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President's Message

Senior Plan FAQs

If a procedure isn't covered by Medicare, will it be covered by GuideStone?
No, GuideStone Senior plans cover only Medicare-approved charges.  If a claim is not covered by Medicare, it will not be covered by GuideStone.
How do I know where I am in terms of the "coverage zones"?
You will receive a Prescription Benefit Update from Medco every month you have prescription drug claims.  This document helps you keep track of where you are in terms of the coverage zones, with a running total of your individual out-of-pocket as well as your total drug spend to date.
What are Medicare Secondary Payer rules (MSP)?

Special regulations determine how a private medical plan, like GuideStone’s plans, pays benefits in coordination with Medicare. These regulations are called Medicare Secondary Payer (MSP) rules and are based on employer size. In general:

  • If an employer has fewer than 20 employees over a certain time period, then the employer is considered exempt from MSP rules and Medicare pays benefits before GuideStone’s plans. In this case, Medicare is the ''primary'' payer of claims.
  • When Medicare is primary, employees on Medicare may enroll in one of GuideStone’s Care Plans. The Care Plus Plan and the Care Basic Plan both coordinate with Medicare coverage and also provide Part D prescription drug benefits.
  • If an employer has 20 or more employees over a certain time period, then the employer is not exempt and Medicare pays after GuideStone plans. In this case, Medicare is the ''secondary'' payer of claims.
  • When Medicare is secondary, employees on Medicare stay on GuideStone PPO Medical plans as long as they are actively working at this employer. Because GuideStone PPO benefits are paid before Medicare, the PPO health plans cost more than the Care Plans.
How can I find out how my drugs are covered on the Senior Care plans?
You can call GuideStone's dedicated line at Medco Health Solutions at 1-866-544-2976 or visit www.medco.com/medd/guidestone to find out how your drugs are covered under the Care plans.  You may ask questions about the formulary, copays and other useful drug information.
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