It's Your Choice 2013 - Decision Guide (ET-2128d-13) - ETF

Choose Your Health Plan
radiology (for example: MRI, PET, and
CT scans) and low back surgeries.
State Maintenance Plan
(SMP)
The SMP is available only in counties that
lack a Tier 1 qualified Alternate Plan HMO
or PPO. You can compare SMP to the
Uniform Benefits package on Pages 22
through 25.
The Standard Plan
The Standard Plan is a PPO administered
by WPS. The Standard Plan provides
you with comprehensive freedom of
choice among hospitals and physicians
throughout Wisconsin and nationwide.
You can compare the Standard Plan to
the Uniform Benefits package on Pages
22 through 25.
Health Plans For Annuitants
Medicare Coordinated Plans
All health plans have coverage options,
which are coordinated with Medicare.
You will remain covered by the plan you
select after you are enrolled in Medicare
Parts A and B. The following exceptions
apply:
1. Members enrolled in Humana will
be enrolled in Humana’s Medicare
Advantage Preferred Provider
Organization (MA-PPO) plan after
they enroll in Medicare Parts A and B.
2. Members enrolled in the Standard
Plan or SMP will be moved to the
Medicare Plus Plan on the member’s
Medicare effective date. See the
Comparison of Benefit Options starting
on Page 22 for more information.
The Medicare Advantage Preferred
Provider Organization (MA-PPO) allows
members to use any health care
provider; however, you will incur greater
out-of-pocket expenses when you use
out-of-network providers. The in-network
MA-PPO benefit is modeled to replicate
the Uniform Benefits package.
Medicare Plus is a fee-for-service
Medicare supplement plan administered
by WPS. This plan is available to eligible
annuitants enrolled in Medicare Parts A
and B. Medicare Plus permits you and
your eligible dependents to receive care
from any qualified health care provider
anywhere in the world for treatment
covered by the plan. You may be
responsible for filing claims and for finding
the providers who can best meet your
needs.
West Salem
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Decision Guide Page 15