IMRF Endorsed Plans

Medical Plans for Retirees/Spouses 65 and over

Health Alliance PPO

• A PPO available to retirees and spouses age 65 and older with Medicare Parts A & B residing in Adams, Brown, Bureau, Cass, Christian, Clark, Crawford, Cumberland, Edgar, Effingham, Hancock, Iroquois, Jasper, Livingston, Logan, Macoupin, Marshall, Mason, McDonough, Menard, Montgomery, Morgan, Peoria, Pike, Putnam, Sangamon, Schuyler, Scott, Stark, Tazewell, Champaign, Coles, DeWitt, Douglas, Ford, McLean, Moultrie, Piatt, Vermilion, and Woodford counties in Illinois.
• $20.00 office visit co-pay, no co-pay for preventative services
• $10.00 annual exam co-pay
• $100.00 per outpatient surgery co-pay
• $250.00 per day inpatient hospital co-pay ($500.00 annual maximum)
• Plan includes a Medicare Part D prescription drug benefit (participant must use an in-network pharmacy). Co-pays are: $6.00 for Tier 1 drugs; $39.00 for Tier 2 drugs; $88.00 for Tier 3 drugs and 33% for specialty drugs. Once your total yearly drug costs reach $2,830.00, you pay 100% for all other drugs until your out-of-pocket cost reaches $4,550.00. You then pay the greater of $2.40 for Tier 1 or 2 multi-source drugs and $6.00 for all other drugs, or 5% coinsurance.

2010 Monthly Premium Rate………..$142.00

65 and Over Plans Blue Cross and Blue Shield of Illinois Plan F Humana Private Fee for Service Plan Health Alliance HMO Health Alliance PPO United Healthcare Missouri Mercy Health Plan Premier Plus Blue Cross and Blue Shield of Texas Plans Humana Regional PPO Seniors Choice (Group Retiree Program) Prescription Drug Plans Blue Cross and Blue Shield Medicare Part D Humana Medicare Part D Plans Humana Group Prescription Drug Plan Sav-Rx Plan Sav-Rx Enrollment Form Delta Dental About Delta Plan Delta Dental Enrollment Form Under 65 Plans Blue Cross and Blue Shield of Illinois - Under 65 Plan Request Personalized Quote Long Term Care About the Plan United Healthcare Vision Plan About the Plan