Retiree Prescription Plan Changes

2022 Update on Retiree Prescription

As a result of the injunction granted by the court in Fitch vs. State of Maryland, there are no changes to the prescription coverage provided to Medicare eligible retirees in 2022.  Please see the 2022 Benefit Guide for retiree healthcare details and the State of Maryland Website for Rates and other retiree information.

Prior Updates

Update on September 20, 2019

The State of Maryland Department of Budget and Management (DBM) recently sent out a certified letter to eligible employees and retirees regarding the Retiree Prescription Program. Please read this letter carefully as it may impact the retiree prescription coverage you receive in the future based on your retirement date from the State.  Updates are posted to the DBM website as of 9/20/2019.

Update on April 24, 2019

The State of Maryland proposed changes to the retiree prescription program (as shown below under ‘2018 Retiree Prescription Communications’) that resulted in a court-ordered injunction. The State of Maryland was ordered to keep the current prescription program until the court case is settled.

The Department of Budget and Management (DBM) Employee Benefits Division recently issued an update regarding the proposed prescription changes.

“The Maryland General Assembly passed Senate Bill 946 in the 2019 Session. This bill provides the following in the event the outcome of Fitch v. State of Maryland is found in favor of the State. If the court rules in favor of the plaintiffs, retirees keep their current benefits.” Please note: According to DBM, the earliest these plans could take effect is January 1, 2023.

Senate Bill 946 Key Highlights:

​Maryland State Retiree Prescription Drug Coverage Program

  • Retired on or before 12/31/19
  • Must enroll in Medicare Part D
  • Reimbursement for out of pocket expenses over $1,500 for retiree only/$2,000 for retiree and family

Maryland State Retiree Catastrophic Prescription Drug Assistance Plan

  • Retirees who began State service on or before 6/30/11 and retired on or after 1/1/20
  • Must enroll in Medicare Part D
  • Reimbursement for out of pocket expenses once the individual reaches the catastrophic phase of Medicare Part D

Maryland State Retiree Life-Sustaining Prescription Drug Assistance Program

  • Applies automatically when the retiree is enrolled in either of the plans above
  • Certain prescriptions covered by State’s employee prescription drug plan and not covered by Medicare

2018 Retiree Prescription Communications

Update on October 11, 2018

“In response to the court order issued October 10, prescription drug coverage for Medicare-eligible retirees will extend beyond December 31, 2018.  This means impacted retirees DO NOT have to enroll in a Medicare Part D plan for 2019 and may continue the coverage they have now into 2019 and at the same premium they are paying now. Details will follow in a notice mailed to retirees‘ homes.” ~ Department of Budget & Management, October 11, 2018

Original Message:

The State of Maryland’s Department of Budget & Management (DBM) announced a change to retiree prescription drug coverage effective January 1, 2019.   This message applies to Medicare eligible retirees and medicare eligible dependents.   This does not impact active employees.

Effective January 1, 2019, State Medicare-eligible retirees will no longer receive prescription drug coverage under the State health plan, and will need to enroll in a Medicare Part D for prescription drug by then to ensure there is no gap in coverage.  Retirees’ dependents who have not yet reached Medicare eligibility will see no change; they will continue to be eligible for both prescription drug and health benefits until they reach Medicare eligibility. Active State employees who are Medicare-eligible, but are still working, will likewise see no change in prescription drug and health benefits.” 

Below are links with more information and resources regarding the initial announcement.  The Department of Budget & Management has been communicating directly with all current retirees and will be posting additional information to their site when it becomes available. 

Want to Provide Feedback to your Legislator?

To send your thoughts to your legislator regarding the Prescription Drug change, go to the following page and follow these instructions:

  1. Click on the words “Who represents me?”near the top right corner of the page.
  2. It will take you to a box to enter your address and zip, then click “find”.
  3. Click “Create Message” Type your message in the box and then click send. It’s that easy!

Original Proposed Highlights & Key Information

  • The retiree and dependents (if medicare eligible) must chose and enroll in a Medicare Part D program to begin on 1/1/2019
  • The State of Maryland Drug program will end for Medicare eligible retirees and their Medicare eligible dependents on December 31, 2018
  • Medicare eligible Retirees/dependents must enroll through Medicare between October 15th – December 7th for a January 1, 2019 effective date
  • The current drug plan through the State of Maryland is “Creditable Coverage” according to Medicare and is ending 12/31/2018
  • The Retiree/dependent will pay for Medicare Part D on their own
  • Premiums and Costs can be found on the Medicare Part D Website
  • Medicare eligible Retirees/dependents are encouraged to use the Medicare Plan Finder to assist with finding a Medicare Part D Plan (please be prepared to have list of the prescriptions you and/or dependents currently take)
  • Some Retirees may income qualify for “Extra Help” through Medicare to reduce drug costs
  • Gov. Hogan announced on 7/13/18 a one-year transition plan to reimburse all out-of-pocket pharmaceutical expenses for impacted retirees in excess of $1,500.

Resources for Retirees

Department of Budget & Management Website
Senate Bill 946
Medicare Part D Website
State Health Insurance Program (SHIP) – Medicare Help (Flyer)
State Health Insurance Program (SHIP) – Medicare Help (Local Offices)
Maryland Department of Aging
Transition Program Announcement announced 7/13/18 (archived)