2024 Benefit Information: Medicare Members

As a Medicare-eligible member, you will continue to have three plan options in 2024:

The Humana® Group Medicare Advantage (PPO) Base Plan (90/10)*
The Humana® Group Medicare Advantage (PPO) Enhanced Plan (90/10)*
The Base PPO Plan (70/30), administered by Blue Cross and Blue Shield of NC

2024 Open Enrollment for Medicare Members

Open Enrollment is the time to evaluate your State Health Plan coverage and make any necessary changes.

IF YOU ARE SATISFIED WITH THE PLAN IN WHICH YOU ARE CURRENTLY ENROLLED, NO ACTION IS REQUIRED.

All members currently enrolled in the Humana Medicare Advantage (Base or Enhanced) Plan (90/10)* will REMAIN on that plan for 2024.

All members currently enrolled in the Base PPO Plan (70/30) administered by Blue Cross NC will REMAIN on that plan for 2024.

If you want to change plans or need to make changes regarding your dependents, you will need to take action during Open Enrollment.

If you have non-Medicare Primary dependents on your plan, they have different options: the Enhanced PPO Plan (80/20) and the Base PPO Plan (70/30). If there are currently enrolled in the Enhanced PPO Plan (80/20), they will be moved to Base PPO Plan (70/30) for the 2024 benefit year. You will need to take action during Open Enrollment if your non-Medicare Primary dependents want to be enrolled in the Enhanced PPO Plan (80/20) for the 2024 benefit year. More information regarding these plan options can be found at www.shpnc.org/2024-benefit-information.

You will not receive a new ID card unless you change your plans. You will continue to use your 2023 ID card in 2024.

*The Humana Group Medicare Advantage Plans have a benefit value equivalent to a 90/10 plan.

2024 Medicare Primary Monthly Rates

2024 Group Medicare Advantage Plan (90/10) Resources

	*Humana Group Medicare Advantage (90/10) Plans**	Base PPO Plan (70/30)
NO Medical or Pharmacy deductibles	✔
Spousal Coverage for $4 (Humana Base Plan)	✔
Customized plan for you combining Medicare Parts A and B along with Medicare Part D (prescription coverage) into one plan	✔
Ability to see providers outside the network for the same copay or coinsurance as in-network providers as long as the provider participates in Medicare and agrees to file claims with Humana	✔
Free enrollment in SilverSneakers	✔
Hearing aid benefit	✔
Routine eye exams	✔
Routine hearing exams	✔
Lower Urgent Care and ER Copays	✔
Humana Well Dine Meal Program where you can receive 2 meals per day for 14 days (total of 28 meals) delivered after an inpatient stay in a hospital or nursing facility	✔
In-home Personal Care for $0; a minimum of 4 hours per day, up to a maximum of 8 hours for certain in-home support services following a discharge from a skilled nursing facility or from an inpatient hospitalization	✔
Prescription Drug coverage	✔	✔
No referral needed to see a specialist	✔	✔
Preventive services covered at 100%	✔	✔
Disease and case management services	✔	✔
Preferred and non-preferred insulin has a $0 copay for a 30-day supply		✔

The State Health Plan utilizes a custom, closed formulary (drug list). The formulary indicates which drugs are excluded from the formulary and not covered by the Plan. All other drugs that are on the formulary are grouped into tiers. Your medication’s tier determines your portion of the drug cost.

CVS Caremark is the State Health Plan’s Pharmacy Benefit Manager.

These documents and tools include information based on the 2023 formulary and are subject to change prior to January 1, 2024.

Learn more about your 2024 health plan options! Plan to attend one of the State Health Plan’s Medicare Outreach events. Select the link below for the date and time that works best for you to register!

In-Person Outreach Events

These onsite events are intended to help Medicare-eligible members select the best plan for them during 2023 State Health Plan Open Enrollment. Representatives from both the State Health Plan and Humana will be in attendance to assist attendees.

Make sure to register soon, as seating is limited. While registration is encouraged, no ticket is required for this event. Temperatures may vary at each venue, so be sure to bring a light jacket. Please note: no refreshments provided.

Click here to view and register for an in-person outreach event near you

Online Webinars

These online webinars webinars will provide an overview of your 2024 benefits and will include presentations from State Health Plan staff as well as Humana. The content shared during these webinars is the same information that is shared during the in-person Open Enrollment meetings held across the state.

On the registration page, click the drop-down menu to select a date and time that works for you! If you need assistance with registering for a webinar, please call the RSVP Hotline at 866-720-0114, Monday - Friday, between 8 a.m. and 5 p.m. ET.

Click here to view and register for an online webinar

Telephone Town Hall Event

Telephone Town Hall meetings are like listening to a radio show over the phone. You'll simply provide your phone number when you register and we'll call you to join the Telephone Town Hall at the start of the event or you can simply call 800-303-1480 at a date and time that is most convenient to you!

Members who have registered and members with a valid phone number in the State Health Plan's enrollment system (eBenefits) will receive a call prior to an event, which will prompt you to join. However, if the phone number we have on file is a mobile number, you must register and agree to be contacted for the meeting via your mobile number. Please note that your phone number will remain confidential and will only be used to contact you for the Telephone Town Hall meeting.

Click to register for the Telephone Town Hall

2024 Benefit Information: Medicare Members