If I retire, do all of the plans offer me the option to self-pay as a retiree?

Yes, you can choose to self-pay month to month as a retiree for non-Medicare and Medicare coverage. In fact, if you have HRA monies, those monies can be directed to pay the IHF premium owed if you choose. You will be offered the same plans as before retirement for non-Medicare coverage, but with no additional deposits to an HRA.

Can I pay a premium for my spouse to join Plan 5 – Basic plan?

No, Plan 5, the Basic Plan, is not offered to spouses of members. It is designed to only cover you and your eligible dependent children. This particular plan offers the core coverage required under the Affordable Care Act.

What happens if I go out-of-network for an emergency?

In the case of an emergency, and if you use an out-of-network provider, the IHF plans pay for the out-of-network care as though it were in-network.

What about Preventive Care? Is that offered at $0 Copay?

Each plan includes preventive care coverage for an annual examination and for certain immunizations. For Plans 1, 2, 4 and 5, preventive care is offered at no cost or copay to the member. The Bronze Plan 3 offers limited preventive care as a grandfathered plan and you do pay the office visit copay.

When I visit a doctor, do I pay a copay? How do the deductible and coinsurance work when I pay a copay?

For Plans 1 – Gold, Plan 2 – Silver, Plan 3 - Bronze and Plan 4 – Choice, you can access a doctor by paying a flat dollar copay. You do not wait to clear the plan deductible, and if you pay a copay, there is no additional coinsurance applied for that visit. These plans are designed to keep access to care as affordable as possible and encourage you to see your doctor.

For Plan 5 – Basic, that plan works differently, and you must meet the deductible first. After that, coinsurance which is equal to 40% of the cost of care applies.

For all of the plans, deductibles do apply for more serious medical conditions and treatments, such as an inpatient hospital visit.

If I have an HRA, can I save the amount of HRA money from year to year? Or do I lose the money each year?

Yes, you can save the amount of the HRA monies from year to year and quarter to quarter to cover future IHF plan costs or premiums if you retire or do not meet eligibility requirements.