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Medicare - Plan Year 2018

Dr. On Demand for Humana Medical Only Plans

We are excited to let you know that KRS has added Doctor On Demand to your plan beginning April 1, 2018.

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Skip the waiting. Doctor On Demand allows you see to see a board-certified doctor in minutes, with video access from your mobile device or computer. It’s easy.

Doctor On Demand is the perfect option when your primary care doctor is unavailable and other healthcare options are closed. You may receive treatment 24 hours a day, seven days a week for many health issues including:

• Colds, flu and sore throat

• Upper respiratory infections

• Skin and eye problems

• Urinary tract infections

Telemedicine is not for emergencies such as chest pain, abdominal pain or shortness of breath.

Doctor On Demand may treat members except children under the age of two for non-emergency health conditions. If needed, your physician may send a prescription to your pharmacy.

MDLIVE for Humana MAPD Essential and Premium Plans

KRS members who are enrolled in the Humana MAPD Essential and Premium plans: There is a $2.00 copay for each MDLIVE visit without having to meet the $500.00 medical deductible. Learn More About MDLIVE

New Medicare Cards are coming......

Watch this video

Medicare Eligible Members join Humana for an Open House

Everyone is invited - you don't have to be a Humana member to attend. Bring a Friend! 

Tuesday, February 13th 10am-4pm 

Location: 1918 Hikes Lane, Ste 101 in Louisville, Ky. 

 For more information call: 1-502-479-6583

If you are a Medicare eligible retiree covered by the Humana Medicare Plan -- if you have Part A, you may get IRS Form 1095-B from Medicare in the early part of the year. If you don't get Form 1095-B, don't worry. Not everyone will get this form from Medicare, and you don't need to have it to file your taxes.

Medicare Secondary Payer (MSP) Act 

NOTICE: Medicare Eligible Retirees currently working for an employer that provides health insurance. The Franklin Circuit Court recently denied a request to enjoin (prevent) Kentucky Retirement Systems from administering the Medicare Secondary Payer (MSP) Act. If you are Medicare eligible and currently working for an employer who offers health insurance, Kentucky Retirement Systems is PROHIBITED from providing coverage under the Humana Medicare Advantage Plan. Please refer to the "Group Medicare PPO 2018 Enrollment Guide" booklet page one for more information, which can also be located at:

You may also contact Kentucky Retirement Systems directly at (502) 696-8800 or toll free (800) 928-4646.

ATTENTION Medicare Eligible RETIREES :


Changes that may affect the cost of some of your prescriptions or supplies you need to meet your healthcare needs are coming to your prescription drug plan on January 1, 2018.


Every year, Humana reviews and updates their drug list.  This happens because prescribing guidelines are adjusted for medicines or supplies, new drugs become available, or other drugs are removed.

If you are a KRS retiree covered by the Humana prescription drug plan, you will soon receive a letter in the mail notifying you if you are impacted by these changes.  The changes may include the following:

1.  Covered prescriptions are grouped in different levels called "Tiers."  If you fill or refill a prescription for a medicine or supply that's moving to a different level, you may have to pay more or less.

2.  The drugs listed on your plan's drug list, or formulary, change every year.  If your medicine or supply is no longer on the formulary list, you'll have to pay the full cost.  For example, Humana will not cover the over the counter medications Claritin® or Zyrtec® in 2018.

3.  Your doctor may need to provide prior approval for your medicine before it's covered.

4.  You might need to try another drug first (step therapy) before your prescription or supply is filled.

5.  A different diabetic supplier may now be a preferred supplier.  If you switch, you will be provided a new meter at no cost.

The letter will also have a section that lists your personalized prescription information to help you understand how the changes will affect the medicine or supplies you are currently using.  Please use the letter to talk with your doctor to discuss what, if any, changes may need to be made to your healthcare needs.



If you have any questions, please visit the Humana website or call Humana before January 1, 2018 at 1-855-267-1935 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., and Saturday, 8 a.m. – 6 p.m., Eastern time.


2018 Changes
Member Costs20172018
Out of Pocket$1000$1200
  • Over the Counter (OTC) Drugs are no longer covered under the KRS Medicare Plan
    • Zyrtec and Claritin (no longer covered)
    • Cough and Cold (no longer covered)
    • Vitamins and Minerals (no longer covered)
    • Questions about what medicines are covered call Humana Customer Service @ 1-855-267-1935
  • 100% coverage for Diabetic Retinal Eye Exam
  • Preferred Diabetic Meters and Supplies : Roche Accu-Chek and True Metrix Air
  • Emergency Room and Urgent Care: 4% coinsurance up to a $65 maximum will not reduce the $500 deductible amount
  • Telemedicine : MDLIVE logo for Virtual Care Anywhere  MDLIVE
    • member cost share 4%
    • available 24 hrs a day/ 7 days a week


Hazardous Duty Retiree: Yearly Requirement

Hazardous duty retirees MUST submit a Form 6256  - Designation of Spouse and/or Dependent Child for Health Insurance Contribution. See FAQ's.  If you fail to submit the form by 12/31/2017 YOU WILL NOT RECEIVE PREMIUM CONTRIBUTIONS for your legal spouse or eligible dependents If you submit the form after Jan 1, you will only receive reimbursement of premiums for the 90 days prior to the receipt of the Form 6256  in Plan Year 2018. 

Example: If you submit the form June 3, 2018, you will receive reimbursement for March - May 2018

Note: The Humana Medicare Employer PPO plans (Essential, Premium) are Medicare Advantage plans.  You must have Medicare Parts A and B.  If you do not have Part B, your premium amount may be higher.  Please contact KRS if you have ​questions about this.  For example if you have 240 months (100%) of Service Credit-Contribution, elect the KRS Premium Plan, and do not have Medicare Part B, you would still have an additional premium payment of $77.70.​​​

2018 Medicare Plan Premiums/Percentage Contribution
Available PlansMonthly Premium
Medical Only$165.01
KRS Essential$75.56
KRS Premium$252.51

Note: The Essential Premium has been reduced for 2018.   The Premium Plan cost remains the same as 2017.

2018 What KRS Pays Towards Your Premiums/Percentage Contribution
Service Credit% of Contributions Rate Paid by KRSAmount Paid by KRS
240 months or more100%$252.51
180-239 months75%$189.38
120-179 months50%$126.26
48-119 months25%$63.13
0-47 months0%$0

Dollar Contribution Rates Plan Year 2018

Is your Participation Date After July 1, 2003? 

See the Dollar Contribution Rates Below. 

If you began participating on or after July 1, 2003, please read the information below. If you have additional questions call KRS at 1-800-928-4646(Toll Free) or 502-696-8800(Frankfort). 

Use this guide if you are receiving benefits, were Hired July 1, 2003 or later, and began Participating with KRS between August 1, 2004 and August 31, 2008.* Or began Participating with KRS on or after September 1, 2008.**

*In order to be eligible for health insurance benefits, you must have 120 months of service upon retirement.

**In order to be eligible for health insurance benefits, you must have 180 months of service upon retirement.

For service in a non-hazardous position, you will receive a monthly dollar contribution of $13.38 for each year of service per month. The Dollar Contribution will increase by 1.5% on July 1st.

i.e. if you began participating September 1, 2003 in a nonhazardous position, and retired effective October 1, 2013, you would receive $133.80 per month towards health insurance premiums.

For service in a hazardous position, you will receive a monthly contribution of $20.07 for each year of service per month. The Dollar Contribution will increase by 1.5% on July 1st.

i.e. if you began participating September 1, 2003 in a hazardous position, and retired effective October 1, 2013 you would receive $200.70 per month towards health insurance premiums. 

If you have hazardous and non-hazardous service, you will receive contribution based on the amount of full years of service for each.

i.e. if you began participating September 1, 2003 in a non-hazardous position until September 30, 2008 (5 years x $13.38 = $66.90), and then began participating October 1, 2008 in a hazardous position, and retired effective November 1, 2013 (5 years x $20.07 = $100.35), you will receive $167.25 per month towards health insurance premiums ($66.90 + $100.35 = $167.25).

If you have a partial year of hazardous service and a partial year of non-hazardous service, they can be combined to equal a full year, you will receive 1 year of non-hazardous service.

i.e. if you have 9 years and 6 months of non-hazardous service and 6 months of hazardous service, your insurance contribution will be based on 10 years of non-hazardous service. You will receive $133.80 per month towards health insurance premiums.

If you are receiving a monthly retirement benefit, that qualifies you to receive a Health Insurance Percentage contribution and also receiving a monthly retirement benefit that qualifies you to receive a Health Insurance Dollar contribution, please contact the Retirement office for help calculating your cost.

How to Calculate your insurance cost if your participation date is after 7/1/2003

Hazardous Formula:

Service Credit-Dollar Contribution Level Amount ($20.07*) X Years of Service = Amount KRS Pays

Hazardous Example:

$20.07* X 10 (let's say you have 10 years of service for this example) = $200.70

Non-Hazardous Formula:

Service Credit-Dollar Contribution Level Amount ($13.38**) X Years of Service = Amount KRS Pays

Non-Hazardous Example:

$13.38** X 10 (let's say you have 10 years of service for this example) = $133.80​

Medicare Secondary Payer

Please be advised that under the Medicare Secondary Payer (MSP) Act, in certain circumstances, a Medicare eligible retiree's reemployment with a participating agency of Kentucky Retirement Systems will PROHIBIT Kentucky Retirement Systems from offering or continuing to offer retiree coverage under the Humana Medicare Advantage Plan.  PLease call KRS if you have questions.  You should also contact Medicare if you have questions. Need more details click here

SilverSneakers LogoLearn more about Silver Sneakers 

Silver Sneakers can help you get fit the way you want by providing you access to fitness locations nationwide. Only retirees enrolled in the Medicare Advantage Essential or Premium plans may take advantage of the Silver Sneakers benefit.

Humana Guidance Center in Louisville

Guidance Centers are retail “store fronts” that provide the community access to wellness resources.  There is an on-site customer service representative that can answer customer service questions, as well as social and wellness programs such as exercise bingo, Zumba, iPad classes, healthy cooking demonstrations and many more activities throughout the month.  

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