What is the difference between RMIP and RMBP?
The Retiree Medical Insurance Plan (RMIP) is the WBG health insurance plan for international staff and staff retiring from headquarters. The Retiree Medical Benefits Plan (RMBP) is the health insurance plan offered by WBG to former staff recruited locally in country offices.
How is RMIP administered?
WBG contracts out administration of medical insurance plans to specific insurance administrators (vendors) who only execute the WBG plans, and have no financial interest related to approving or denying claims. Currently, the vendors are as follows:
- Medical: AETNA for members residing in the U.S. and members residing overseas who chose to enroll with AETNA. Once a member enrolls in Medicare, it becomes the primary insurer and AETNA secondary.
- Dental: CIGNA Dental for members in the U.S.A., who are covered by Aetna medical.
- Prescription Drug Coverage: CVS/Caremark for medications purchased in the U.S. SilverScript covers members who are Medicare D eligible. If the member purchases medications outside the U.S., reimbursement will be made by the medical vendor.
- CIGNA International administers medical, dental and prescription drug coverage for members with a non-U.S. pension address. For members residing outside the U.S. and under CIGNA International, once they enroll in their respective National Health Plan (NHP), it becomes the primary insurer and CIGNA International the secondary.
What are the benefits covered by RMIP?
- RMIP is a comprehensive health insurance plan offered by the World Bank Group (WBG) for former Headquarters (HQ) staff and their eligible dependents.
- For details, see the RMIP Summary Plan Description.
How can I find information about the specific insurance vendors under RMIP?
The websites of the vendors are very good sources of information about the benefits that RMIP offers, limitations, claim processes, status of claims, etc.
What if I have problems with my insurance claims?
- Contact the Customer Service for the vendor listed on the back of your member card. All vendors maintain special customer service representatives who are knowledgeable about RMIP and/or have access to the relevant information.
- However, if you’re not satisfied with the response, contact HR at firstname.lastname@example.org including details and a copy of the complaint/dispute.
- If issues remain, send an email to email@example.com with the subject line, Attn: Chair, Health Insurance Committee.
What about direct deposits?
- For WBG retirees, AETNA provides direct deposits to your bank account in the U.S. if you are enrolled in direct deposit.
- CIGNA Dental reimburses your payment by sending a check through the mail.
- CIGNA International reimburses payments by direct deposit in some countries or by check in other countries.
- Procedures for obtaining direct deposits are on the vendors website or you can call Customer Service of the vendor to get details.
Where do I get ID cards for the vendors?
The respective vendors, including Medicare, issue all ID cards. If you have not received your card, contact the respective provider.
What is Medicare?
Medicare is the U.S. health insurance program for people age 65 or older and younger people receiving Social Security disability benefits. The program helps with the cost of health care, but it doesn’t cover all medical expenses.
Do I have to join a National Health Plan (NHP), e.g., Medicare, when I retire?
- Yes, under RMIP rules, retirees and their dependents are required to enroll in the National Health Plan (NHP) of the resident country registered with Pension (PEN), if they are eligible as a national of that country. In the U.S., Medicare is the National Health Plan and enrollment is required for all eligible retirees and their spouse/partner who is eligible for Medicare in the RMIP.
- An eligible retiree/spouse/partner is required to enroll in Medicare B (always comes with a premium) and only in Medicare A if (s)he is eligible to enroll premium-free. Premium-free Medicare A is only available for individuals who have contributed at least 40 quarters to Social Security.
- Note that a spouse or partner who is eligible for Medicare needs to enroll in Medicare even if the former staff member is not yet eligible. This is important to avoid Medicare late enrollment penalties.
- See all relevant Medicare details and FAQs provided by HR. The information explains where to apply for Medicare, how claims are submitted, and how premiums are reimbursed by WBG.
When must I apply for Medicare?
RMIP members who are turning 65 and are eligible for Medicare (U.S. citizens and U.S. Green Card holders who have been living in the U.S. for the past five years, even if part of those years were in G4 status) are required to apply for Medicare up to three months before or three months after their 65th birthday.
I’m a Green Card holder and can’t complete Medicare enrollment online, unlike U.S. citizens. What do I do?
Arrange for an interview with Social Security. Bring a letter from HR confirming retiree eligibility for Social Security.
Do I need to inform anybody after enrollment in Medicare?
- Notify your medical care providers, and pharmacy as soon as you enroll in Medicare and have your card (or membership number) as their billing approach will change. Medical care providers will file with Medicare and pharmacies with SilverScript.
- Also inform AETNA so they can set up direct coordination with Medicare. Providers will bill Medicare who will coordinate with AETNA. Normally, this works automatically, and you do not need to intervene. Medicare and AETNA will inform you separately about what they do (not) pay and what you might have to pay yourself.
What if my doctor does not participate in Medicare?
Ask your doctor to provide you an opt-out letter, which you must include when you file a claim with AETNA for reimbursement. Doctor’s offices are familiar with the opt-out letter requirement.
I am on Medicare and just had surgery. I need physical therapy, but the provider does not deal with insurance. What do I need to do to get reimbursed?
- Note that since the provider does not deal with insurance, you are likely to be charged at a higher rate than what Medicare or Aetna allow and you are probably paying more out of pocket.
- First, submit Patient’s Request for Medical Payment Form (CMS 1490S) along with physician’s referral requisition for physical therapy services and copy(s) of paid invoices for service
- Once you receive approval/rejection from Medicare, send to MIP Claims (Aetna) the following documents:
- Completed World Bank Claim for Hospital and Other Medical Expenses
- Copy of Invoice(s) for physical therapy services showing paid in full or proof of payment
- Medicare approval/rejection of the claims
- Physician’s Referral Requisitions for Physical Therapy Services
What is SilverScript (Medicare Part D) and how do I apply for it?
- The WBG sponsors a Medicare Part D plan combined with additional coverage to mirror the current WBG prescription drug plan for staff. The pharmacy vendor for HQ-based staff is CVS/Caremark.
- For retirees eligible for U.S. Medicare, a Medicare Part D plan is also offered through SilverScript which is an affiliate of CVS/Caremark.
- You do not need to enroll in Medicare Part D; the WBG automatically enrolls you if you are eligible. Medicare requires that you be given the choice to opt out of the plan. However, if you are eligible for Part D and you choose to opt out, you will lose your prescription drug coverage under RMIP.
Will I be reimbursed for the cost of NHP/Medicare?
- The Medicare B and D premiums are reimbursed by WBG.
- A premium reduction under RMIP may be available to members who permanently reside outside of the U.S. and who enroll in the national health plan of their country of permanent residence. See more information on the Retirees Page on the WBG External Web.
I am about to turn 65 or am already participating in Medicare and I get mail which offers additional insurance plans. Do I need to sign up for those?
- U.S. citizens and permanent residents are required to sign up for Medicare B and through HR for Medicare D (Silver Script).
- Retirees who are eligible to receive Medicare A without paying a premium are expected to sign up for this and will benefit from using that option.
- But there is no need to sign up for so-called ‘Medicare Advantage’ plans which are commercial additional insurance for items already covered by RMIP and Medicare.
I just received a letter from the U.S. SSA announcing higher premiums for Medicare Part B and D due to Income-related Monthly Adjustment Amounts (IRMAA) for next year. What do I need to do?
Submit Form F00032 Retiree MIP Medicare Reimbursements to HR Operations with a copy of all the letters that SSA sent you which specify the Medicare IRMAA Parts B and D you owe for the period for which reimbursement is claimed. If no SSA letter is available, attach Medicare premium invoice.
I’m a Medicare enrollee who pays the standard Part B premium. Do I have to do anything if there is a rate increase?
No, you don’t need to take any action because your premium reimbursement will be automatically updated.
I’m a U.S. citizen and Medicare enrollee whose Medicare premium is deducted directly from my social security payments. Do I need to do anything if there is a rate increase?
- Yes, Medicare enrollees who pay their Medicare premiums via a deductible from their Social Security benefit check are required to submit proof of their 2022 Medical Part B premium amounts to HR Operations along with Form F00032.
- Until you submit the updated 2022 premium information to HR Operations you will only receive an initial reimbursement of the previous year’s standard reimbursement amount per person.
I retired from a country office. What is the Retiree Medical Benefits Plan (RMBP) and what are its benefits?
Where can I find more Information about RMIP and RMBP ?
Details of medical insurance benefits for both Headquarters and Country Office retirees, forms for medical and dental claims, enrollment in national health plans and reporting life events, and additional resources are described on the Retirees Page on the WBG External Web.