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With the Optum Rx® Drug Pricing Tool, you can see if your drug is covered under your plan and what you would pay out-of-pocket with and without the Medicare PDP EGWP.
Go to Optum RxEGWP stands for "Employer Group Waiver Plan." It is a Medicare Prescription Drug Plan (PDP) that combines both employer coverage and Medicare coverage into a single, coordinated drug plan. It allows members — who might otherwise forgo Medicare drug coverage — to benefit from the Medicare system they paid into, often for decades.
Medicare PDPs have made prescription drugs more affordable for the millions of retirees that depend on them. This Medicare PDP EGWP will provide enhanced prescription drug coverage, including:
Our Medicare PDP EGWP allows members — who might otherwise forgo Medicare drug coverage — to benefit from the Medicare system they paid into, often for decades. Auto-enrollment is intended to make the process easier for our members.
Both the Office of Personnel Management (OPM) and Medicare rules allow us to auto-enroll eligible members. Auto-enrolled members may opt-out within 21 days or may disenroll at any time.
Our Medicare PDP EGWP is available exclusively to Compass Rose High Option members entitled to Medicare Part A and/or enrolled in Medicare Part B and not enrolled in Compass Rose Medicare Advantage. You must also live within our U.S. service area and continue to pay your premiums.
There are limited situations where we are required to end your membership in our Medicare PDP EGWP. For example, if Medicare revokes your eligibility, if you are no longer lawfully present in the United States, or if you become incarcerated.
No, your enrollment in the Medicare PDP EGWP is in addition to your existing High Option Compass Rose Health Plan and your Medicare Part A and/or Part B coverage.
Yes, you remain a Compass Rose Health Plan member within the FEHB program.
You can use the Optum Rx® drug pricing tool online to see what is covered and what your current prescriptions will cost. To use the tool, visit compassrosebenefits.com/OptumRx.
No, if there are active refills on your prescriptions they will be transferred to your Medicare PDP EGWP profile.
Each individual's eligibility is determined individually. Auto-enrollment of eligible members is also performed individually.
The Compass Rose Medicare PDP EGWP is a benefit for eligible members who have or are entitled to Medicare coverage. If your covered spouse or other covered family members are also entitled to Medicare Part A and/or enrolled in Medicare Part B and meet the other automatic enrollment rules, they will be auto-enrolled separately. If your family member is enrolled in Compass Rose Medicare Advantage or does not have Medicare, they will keep their current Compass Rose prescription drug coverage.
Eligible members will receive detailed communication in the mail. If you have further questions, please call Optum Rx toll free at (844) 368-0690 24 hours a day, 7 days a week.
Yes, each individual enrolled in the Medicare PDP EGWP will have their own separate member ID card (provided by UMR) that includes both medical and pharmacy benefits. You will receive this new member ID card once your enrollment begins.
Eligible members will receive detailed communication in the mail. If you have further questions, please call Optum Rx toll free at (844) 368-0690 24 hours a day, 7 days a week.
Each individual member (including your spouse or other dependents) who is auto enrolled in the Medicare PDP EGWP may opt out within 21 days. After 21 days, your enrollment will become effective. If you are enrolled, you may still disenroll at any time. However, Medicare only processes disenrollments at the end of each calendar month. If you opt out or disenroll, your traditional FEHB High Option prescription benefits will apply. To opt out, call Optum Rx at (855) 235-1405 or mail or fax a signed disenrollment request to:
Optum Rx Enrollment Services
Attn: Enrollment Services
PO Box 269027 Fort Lauderdale, FL 33326
Fax: 1-800-784-1580
Depending on your income, you may need to pay an Income Related Monthly Adjustment Amount (IRMAA) for the Compass Rose Medicare PDP EGWP.
IRMAA is an amount Social Security determines you may need to pay in addition to your monthly Part B and D premium if your modified adjusted gross income on your IRS tax return from 2 years ago is above a certain limit. Although you will not have an additional premium, the Medicare PDP EGWP is considered a Part D plan. Therefore, if you currently have or would be subject to a part B IRMAA, then you may incur an additional part D IRMAA when enrolling in this plan. Learn more at medicare.gov.
