Teachers' Retirement Insurance Program (TRIP) - The TRAIL



Welcome to Your TRAIL MAPD Initial Enrollment Period

The Teachers' Retirement Insurance Program (TRIP) offers members a healthcare program called Total
Retiree Advantage Illinois (TRAIL). This program provides Medicare-eligible members and their covered
dependents comprehensive medical and prescription drug coverage through TRAIL Medicare Advantage
Prescription Drug (commonly referred to as "MAPD") plans.

As an individual who is enrolled in Medicare Parts A and B, your annual TRAIL MAPD Open Enrollment
Period will be held in the fall of each year. The TRAIL MAPD plan year is January 1 through December 31.
All Illinois counties have an HMO and PPO option. Members residing outside Illinois may elect the PPO
option only.


To be eligible for coverage under a Total Retiree Advantage Illinois Medicare Advantage
Prescription Drug (MAPD) plan, you and your eligible dependents must:
• Live in the United States or the U.S. Territories, AND
• Be enrolled in Medicare Parts A and B, due to age or disability.
You Have Important Healthcare Coverage Decisions to Make
The TRAIL MAPD Program provides you and your enrolled dependents comprehensive medical and
prescription drug coverage through TRAIL plans. These types of Medicare Advantage Prescription Drug
plans, commonly known as "MAPD" plans, are Medicare-approved plans that combine the different parts of
Medicare into one plan. Since these plans are a type of Medicare, you must continue to pay your federal
Medicare premiums in order to remain enrolled in TRAIL MAPD.


TRIP Initial Enrollment Guide 2021.pdf

As NEWLY‐ELIGIBLE for the TRAIL MAPD Program, you:
• MUST elect one of the TRAIL MAPD health plans during your enrollment period via MyBenefits.illinois.gov, or by calling the MyBenefits Service Center (tollfree) 844-251-1777. Due to your Medicare-eligibility, you cannot keep your current TRIP health plan. You must complete your enrollment into a TRAIL MAPD plan within your enrollment period.
• Will have your medical and prescription drug claims processed by the TRAIL MAPD plan instead of
Original Medicare and your current medical plan, once you've completed your TRAIL MAPD enrollment
becomes effective.
• Will only have one ID card to show at your doctor visits and when picking up your prescriptions.
• May cancel your TRIP coverage. Canceling will terminate your medical and prescription drug coverage
through TRIP. Reenrollment is allowed for TRIP throughout the plan year with a qualifying enrollment
opportunity and coverage will be effective the first of the month following your enrollment request or
during your annual TRAIL MAPD Enrollment Period.

Important Information You Need to Know about your TRAIL MAPD Plan

• TRAIL MAPD is a retiree healthcare program sponsored by the Teachers' Retirement Insurance Program
(TRIP). The plans offered through the TRAIL Program are Medicare Advantage plans which include
Prescription Drug coverage. These plans are typically called "MAPD" plans. As a TRIP member who is
Newly-eligible for enrollment in a TRAIL MAPD plan, you must make a choice during this TRAIL MAPD
Enrollment Period to enroll in one of the MAPD plans offered. If you do not want TRAIL MAPD coverage,
you can cancel which will terminate your medical and prescription drug coverage. Canceling TRAIL MAPD
coverage does not allow you to stay in your current TRIP health plan.
• TRAIL MAPD plans are offered by private companies approved by Medicare. Medicare pays a fixed
amount for your care each month to these companies. When you enroll in a Medicare Advantage
Prescription Drug (MAPD) plan, you are no longer in Original Medicare, but still have the same covered
services and the same rights and protections as people with Original Medicare.
• The TRAIL MAPD plans provide all of your Part A (hospital) and Part B (doctor and outpatient) benefits,
including emergency and urgent care, and Medicare Part D (prescription drug) coverage.
You must keep Medicare Parts A and B and continue to pay the applicable
Medicare premiums, including applicable IRMAA (Income Related Monthly
Adjustment Amount) surcharges.
• All members and dependents must ensure that their Medicare information, including the Medicare
Beneficiary Identifier (MBI), is on file. If the MBI (found on your Medicare card) is not provided, your TRAIL
MAPD and TRIP coverage will be canceled.
• You can only be in one Medicare Advantage or Medicare Part D (prescription drug) plan at a time.
Enrollment in the TRAIL MAPD plan provides you with Medicare Advantage coverage as well as Medicare
Part D coverage. Therefore, enrollment in a different Medicare Advantage or Medicare Part D plan will
automatically cause your TRAIL MAPD coverage to end, which will include termination of your TRIP
medical and prescription drug coverage.
• You may terminate the TRAIL MAPD coverage at any time by contacting the plan administrator in writing.
You may reenroll throughout the plan year with a qualifying enrollment opportunity and coverage will be
effective the first of the month following your enrollment request or during your annual TRAIL MAPD
Enrollment Period.
• If your residential or mailing address changes, you must notify both your retirement system and the Social
Security Administration in writing as quickly as possible.
• If you enroll in one of TRIP's TRAIL MAPD HMO plans and move outside of the plan's service area to a
different county in Illinois where your current HMO is not available or to a different state, you must elect
a new MAPD plan available in your new area. If you move outside the State of Illinois, your coverage will
be defaulted to the UnitedHealthcare PPO plan.
• Medicare Advantage Plans are not a Medicare Supplement plan. Medicare Advantage Plans,
sometimes called "Part C" or "MA Plans," are an "all in one" alternative to Original Medicare. These
"bundled" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical
Insurance), and in the case of your TRIP-Sponsored TRAIL plan, Medicare prescription drug (Part D) is
also included.
• Once you have enrolled in TRAIL MAPD plan, you will only use your red, white and blue Medicare card
for hospice care. All other claims for your healthcare services (including prescription drugs) should be
sent to your MAPD plan administrator for processing and benefit determinations.
• Medicare-eligible retirees, annuitants and survivors who want to continue medical and prescription
drug coverage through TRIP, are required to enroll in one of the TRAIL MAPD plans if they and their
covered dependents are all enrolled in Medicare Parts A and B. Remaining in your current TRIP
health plan is not an option. If you do not complete the online enrollment process or call the
MyBenefits Service Center by your enrollment deadline, the State will assume you do not want your
TRIP TRAIL MAPD health insurance and will terminate your medical prescription drug coverage. If
your TRIP medical and prescription coverage is terminated, you will have only Original Medicare for
your medical coverage. To obtain additional coverage you may enroll in a Part D prescription drug plan
for prescription drug coverage, reenroll in the TRIP-Sponsored TRAIL plan throughout the plan year
with a qualifying enrollment opportunity and coverage will be effective the first of the month
following your enrollment request or enroll during your next annual TRAIL MAPD Enrollment Period.
• Plan Year deductible and Out-of-Pocket Maximums will start over with your new TRAIL MAPD Plan.
The MAPD plans are not permitted to take into account the deductible you might have already paid in your
other plan. Any deductible paid to your current medical plan will not count toward your MAPD plan's
annual deductible. The PPO plan's annual medical deductible will start again for the TRAIL MAPD Plan Year.
• Your current health plan may cover services that Original Medicare does not cover. Medicare
Advantage plans are required to cover all services covered by Original Medicare. In order to be
covered, the service must be considered medically necessary and in certain cases, meet Medicare
guidelines for approval. Some services have limits to how often they can be obtained.



The State of Illinois offers members of the Teachers' Retirement Insurance Program (TRIP) a healthcare program called Total Retiree Advantage Illinois (TRAIL). This program provides eligible members and their covered dependents comprehensive medical and prescription drug coverage through Medicare Advantage Prescription Drug plans (commonly referred to as “MAPD” plans).

All Illinois counties have an HMO and PPO option. Members residing outside Illinois may elect the PPO option available nationwide.

 
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Last Updated 09/21/2020