Former Player Life Improvement Plan

 

Joint Replacement Program

The Joint Replacement Program is designed to assist all vested, former players in need of knee, hip or shoulder replacements by reimbursing eligible players up to $5,250 towards the cost of expenses associated with their joint replacement surgery. The program also assists players in gaining access to a nationwide network of excellent healthcare facilities and coordinated care. Additional resources may be available for a player without any means of acquiring health insurance coverage.

 

Joint Replacement Benefits

The Plan provides the Basic Benefit to any Eligible Player. If you are covered by Insurance, the Basic Benefit is the lesser of (i) $5,250 or (ii) your Coinsurance for health care items or services directly related to your surgery, such as your co-pays, provided the expense was incurred within one year of your surgery. If your surgery was performed before October 1, 2009, the $5,250 benefit was $5,000. If a player is not covered by insurance and does not have the means to pay for this surgery, he may qualify for financial assistance from the NFL Player Care Foundation. In that case, they will not bear any of the costs associated with the surgery as long as the surgery is at one of several specially designated facilities. In addition, most normal complications arising from surgery are covered in full, up to a maximum of $250,000.

To receive an application to the Player Care Foundation, please contact the NFL Player Care Foundation at (800) 635-4625 – prompt 1.

Who is eligible for the Program?

To be eligible for the Basic Benefit, you must be a Retired Player and an independent, Board Certified Orthopedic Surgeon or Rheumatologist must certify, on a form provided by the Plan, that surgery to replace your knee, hip, or shoulder is Medically Necessary. You must then send the certification, along with a completed application, to the Benefits Administrator to obtain confirmation that you are an Eligible Player. Effective November 1, 2010, if you apply for Joint Replacement Benefits after your surgery, the Benefits Administrator must receive the certification and completed application no later than 365 days after the date of the surgery.

What are the Benefits?

The Program will reimburse, or pay, the lesser of $5,250 or the coinsurance (if they are covered by insurance). Players are also entitled to special treatment on a VIP basis if they elect to have their surgery at one of the healthcare facilities designated by the NFL Former Player Life improvement Plan. You must then send the certification, along with a completed application, to the Benefits Administrator to obtain confirmation that you are an Eligible Player. Effective November 1, 2010, if you apply for Joint Replacement Benefits after your surgery, the Benefits Administrator must receive the certification and completed application no later than 365 days after the date of the surgery.

How do players apply?

Players must complete an application and a HIPAA authorization form. Also, they must have a Board Certified Orthopedist or Rheumatologist complete the form to certify that joint replacement surgery is medically necessary. Application materials are available by calling the NFL Player Care Foundation at (800) 635-4625 – prompt 1.

Where should Players have their surgery?

If players have insurance coverage or other financial resources, they may have their surgery anywhere they choose. However, the NFL Former Player Life Improvement Plan will grant access to a network of facilities throughout the country that are designated centers of excellence for joint replacements. If they choose one of these facilities, they will be treated as a VIP simply because they are retired NFL players. If a player qualifies for financial assistance from the NFL Player Care Foundation, surgery must be at one of the facilities designated by the NFL Former Player Life Improvement Plan. These facilities are located throughout the United States and players may choose where they will have their surgery.

Can Benefits be paid directly to a Provider?

Unless surgery is funded through the NFL Player Care Foundation, Benefits will only be paid to the Player.

Are Plan Benefits subject to an offset?

Generally yes. For example, the joint replacement benefits are secondary to any other plan or arrangement available to cover expenses related to surgery.

 

Joint Replacement Facilities

Broward General Medical Center
1600 South Andrews Avenue
Ft. Lauderdale, FL 33316
www.browardhealth.org

Centinela Freeman Regional Medical Center
4650 Lincoln Blvd.
Marina del Rey, CA 90292
www.centinelafreeman.com/Marina

Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
www.clevelandclinic.org

Georgetown University Hospital
3800 Reservoir Road
Washington, DC 20007
www.georgetownuniversityhospital.org

Good Samaritan Hospital/Arthritis Institute
1225 Wilshire Boulevard
Los Angeles, CA 90017
www.goodsam.org

The Methodist Hospital
6565 Fannin Street
Houston, TX 77030
www.methodisthealth.com

Mount Sinai Medical Center
1190 Fifth Avenue
New York, NY 10029
www.mountsinai.org

Northwestern Memorial Hospital
251 East Huron
Chicago, IL 60611
www.nmh.org

Stanford Hospital
300 Pasteur Drive
Stanford, CA 94305
www.stanfordhospital.com

Texas Orthopedic Hospital/Fondren Orthopedic Group
7401 South Main Street
Houston, TX 77030
www.texasorthopedic.com

Union Memorial Hospital
201 East University Parkway
Baltimore, MD 21218
www.unionmemorial.org

University of Pittsburgh Medical Center
200 Lothrop Street
Pittsburgh, PA 15213
www.presbyterian.upmc.com

HCR Manor Care (rehab and physical therapy)
Nationwide
www.hcr-manorcare.com

 

Medicare Supplement

The NFL Former Player Life Improvement Plan currently pays $120 per month towards the premium for coverage under a Medicare supplement program and this amount increases to $140 on April 1, 2014. This benefit is available to any player vested in a retirement benefit under the Bert Bell/Pete Rozelle NFL Player Retirement Plan who is age 65 or older and who also has both Medicare Parts A and B coverage.

To obtain this benefit, a Player must enroll in one of the selected AARP Medicare Supplement Plan choices, underwritten by United HealthCare Insurance Company. Information regarding the available options is sent to an eligible Player shortly before his 65th birthday.

Who is eligible?

A Player is eligible for benefits if he is (1) vested under the Bert Bell/Pete Rozelle NFL Player Retirement Plan, (2) at least age 65 and (3) covered by Medicare Parts A and B.

What are the benefits?

The Plan will pay $120 per month toward the cost of an eligible AARP Medicare Supplement Insurance plan underwritten by United HealthCare. The Plan will pay this monthly subsidy directly to United HealthCare and the Player will be billed for any remaining balance due.

What are the Medicare Supplement plan choices?

Retirees in most states have a choice of up to 12 standardized Medicare supplement plans. The plans offer varying levels of benefits and costs.

Can spouses be covered?

A player may elect coverage for his wife, but he must pay the required premium. The $120 monthly subsidy is not available for this coverage.

 Are prescription drug plans covered?

A player may choose to enroll in a prescription drug plan, but he must pay the required premium. The $120 monthly subsidy is not available for his coverage.

Must players be members of AARP to receive the subsidy?

Yes, AARP membership is required to enroll in one of the AARP Medicare Supplement Insurance plans. If a player is not already a member of AARP, United HealthCare will pay the fee for the first year of membership. In future years, the Player will be billed by AARP for the annual membership fee (currently $16).

How do players enroll?

Players will be sent personalized enrollment kits that explain the benefits in greater detail. In addition, players may speak with a Customer Service Representative to ask questions and to enroll.

How do players contact Customer Service Representative?

For Medicare supplement questions, a player should call (800) 545-1797 (TTY 1-877-730-4192) and identify himself as a retiree of the NFL. Customer Service Representatives are available Monday-Friday, 7:00am-11:00pm ET and Saturday, 9:00am-5:00pm ET.

For Medicare Part D (prescription drug) questions, a player may call (800) 545-1797 (TTY 1- 877-730-4192), 24 hours a day, 7 days per week.

 

Vested Inactive Life Insurance

The Life Insurance Benefit is available to all vested, inactive players who have not yet reached age 55 and have not yet retired under the Bert Bell/Pete Rozelle NFL Player Retirement Plan. Each eligible player has term life insurance in an amount equal to $20,000 plus $2,000 for each Credited Season in excess of the eligible player’s vesting number, up to a maximum of 15. The maximum Life Insurance Benefit is $50,000.

Benefits are paid in a single lump sum to the Player’s beneficiary, who must file a claim with the Life Insurer, currently the Hartford.

Who is eligible for the Program?

Players are eligible for benefits if they are vested under the Bert Bell/Pete Rozelle NFL Player Retirement Plan. Coverage begins when they are no longer eligible for life insurance coverage under the NFL Player Insurance Plan and continues until the earlier of (a) he begins his pension benefits under the Retirement Plan or (b) he reaches normal retirement age under the Retirement plan (55 years).

How much is a player’s life insurance?

The amount of his life insurance is equal to $20,000, plus $2,000 for each Credited Season in excess of four (three if his last credited season was after 1992). The maximum benefit is $50,000.

Can a player get life insurance for his wife?

No. This benefit only covers former NFL players.

Can players name a beneficiary?

Yes. If a player is married at the time of his death, his wife is his beneficiary. He can always name a specific person as his beneficiary by completing the beneficiary designation form.

To learn more, please contact the Benefits Administrator at 800-635-GOAL (800-635-4625), prompt 1.

 

Neurological Care Program

The Neurological Benefit makes available neurological specialists at six medical centers to evaluate and treat possible neurological conditions among retired players. The program will assist players with coordinated care at excellent healthcare facilities nationwide. Each center will have available to retired NFL players a team of specialists, led by a neurologist who will serve as a program director. Eligible players who cannot afford treatment may apply to the NFL Player Care Foundation for a grant help with the costs of treatment.

For former players receiving health insurance benefits through the NFL Player Insurance Plan, the cost of medical care, medical services, or medical supplies approved by the hospital’s lead physician will be paid at 100%, with no out-of-pocket cost to the player.

Who is eligible for the Program?

Players are eligible if they are former NFL players vested under the Bert Bell/Pete Rozelle NFL Player Retirement Plan.

What are the benefits?

The Program provides facilitated access, comprehensive evaluation and possible treatment at five top-tier medical centers recognized for their expertise in spine care. Each of the medical facilities has a dedicated orthopedic team led by a spine surgeon to service eligible players.

The six medical facilities are:

  •  Mt. Sinai Medical Center, New York, NY
  • Emory Spine Center, Atlanta, GA
  • Tulane University, New Orleans, LA
  • Washington University Medical Center, St. Louis, MO
  • University of California Medical Center, San Francisco, CA
  • University of California Medical Center, Los Angeles, CA

The Program does not provide any funding. However, financial assistance for players may be available to players who qualify for charitable grants through the NFL Player Care Foundation. Further information on the Player Care Foundation is available on this site or you may call the Foundation at 1-800-635-4625.

How do Players apply?

Players interested in the program should contact the medical facilities directly through one of the contacts below:

Mt. Sinai Medical Center, New York, NY
Dr. Andrew Hecht
212-241-0735

Tulane University, New Orleans, LA
Dr. Gregory Stewart / Dr. Roger Kelley
504-988-8476

Washington University Medical Center, St. Louis, MO
Dr. David Brody
314-362-1381

University of California Medical Center, San Francisco, CA
Dr. Mitchel Berger
415-353-3933

University of California Medical Center, Los Angeles, CA
Dr. Christopher Giza
310-825-6196

 

Spine Treatment Program

The Spine Treatment Benefit makes available spine specialists at five hospitals across the country to evaluate and treat spine-related conditions among retired players. The benefit will assist players with coordinated care at excellent healthcare facilities nationwide. Each hospital provides an orthopedic spine surgeon who serves as a program director and coordinates the services of a time of healthcare professionals in the evaluation and, if warranted, treatment of eligible former players. The team includes a neurosurgeon and a physiatrist. Eligible players who cannot afford treatment may apply to the NFL Player Care Foundation for a grant to help with the costs of treatment.

For former players receiving health insurance benefits through the NFL Player Insurance Plan, the cost of medical care, medical services, or medical supplies approved by the hospital’s lead physician will be paid at 100%, with no out-of-pocket cost to the player.

Who is eligible for the Program?

Players are eligible if they are former NFL players vested under the Bert Bell/Pete Rozelle NFL Player Retirement Plan.

What are the benefits?

The Program provides facilitated access, comprehensive evaluation and possible treatment at five top-tier medical centers recognized for their expertise in spine care. Each of the medical facilities has a dedicated orthopedic team led by a spine surgeon to service eligible players.

The five medical facilities are:

  • Mt. Sinai Medical Center, New York, NY
  • Emory Spine Center, Atlanta, GA
  • Washington University Medical Center, St. Louis, MO
  • University of California Medical Center, San Francisco, CA
  • University of California Medical Center, Los Angeles, CA

The Program does not provide any funding. However, financial assistance for players may be available to players who qualify for charitable grants through the NFL Player Care Foundation. Further information on the Player Care Foundation is available on this site or you may call the Foundation at 1-800-635-4625.

How do Players apply?

Players interested in the program should contact the medical facilities directly through one of the contacts below:

Mt. Sinai Medical Center, New York, NY
Dr. Andrew Hecht
212-241-0735

Emory Spine Center, Atlanta, GA
Dr. John Heller
404-778-7000

Washington University Medical Center, St. Louis, MO
Dr. Daniel Riew
314-747-2565

University of California Medical Center, San Francisco, CA
Dr. Robert Tay
415-353-2840

University of California Medical Center, Los Angeles, CA
Dr. Jeffrey Wang
310-319-3334

 

Discount Prescription Drug Card

Eligible former players and their dependents are offered a Discount Prescription Drug Card which provides for discounts on prescription medication at over 57,000 pharmacies participating in Cigna’s network, including all major chains.

How do players find a participating retail pharmacy?

The discount prescription card is accepted at over 57,000 retail pharmacies nationwide, including all major chains. A player can ask his local pharmacy if they participate or call toll free 800-622-5579 to find out if a specific pharmacy participates in the program. Players may also log onto www.myCigna.com to access information about participating pharmacies.

How is this Program different from traditional prescription insurance?

This Program is not insurance, it is a discount prescription program. The card provides immediate discounts at the pharmacy. A player can present his card at the pharmacy and will pay the lower of the discounted price or the pharmacy’s regular retail price. There are no claim forms to complete and no limit to the number of times he can use the card. These discounts are available only at participating retail pharmacies.

If a player currently has insurance with a prescription drug card, can he use his discount prescription card with his current insurance benefit to reduce his costs?

No, he cannot use his discount card in conjunction with other insurance, including Medicare. However, he is able to use his card to purchase prescriptions that are not covered by his other insurance plan(s).

How much will he save?

Savings on each prescription may vary. The discounted price he receives will depend on the medication, whether it is brand or generic and the pharmacy from where he purchases the medication. Savings are generally much greater on generic medications and may be as much as 70%.

Does a player have to choose between discount prescription cards and the Wal-Mart $4 generic option?

No, he should always present his discount prescription card at a participating pharmacy, including Wal-Mart. He will receive the lowest price available from the pharmacy for that prescription medicine on that day. He will receive the $4 price at Wal-Mart when it is lower than the price using the discount prescription card.

To learn more, please contact the Benefits Administrator at 800-635-GOAL (800-635-4625), prompt 1.

 

Assisted Living Facilities

Who is eligible for the Program?

Players are eligible if they are vested under the Bert Bell/Pete Rozelle NFL Player Retirement Plan.

What are the Benefits?

Brookdale and Silverado have agreed to grant priority access to eligible players. Often that means he will not have to wait to move into a community of his choice. In addition, there are discounts that vary by provider. For specific information, please contact the provider directly.

How does a player get the Benefits?

He can take advantage of these benefits by identifying himself as a vested NFL Player if he contacts the assisted living provider directly. 

Players interested in assisted living facilities should contact them directly:

Brookdale Senior Living (Preferred Provider)
(500 communities in 37 states)
www.brookdaleliving.com
(866) 785-9025

Silverado Senior Living
(Locations in Arizona, California, Texas and Utah)
www.silveradosenior.com
(888) 328-5400