- CareFirst Member Claim Form
- CVS Mail Service Order Form
- CVS Reimbursement Claim Form
- Delta Dental Claim Form
- Davis Vision Claim Form
- Enrollment/Change Form
- Retiree Open Enrollment Dental Change Form
- Retiree Update Form to change name or address
- Retiree Beneficiary Update Form for Group Life Insurance
FCPS offers two dental plans administered by Delta Dental. One is a Standard plan with an annual limit of $1500 per person per plan year and one is a buy-up option plan with an annual limit of $2500 per person per plan year.
See Dental Plan Summary below for coverage details.
Retirees can change their dental plan from standard dental to buy-up during retiree open enrollment in October, change will be effective January 1st. To change dental plan level,complete the Retiree Open Enrollment change form found under the forms section.
FCPS offers group life insurance as a part of your retirement package.
The coverage is equal to your final yearly salary, capped at $50,000.
FCPS pays for the first $25,000 of your coverage. If you choose the maximum coverage allowed (over $25,000), see the rate chart below:
To change your beneficiary, please complete and submit the Retiree Beneficiary Update Form found under the forms section. Please contact Christine Hobble at 301-644-5052 to submit a life insurance claim.
FCPS retiree health plan includes both vision and prescription coverage. Your plan is on a calendar year basis January 1st through December 31st.
CareFirst Medical Plan (Non-Medicare Eligible Retirees)
BlueChoice Advantage offers in- and out-of-network coverage and no referral is needed to see a specialist. Please refer to the CareFirst and the Vision Plan Summary below for coverage details. Searching for provider call 1-866-386-2043 or visit www.carefirst.com/frederick
- CareFirst Non-Medicare Benefits-at-a-Glance
- CareFirst Non-Medicare Summary Details 2023
- CareFirst Retiree Summary Plan Description
Medicare Eligible Retirees
You must pay the Medicare Part B Annual Deductible of $226 as of 2023, (indexed annually), prior to CareFirst paying any of your medical bills. Medicare will pay first and then CareFirst will pay second. In most cases, the remaining balances should be paid by CareFirst if you are using in-network Medicare providers. To make sure that your Medicare bills are sent to CareFirst automatically, you can call CareFirst and request that a “crossover” form be placed on file on your behalf. This will assist in the claims processing for you.
As a retiree covered under the FCPS medical plans, your prescription drug plan is included in your coverage.
- Medicare enrollees: you will be enrolled in the SilverScript CVS Plan. The coverage offered through Silver Script is considered creditable coverage, meaning it is at least as good as the coverage offered through Medicare Part D.
CVS Caremark - Medicare Eligible Plan Highlights
- Non-Medicare: you will be enrolled in the CVS CareMark Plan. CVS uses a formulary list of generics and preferred medications to keep your prescription copays at the lowest cost possible. To see a complete list of the approved formulary medications, please review under your plan on the appropriate CVS website.
- Maintenance Choice Program - Mail Order Prescriptions – plan participants who take maintenance medications have the choice to purchase their 90-day supply from the mail order program or from a CVS/Pharmacy store and pay the same mail order copayment.
- Mandatory Generics – required when available as well as using the mandatory specialty pharmacy program or specialty prescription drugs.
To access forms that will allow you to change your address, your tax withholding, direct deposit information or your beneficiary, visit the Maryland State Retirement Agency or sign into your mySRPS account.
For phone access, your PIN is the 2 digit month and 2 digit year you retired.
For questions about your Pension payment, please contact the Retirement Agency.
To apply for Medicare, call, apply online, or visit your local Social Security Office.
Ste N 5340 Spectrum Dr
Frederick, MD 21703
1-866-331-7089 or 1-800-633-4227
Once you meet the criteria below you are required to enroll in Medicare Part A and Part B. Submit a copy of your Medicare card to FCPS Benefits Office.
- when you and/or your dependent attain age 65
- if you or your dependent are under 65, but receiving social security disability, you may be required to enroll in Medicare
To Apply for Social Security Benefits, call 1-866-331-7089 or visit their website.
OPEN ENROLLMENT: Retirees may add or remove a dependent or change their dental plan during Retiree Open Enrollment in October with the change effective January 1st.
LIFE EVENTS: Retirees may add or remove a dependent within 30 days of a qualifying life event. An enrollment form and supporting documentation must be received within 30 days of the qualifying life event.
Please note: once a Retiree waives coverage you cannot re-enroll at a later date.
Frederick County Senior Services
The Department of Senior Services is a wealth of information on a variety of resources.
Maryland Retired School Personnel Association
The Maryland Retired School Personnel Association, formerly Maryland Retired Teachers Association, represents 14,000 members in 24 local units throughout the state. It is the only organization in Maryland that works exclusively for retired school employees.
Frederick County Retired School Personnel Association
FCRSPA is the local chapter of MRSPA. The Association organizes social events, legislative events, and provides insurance updates and information.