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Retiree H&W -
Filing a Claim for Benefits
Retirees
With Medicare
If you are covered by Medicare it is your
primary insurance and will be billed directly by your
provider. Once your provider
receives payment from Medicare, they may submit the remainder
of the bill, along with an explanation of benefits from
Medicare, to the Alaska Electrical Health & Welfare Plan for
payment.
If your provider does not bill secondary
insurance, you will need to submit a copy of the Medicare
explanation of benefits, along with a copy of the original
receipt, to the Trust Offices. You may submit a copy
of your receipt immediately after your doctor's appointment and
the Trust Office will hold the claim until you submit the
Medicare explanation of
benefits.
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Assigning
Benefits (No Medicare)
Many health care providers will bill the Plan for you for
the services you receive. This is referred to as
"assignment of benefits." Most providers will want to
see and/or photocopy your insurance card. (If you need
a card, please call the Trust Offices.) From the
insurance card they will obtain the participant's name
and Employee ID number, and the address for claims to be submitted.
The provider will usually ask for you to pay the deductible
and any non-covered expenses at the time of service. The
provider will send the bill to the Trust Office for payment.
When the Trust Office pays the provider, you will receive an
Explanation of Benefit (EOB) in the mail. Please review
the EOB to ensure that the services you received were properly
billed and paid for.
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Getting
Reimbursed for Medical Bills You Have Paid (Unassigned
Benefits - No Medicare)
If your health care provider does not bill insurance, be sure
to get a complete itemized statement that includes:
-
Date of service
-
Medical codes
-
Diagnosis codes
-
Signature of the
provider
-
Participant's
ID number
-
Participant's
name and Date of Birth
-
Notation that
payment has been received or a receipt
The Plan can not
reimburse you from any receipt that does not include this
information. You may submit the bill to the Trust
Offices for reimbursement via fax, mail, or in person. A
reimbursement check will be mailed directly to you when the
claim is processed.
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Filing an
Annual Medical/Dental Claim Form for the Patient
For prompt processing of your claim, make sure that the
patient has an updated
Annual Medical/Dental Claim Form filed with the Trust
Offices. This form must be updated at least once every
twelve months or whenever the information changes, such as a
change in your spouse's insurance.
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Submitting
Your Claim
Mail or fax your completed claim form(s) to the Trust Offices
as listed below:
Fax:
(907) 278-7576
Mail: Alaska Electrical Trust Funds
Attn: Medical
701
E. Tudor Suite 200
Anchorage, AK 99503
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