Coverage and Benefits

Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.

IBM-sponsored group coverage includes both medical and prescription drug benefits. To participate in these plans, you must enroll in both the Group Medicare Advantage (MA) plan and the Group Prescription Drug Plan (PDP).

2027 Plan Updates:

See a high-level summary of key 2027 plan changes. Refer to your plan materials for complete benefit details.

Enhanced Plan

Medical

Quarterly over-the-counter item allowance will no longer be offered
Addition of a $100 Medical Deductible
Medical out-of-pocket increased to $1,000

Pharmacy

Deductible on Tiers 3, 4 and 5 increased to $450
Tier 5 cost share reduced to 28%

Essential Plan

Medical

Quarterly over-the-counter (OTC) item allowance will no longer be offered.
Medicare Part B premium credit of $25 per month will no longer be offered

Pharmacy

Deductible on tiers 3, 4 and 5 increased to $700
Tier 5 cost share reduced to 25%

Dental

No deductible
Maximum Benefit Amount is $500
Minor services coverage increased from 80% to 100%
Major services no longer covered

UnitedHealthcare® Group Medicare Advantage (PPO)

2027 Materials

Medical Plan Materials

Part D Plan Materials

As you prepare for 2027, review the Enhanced and Essential plan comparison below to understand your Medicare Advantage and Prescription Drug Plan options.

Already enrolled? Watch for your 2027 Annual Notice of Change (ANOC), which outlines any changes to your coverage for the upcoming year. Your ANOC will be mailed in November.

Have questions about your benefits? Use the Chat Now feature or call 1-877-852-0641 (TTY 711).

Plan options and costs
Medical Benefits and Costs	Enhanced UnitedHealthcare Medicare Advantage (PPO) Plan	Essential UnitedHealthcare Medicare Advantage (PPO) Plan
Enhanced UnitedHealthcare Medicare Advantage (PPO) Plan	Essential UnitedHealthcare Medicare Advantage (PPO) Plan
Annual medical deductible	$100	$0
Annual medical deductible
$100	$0
Annual out-of-pocket maximum	$1,000	$5,000
Annual out-of-pocket maximum
$1,000	$5,000
Premium information	2027 Subsidy	2027 Subsidy
Premium information
2027 Subsidy	2027 Subsidy
Office and clinic visits	$5 copay for primary $30 for specialist	$10 copay for primary $40 for specialist
Office and clinic visits
$5 copay for primary $30 for specialist	$10 copay for primary $40 for specialist
Hospital services (inpatient)	$250 copay per stay	$275 copay per day: days 1–5 $0 copay per day after that
Hospital services (inpatient)
$250 copay per stay	$275 copay per day: days 1–5 $0 copay per day after that
Hospital services (outpatient)	$100 copay	$275 copay
Hospital services (outpatient)
$100 copay	$275 copay

Plan options and costs
Part D Benefits and Costs	Enhanced UnitedHealthcare® MedicareRx (PDP)	Essential UnitedHealthcare® MedicareRx (PDP)
Enhanced UnitedHealthcare® MedicareRx (PDP)	Essential UnitedHealthcare® MedicareRx (PDP)
Annual prescription (Part D ) deductible	$0 for Tier 1 and Tier 2 $450 for Tier 3, Tier 4 and Tier 5	$0 for Tier 1 and Tier 2 $700 for Tier 3, Tier 4 and Tier 5
Annual prescription (Part D ) deductible
$0 for Tier 1 and Tier 2 $450 for Tier 3, Tier 4 and Tier 5	$0 for Tier 1 and Tier 2 $700 for Tier 3, Tier 4 and Tier 5
Prescription Drug	Tier 1: $0 copay, no deductible Tier 2: $8 copay, no deductible Tier 3: $40 copay, $450 deductible Tier 4: $90, $450 deductible Tier 5: 28% coinsurance, $450 deductible	Tier 1: $5 copay, no deductible Tier 2: $15 copay, no deductible Tier 3: $47 copay, $700 deductible Tier 4: $100, $700 deductible Tier 5: 25% coinsurance, $700 deductible
Prescription Drug
Tier 1: $0 copay, no deductible Tier 2: $8 copay, no deductible Tier 3: $40 copay, $450 deductible Tier 4: $90, $450 deductible Tier 5: 28% coinsurance, $450 deductible	Tier 1: $5 copay, no deductible Tier 2: $15 copay, no deductible Tier 3: $47 copay, $700 deductible Tier 4: $100, $700 deductible Tier 5: 25% coinsurance, $700 deductible
Premium information	2027 Subsidy	2027 Subsidy
Premium information
2027 Subsidy	2027 Subsidy

Understanding the 2027 IBM subsidy (pdf)

Understanding the IBM 2026 subsidy (pdf)

Questions about your IBM subsidy? Use the Chat Now feature, or call the IBM Retiree Call Center at 1-877-852-0641 (TTY 711).

Preventive services

The following preventive services are covered under your plan for a $0 copay when you visit your primary care provider:

Annual Wellness Exam
Annual Routine Physical
Screenings for certain Cancers (Prostate, colorectal, breast cancer)
Screening for diabetes
Smoking and Tobacco Use Cessation

Questions about these preventive services? Use the Chat Now feature or call the IBM Retiree Call Center at 1-877-852-0641 (TTY 711).

Disclaimer

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.