Princeton Medicare Plan

Plan Type: Medical

This plan provides secondary coverage and assumes that participants are enrolled in Medicare Parts A and B.

Features

  • Administered by Aetna
  • Covers 50% of unreimbursed Medicare expenses after $300 annual deductible for most covered services
  • Annual physicals covered at 80% after deductible
  • Outpatient mental health and substance abuse visits covered at 80% after deductible
  • Hearing exam limited to one exam per calendar year
  • Hearing aid coverage limited to a maximum reimbursement of $1,500 every 3 years
  • Copayments for prescriptions
  • Provides separate primary coverage for non-Medicare eligible dependents, without coordination with Medicare; most services covered at 80% after $300 in-network deductible and annual physical covered at no cost. Refer to the Summary Plan Description (SPD) for more information.

Additional Information

Medicare Direct for Retirees/Dependents Age 65 & Older

HR recommends participants also enroll in Aetna’s Medicare Direct program to minimize work for individuals and their physicians. The program ensures any claims processed by Medicare are automatically sent to Aetna for secondary processing.

To enroll, call Aetna at (800) 535-6689, provide the Aetna group number (397432), Social Security number, and Medicare number. Enroll all Medicare-eligible dependents in this program approximately 10 days after the retirement date.

Prescription Drug Coverage

Retirees enrolled in the PMP automatically receive prescription drug coverage through the Princeton Medicare Prescription Drug Plan (PMPDP). It is integrated with the Medicare Part D Program. This plan is also less commonly known as an Employer Group Waiver Plan (EGWP). For details, refer to the prescription drug webpage.