Teachers' Retirement Insurance Program (TRIP) - The TRAIL
Image source: /content/dam/soi/en/web/cms/benefits/trail/publishingimages/trail-logo-color-large.png
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.
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 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.
• 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 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. 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 the PPO option. Members residing outside Illinois may elect the PPO option only which is available nationwide.
Any Required and supporting documentation you may have, may be uploaded online, or faxed (toll-free) 844-676-1725.