Coverage, Benefits & Star Ratings

Your plan information

The following tools and references can help you manage your employer or group sponsored Medicare Plan. Since retiree plans vary, it’s important to review the information from your former employer, group sponsor or us.

2020

2020 benefits

2020 FCPS Plan Benefit Summary

2020 Cover Letter

2020 Annual Notice of Change (ANOC)

2020 Schedule of Cost Sharing (SOC)

2020 Evidence of Coverage (EOC)

2020 Plan Handbook

2020 FAQ

Star Ratings

Each year, Medicare rates health and prescription drug plans on a five–star quality rating system. The Star Ratings measure Medicare Advantage plans based on five areas:

Staying healthy
Managing chronic (long-term) conditions
Member experience with the health plan
Member complaints
Health plan customer service

If you're enrolled in the Fairfax County Public Schools Aetna Medicare Advantage plan, your plan is rated 4.5 out of 5 overall stars!

2020 Star Rating

About your pharmacy plan

Fairfax County Public Schools has chosen SilverScript®, an affiliate of CVS Caremark®, to provide your Medicare Part D prescription drug coverage. SilverScript is an approved Medicare Part D prescription drug plan provider.
Learn more about SilverScript

Learn more about vaccine coverage

Vaccine coverage

Information for your doctor

For your doctor flyer

24/7 access to board-certified doctors

Teladoc telemedicine is a 24/7 service that allows you to speak to a licensed doctor by web, phone or mobile app — usually within 15 minutes.

You’ll need to register for the service. After you’ve registered, you can schedule a session with a doctor. You can get more information or set up your account at Teladoc or call 1-855-835-2362 (TTY: 711), 7 days a week, 24 hours a day.

You’ll just have to request a visit. You can use Teladoc for non-emergency conditions like allergies, sinus infection, rash, cold or flu.

If you need emergency care, call 911 or go to the nearest emergency room immediately.

Cost and quality of care

Learn more about quality and cost of care on our secure member site.
Log on to the secure member website

Referrals & prior authorizations

Looking for referral and pre-approval requirements?
Check your plan’s Evidence of Coverage.

Check your claims

Review your claim and payment status

Flu shot coverage

Protect yourself from the flu.
Learn about your flu shot benefit

Medicare coverage changes

The Centers for Medicare & Medicaid Services periodically issues National Coverage Determinations. They issue these when a service’s or drug’s coverage rules change.

View a list of coverage determinations

Coverage during a disaster or emergency

We want to make sure you can access your benefits even during urgent situations - like a public health emergency or state of disaster.
Finding care during a disaster or emergency

How we decide which health care services to cover

We help you get medically necessary health care services in the most cost-effective way under your health plan. And we work with you and doctors to evaluate services for medical appropriateness, timeliness and cost.

Specifically, we:

Base our decisions on appropriateness of care, service and plan coverage
Use nationally recognized guidelines and resources to make changes
Don’t pay or reward providers, employees or others for denying coverage or care
Focus on reviewing the risks of members who aren’t fully using certain services

How we review new technologies

Doctors and health care companies continuously develop new technologies. This can include anything from a new procedure to a new way to use a device.

When we learn about a new technology, we:

Carefully review the latest information and ask experts for their opinions
Compare the information with well-known standards
Base all of our decisions on making sure you have the right care and services

Husband and wife riding a ski lift up the mountain

Your plan information

2020

2020 benefits

2020 FCPS Plan Benefit Summary

2020 Cover Letter

2020 Annual Notice of Change (ANOC)

2020 Schedule of Cost Sharing (SOC)

2020 Evidence of Coverage (EOC)

2020 Plan Handbook

2020 FAQ

Star Ratings

About your pharmacy plan

Learn more about vaccine coverage

Information for your doctor

24/7 access to board-certified doctors

Cost and quality of care

Referrals & prior authorizations

Check your claims

Flu shot coverage

Medicare coverage changes

Coverage during a disaster or emergency

How we decide which health care services to cover

How we review new technologies

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