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Catastrophic HRA

Worried About High Prescription Drug Costs?

Do you have an extremely high usage of prescription drugs that may cause you to reach the Medicare Part D catastrophic coverage limit? The Catastrophic Health Reimbursement Account can provide the protection you need.

What Are Catastrophic Drug Expenses?

To protect USG retirees who have an extremely high usage of prescription drugs who may reach the Medicare Part D catastrophic coverage limit, USG has created a special program called the Catastrophic Health Reimbursement Account.  

Catastrophic prescription drug expenses are prescription drug expenses that exceed your annual Medicare “True Out-of-Pocket” limit and for which Medicare will not reimburse you.

  • Eligibility

    All Post-65 retirees enrolled in an individual Medicare health plan through Aon Retiree Health Exchange, and their eligible dependents who reach the catastrophic coverage stage under their Medicare Part D program, are eligible for the plan.

  • Medicare Part D and Your Catastrophic HRA

    Here is how your Catastrophic HRA works with Medicare Part D.

    1. You pay out-of-pocket for monthly Medicare Part D premiums. This will not change while you are enrolled in Medicare Part D.
    2. You pay 100% of your prescription drug costs until you reach the deductible amount.
    3. After reaching the deductible, you pay 25% of the cost of your drugs (Part D pays the rest), up to the Medicare Part D annual limit ($4,130 for 2021).
    4. Once you reach this limit, you pay 25% for covered brand-name drugs and generic drugs until the total you have spent on copays and drugs reaches the yearly out-of-pocket spending limit, which is $6,550 for 2021.  
    5. Catastrophic coverage: Once you have met your Medicare out-of-pocket limit for prescription drug expenses and you are eligible for reimbursement of your catastrophic prescription drug expenses, USG will reimburse you dollar-for-dollar, separately from your HRA, for your Medicare Part D copay and coinsurance expenses.
  • How to Know If You’ve Reached Catastrophic Coverage Limit

    If you or your covered spouse reaches the catastrophic coverage limit, you will receive a Medicare Part D Monthly Prescription Drug Summary statement showing you have reached this limit. Review this statement each month, so that you are aware of which drug coverage phase you are currently in.

    Please:

    An Aon Benefits Advisor is available to help you with your healthcare questions and concerns. Call Aon Retiree Health Exchange to speak with a licensed Benefits Advisor.

Activate Your Catastrophic HRA

  • Complete Activation Form

    Before submitting any claims, an account must for be opened for you. The activation form is available by calling Aon Retiree Health Exchange. You will need to complete the form and provide your Explanation of Benefits statement from your carrier showing that you have reached the catastrophic coverage phase.

    After confirming you’ve reached the catastrophic coverage stage of your plan, an account will be created for you.  

    Because your Medicare limits reset each year, you will need to submit a new activation form annually.

  • Submit Claims

    Once your account is established, you can submit claims for your out-of-pocket prescription costs incurred from the date you met the catastrophic coverage stage through the end of the year. Claims incurred during your eligibility period must be submitted to YSA by March 31 of the following year.

    After your account is activated, Catastrophic HRA claims must be filed by paper (they cannot be submitted online). A paper claim form is available for download on the YSA website or by calling Aon Retiree Health Exchange. With each claim form, you’ll need to provide documentation substantiating the amount.