids
- Most chiropractic services
- Most immunizations
- Private duty nursing
- Services incurred outside the U.S.
Can you explain the difference between the deductible and the out-of-pocket maximum?
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 maximumis the most you will be required to pay for covered healthcare services in one calendar year (not including the deductible). Refer to the current edition of PLUS in print for an example.
My spouse and I are both Pfizer retirees and we currently have family coverage. Can we choose to each elect individual coverage rather than electing family coverage?
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.
Where can I find a list of the services that are considered preventive care services and are therefore covered at 100%?
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.
I am a retiree with family coverage through Pfizer that currently covers my spouse and me. If I should die, what would happen to the coverage for my spouse?
Following the death of a retiree, eligible surviving spouses will continue to be offered the same coverage each year that they would have been offered if the retiree were still living. Details about surviving spouse coverage can be found in the Pfizer Retiree Medical Plan Summary Plan Description.
Does Pfizer retiree medical coverage stay in effect if I travel outside the U.S.?
Yes, the Pfizer Retiree Medical Plan covers you wherever you may seek care. However, because Medicare is an insurance program sponsored by the U.S. government, you may not be covered by Medicare when you are overseas. You should contact your carrier (UnitedHealthcare, Medicare or both) prior to your travel to determine the level of coverage provided should you incur services abroad.
Who determines which providers are in-network?
UnitedHealthcare, the administrator of the Pfizer Retiree Medical Plan, determines the network of providers that applies to retirees under the age of 65. UnitedHealthcare actively works on recruiting physicians and hospitals into its network. Sometimes physicians and hospitals choose not to participate in a particular network. Pfizer evaluates UnitedHealthcare’s network regularly to ensure that Pfizer colleagues and retirees have an adequate number of physicians and hospitals available to them. You can find out whether your physician is in-network by visiting www.myuhc.com/groups/pfizer or by calling 1-800-638-8010.
Note that if you are age 65 or over, your benefits are not impacted by whether or not a provider participates in the UnitedHealthcare network. If you are age 65 or over, it is important, however, that you confirm that your provider accepts Medicare assignment.
MetLife is the administrator of the dental plan and follows the same process as UnitedHealthcare when determining which dental providers to include in its network.
I didn't enroll in dental coverage during annual enrollment. Can I still enroll for dental coverage?
Pfizer has extended the enrollment period for the dental plan through April 30, 2010. This is a one-time opportunity. After April 30, 2010, if you drop dental coverage, you will not be able to enroll in the plan at a later date.
If you would like more information on dental coverage, call MetLife at
1-800-Get Met8 (1-800-438-6388).
Can I switch between the two dental options?
Yes. You can change dental coverage options annually during the annual enrollment period, as long as you do not drop dental coverage entirely.
When I retired, I was told I had a Company-paid life insurance policy. Do I still have that insurance?
The recent changes to retiree medical benefits did not affect life insurance coverage. Retirees who were eligible for life insurance upon retirement remain eligible. You can view the amount of your life insurance coverage on the Health and Insurance page on www.hrSourcebenefits.pfizer.com or by calling hrSource to speak with an hrSource Benefits Specialist.
How do I report an issue or concern I’m having with a plan administrator or with hrSource?
If you have an issue with a plan administrator or with hrSource, you may escalate that issue by asking to speak with a supervisor while you are on the phone with a representative from the plan administrator or hrSource.
Although this document contains information about the Pfizer Retiree Medical Plan, it is not intended to provide every detail. More information can be found in the Pfizer Retiree Medical Plan Summary Plan Description. While Pfizer expects to continue the benefits described here, it reserves the right to amend, suspend or terminate the Plan at any time, with or without notice, and for any reason.
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