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Independent Health Passport PPO
This health insurance plan is available to all Medicare-eligible retirees & their eligible dependents (who are enrolled in Medicare Part A and Part B). Retirees who are eligible for district health insurance are encouraged to review the chart below to determine their eligibility for enrollment in this health insurance plan.
Union Retirement Date Passport PPO Forever Blue BCSA Before 9/20/2017 Voluntary Ineligible BCSA On or after 9/20/2017 Ineligible Mandatory BEST Before 7/1/2021 Voluntary Ineligible BEST On or after 7/1/2021 Mandatory Ineligible BTF Regardless of retirement date Voluntary Ineligible Local 264 Cook Managers Before 7/1/2014 Voluntary Ineligible Local 264 Cook Managers On or after 7/1/2014 Ineligible Mandatory Local 264 Service Center Before 7/11/2012 Voluntary Ineligible Local 264 Service Center On or after 7/11/2012 Ineligible Mandatory Local 409 Before 12/21/22 Voluntary Ineligible Local 409 On or after 12/21/22 Mandatory Ineligible PCTEA Before 7/1/2012 Voluntary Ineligible PCTEA On or after 7/1/2012 Ineligible Mandatory The Passport PPO program includes several benefits. The chart below describes the benefits for those subscribers who live in the 8 counties of Western New York. For those who live outside of the area, your information is here.
Passport PPO
Annual Physical
$0 copay
Primary Doctor Visit
$5 copay
Specialist Doctor Visit
$15 copay
Hospital Inpatient
$0 copay
Diabetic Supplies
$0 copay
Dental
Eyewear
Hearing Aids
Provided by StartHearing® ($699/$999)
Free Silver Sneakers Membership
Passport PPO includes additional benefits that you will find valuable, including:
- Lab Services – Participation with all local labs, not just Quest Diagnostics.
- Prescription Coverage – Tier enhancements to many commonly-used prescriptions, including vaccines, along with less requirements for prior authorization or step therapy.
- Senior Savings Program – Get a $30 incentive reward just for doing your free Enhanced Annual Wellness Visit with your doctor.
- Receive a $10 reward for completing a Health Risk Assessment
- 3 Local Member Service Centers – Conveniently located and staffed with experienced RedShirts 5 days a week, year-round, to answer your questions and help you get the most from your health plan and your health care dollar.
Please call Member Services with medical or pharmacy benefit questions, or if you are in need of care management services or help in locating a provider, etc.
Independent Health Member Services
Phone: 716-250-4401
Toll-Free: 1-800-665-1502
(TTY: 711)
Enrollment
Retirees can choose to enroll in the Independent Health Passport PPO by completing the Medicare Advantage Form. Applications will be accepted any month during the year once a retiree has reached Medicare eligibility and is enrolled in Part A & Part B. Applications received by the 15th of the month, will be processed for the first day of the next month. Applications received by the Benefits office will be processed for the first day of the following month.
For example, applications received by June 15th will be processed for July 1st; applications received after June 15th will be processed for August 1st.
Should a retiree, or their eligible spouse/dependent, choose to return to a commercial benefit plan, they must take action during annual Open Enrollment, which is held in the month of November, and identify a plan that was available to them at the time of the retirement.
Please send the completed form to the BCSD Benefits Office by scanning or taking a picture via email: Benefits@buffaloschools.org
OR
Fax (716) 816-3587