August 2016 Welfare Notes

July, 2016

Kaiser Prescription Drug Copayment Reimbursement Procedures


All prescription copayment receipts submitted to the Welfare Plan for reimbursement must indicate the name of the patient.  Due to patient privacy considerations, Kaiser has discontinued providing this information on prescription receipts without authorization from the Plan participant. Therefore, when SUP Members pickup prescriptions from Kaiser they should request and complete a form entitled "Authorization for Use and Disclosure of Pharmacy Information."  With this information on file, Kaiser will provide the Plan participant with a detailed print-out of prescriptions purchased which includes all the information necessary for the Plan Office to process the participant’s claim for copay reimbursements.


Pensioners Annual Allowance


The fiscal year for the Pensioners Annual Allowance runs from August 1st through July 31st of the following year.


The maximum reimbursable totals for the fiscal year are $3,000.00 for medical premiums, $1,000.00 for prescription drugs, and $1,000.00 for “other” expenses including medical, dental, and vision expenses.  As an example, $300.00 in medical expenses, $500.00 in dental expenses, and $200.00 in vision expenses would total the $1,000.00 maximum allowed for “other” expenses.


A medical, dental, or vision expense is considered to be incurred on the date you receive treatment or the date of the visit giving rise to the expense.  For prescription drugs, the incurred date is the date you paid for the prescription drug.  For medical premiums, the expense is incurred on the due date for the premium being paid, not the date of your premium payment.


Claims for reimbursement must be submitted to the Plan office within 90 days of the date charges were incurred or within 90 days of Medicare’s processing of the claim. The patient's name, dates of service, a description of the services, and the amounts charged for services must be indicated by the provider of services on the statement submitted for reimbursement.