Total Retiree Advantage IL (TRAIL)

The Teachers' Retirement Insurance Program (TRIP) offers its 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 an “MAPD”) plan.

All newly-eligible participants, who elect to enroll in the TRAIL MAPD Program will be enrolled in the Aetna Medicare Advantage Prescription Drug (MAPD) PPO Plan. 

To be eligible for coverage under the Total Retiree Advantage Illinois MAPD plan, you and your eligible dependents must:

• Live in the United States or the U.S. Territories, AND
• Be retired and enrolled in Medicare Parts A and B, due to age or disability.

You Must Take Action

As a TRIP member who is eligible for Medicare, the Teachers' Retirement Insurance Program (TRIP) offers you a retiree healthcare program called Total Retiree Advantage Illinois (TRAIL).  

The TRAIL Program provides comprehensive medical and prescription drug coverage through the Aetna MAPD PPO plan, which is a Medicare-approved plan that combines the different parts of Medicare into one plan. Since Aetna MAPD PPO is a type of Medicare, you must continue to pay your federal Medicare Parts A and B premiums in order to enroll and remain enrolled in TRAIL MAPD.

As a newly-eligible participant in the TRAIL MAPD Program, you may:

• Elect to cancel your coverage. Note: If you cancel your TRIP TRAIL MAPD coverage, medical and prescription drug coverage for you and your enrolled dependents will end.  Re-enrollment is allowed for TRIP members throughout the plan year with coverage effective the first of the month following your enrollment request or during your annual TRAIL MAPD Enrollment Period.

• Elect to re-enroll in coverage. You may re-enroll in medical/prescription drug coverage if you previously canceled coverage.

• Add or drop dependent coverage. IMPORTANT: You must contact the MyBenefits Service Center (toll-free) 844-251-1777 if you want to add a dependent not enrolled in Medicare Parts A and B.  If you add a non-Medicare dependent, you will be ineligible to enroll in a TRAIL MAPD plan.

For more complete benefit information regarding TRAIL and the health plan benefits with your new Aetna MAPD PPO plan, please review your:

• TRAIL MAPD is a retiree healthcare program sponsored by the Teachers' Retirement Insurance Program (TRIP).  The plan offered through the TRAIL Program is a Medicare Advantage plan which includes prescription drug coverage. As a TRIP member, who is newly-eligible for enrollment in the TRAIL MAPD health plan, this is your opportunity to enroll in the Aetna MAPD PPO Plan.  If you do not want TRAIL MAPD coverage or do not enroll in the Aetna MAPD PPO plan, you will be waived from TRIP’s coverage.  If you cancel coverage, you will lose medical and prescription drug coverage. Canceling TRAIL MAPD coverage does not allow you to stay in your current TRIP health plan.

• The TRAIL MAPD health plan is offered by Aetna. Medicare pays a fixed amount for your care each month to Aetna.  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 health plan provides 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.

• If the member's and/or dependent's Medicare Beneficiary Identifier (MBI) number is not on file, it must be provided during your enrollment, please make sure you have this information available.

• If you fail to provide a copy of the Medicare card with your MBI number to the Medicare COB unit or your Retirement system, your TRAIL MAPD and TRIP medical insurance will be waived for the dependent(s) with the missing documentation and waived for the entire household if the member's documentation is not provided.

• 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 re-enroll throughout the plan year 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.

• 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 the TRAIL MAPD health 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 TRIP members who want to continue medical and prescription drug coverage through TRIP, are required to enroll in the TRAIL MAPD health plan 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, we will assume you do not want your TRIP TRAIL MAPD health insurance and will terminate your medical and 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, re-enroll in the TRIP-Sponsored TRAIL plan throughout the plan year with coverage 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 Health Plan. The MAPD plans are not permitted to consider the deductible(s) you might have already paid in your other plan.  Any deductible paid to your current medical plan will not count toward your MAPD plan year deductible.  Your annual PPO 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.

Illinois Department of Public Health

Any Required and supporting documentation you may have, may be uploaded online, or faxed (toll-free) 844-676-1725. 

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