UC Medicare Choice presentation

University of CA – Transition to Medicare presentation transcript.

Hello everyone and welcome to the 2022 education presentation for future UC Medicare choice plan members. My name is Daniel Godfrey Client Service Manager for UnitedHealthcare dedicated to the University of CA. Thank you for taking time to attend this Webinar/Teleconference as we will discuss UC Medicare Choice and eligibility along with the specific benefits and features of UC Medicare choice. Let’s begin..

Slide 2

This presentation will provide an overview of UC Medicare choice eligibility and enrollment, original Medicare basics,  Details about UC Medicare choice benefits, programs, and features; and what you can expect next.

Slide 3

What do you need to know in order to enroll in UC Medicare Choice?

Slide 4

The first thing you need to know are the eligibility “RULES” to enroll in UC Medicare choice. To start – You must be retired or retiring and no longer employed with the University. Secondly, you are a UC Retiree eligible for Health Benefits (meaning you did not take the lump Sum cash option). Thirdly, UC Medicare choice is only available to those retirees living in CA. If you live outside of CA or planning to move out of CA-please contact RASC to understand your coverage options. Lastly- You must be enrolled in, or eligible for Medicare to be enrolled in UC Medicare choice. If you are covering non-Medicare family members at the time of your enrollment into UC Medicare choice, they will need to either remain in or be enrolled in the UC Blue and Gold partner plan.

Slide 5

We understand that eligibility rules can be complicated, and everyone's circumstance is not the same. Whether you are planning to retire this year, or you are retired and new to Medicare all together and or just trying to understand your options, we are here to help it all make sense. 

So lets take a moment to review some important eligibility conditions to keep in mind when enrolling in UC Medicare choice.

1. If you are an active employee planning to retire this year and turning 65 years old or older, you must a member of the HSP or UC B&G plan in order to be eligible for UC Medicare choice plan coverage.  You need to complete the required UC medical forms during your retirement process.  If you are member of another UC medical plan such as UC Care, Core or Kaiser, then you will need to participate in this year’s Open Enrollment to enroll in UC Medicare Choice to take effect January 1 of next year.
2. If you are a Medicare eligible Retiree turning 65, living in CA and currently a member of the UC HSP or UC B&G, then all you need to do is to complete the required UC form, UBEN 121 within 90 days of your 65^th birthday.  However if you are a member of another UC medical plan such as UC Care, Core or Kaiser, then you need to participate in this year’s Open Enrollment in order to enroll in UC Medicare plan choice to take effect January 1 of next year.
3. Medicare retirees living in CA and are members of another UC Medicare plan have the option to enroll in UC Medicare choice during UC Open Enrollment period.  Simply complete and submit the required UC medical forms designating UC Medicare choice as your Medicare plan.
4. If you are Medicare retiree living outside of CA, you need participant in this year’s Open Enrollment after your move back to CA.  UC Medicare choice is only available to eligible UC retirees and their Medicare eligible dependents living in CA

Please keep in mind that the Health Savings Plan (HSP) is not an option for new retirees (the UC Blue & Gold is).  In other words, you must be enrolled in the HSP before you retire to continue in the HSP.

Slide 6

Let's take a  moment to review the ABC of Enrolling in UC Medicare Choice

A- Apply to Medicare – You can apply to Medicare by calling social security directly or by going online to the social security website to enroll.

B- Bring up to date contact information with UC. Its very important that UC has your most up to date contact information so that they can contact you if needed during your enrollment period.

C- complete the UBEN 121 form for Medicare Advantage Enrollment for UC Medicare choice. If you are changing from the UC HSP plan, you must also complete a UBEN 100.  Forms are available on UCnet and must be completed before your Medicare coverage will be effective.

D- Non Medicare dependents like spouses, children who are not Medicare Eligible must enroll in UC Blue and Gold, partner plan to UC Medicare Choice.  Contact RASC for details.

E- Establish UCRAYS Account- UC Retirement At Your Service or (UCRAYS) is an easy and convenient way to Update your contact information and preference, Add a beneficiary, View or adjust your tax withholding, and Verify your pension income and many more functions

Slide 7

Here is what you need to know if you are new Medicare.

Step 1 take a moment to Review all UC Medicare materials that you receive. The materials will be sent to you in the mail 3 months before your 65^th birthday. Also, Be sure to contact social security to enroll in Medicare Parts A & B along with completing the UBEN 121. You can complete the UBEN121 online at UCRAYS or the paper form.

Step 2- You will receive a UC Medicare choice plan guide before you turn 65. A new ID card and quick start guide will also be sent to you After UnitedHealthcare has processed your enrollment.

Finally Happy Birthday- You can start using UC Medicare Choice plan benefits on your effective date.

Slide 8

Now let’s take a moment to review Original Medicare Basics.

Slide 9

You become eligible for Original Medicare parts A & B when you reach age 65 and you worked full time for at least 10 years and contributed to social security. Some people qualify for Original Medicare prior to the age of 65 because of a disability or another special situation. You also must be a US citizen or a legal resident who has lived in the United States for at least 5 consecutive years.  There are also circumstances you may be eligible under your spouse, or deceased spouse's work record when they turn 62. Your eligibility for Medicare is not related to your income, or health status. 

If you are not eligible for Medicare premium-free Part A, UC does not require you enroll in Part B.  Please provide RASC with a copy of the SSA determination/denial letter so you may remain in a non-Medicare UC plan without a penalty. 

Slide 10

Original Medicare is made up of two parts. Part A is coverage for hospital stays and inpatient care. Part B helps pay for doctor’s visits and other out patient care. When enrolled in Original Medicare Parts A and B, Medicare beneficiaries may choose to enroll in additional coverage.

There are two ways to obtain additional coverage, one way is to enroll into a Medicare Supplement plan – which is offered by private insurance companies and helps pay for Medical care that is not covered by original Medicare. These plans are also referred to as Medi-Gap plans. Because Medicare supplement plan do not cover prescription drugs, you may also choose to enroll into a Part D prescription drug plan.

The other way to obtain additional coverage is to choose a Medicare Advantage plan, also called part C. A Medicare Advantage plan includes all of the benefits of parts A and B as well as coverage for prescription drugs- which is provided through Part D- and also includes additional benefits and services not covered by original Medicare.

Slide 11

You should keep in mind some important Medicare rules. To enroll in the UC Medicare Choice plan, you must be enrolled in Medicare parts A and B. You must also continue to pay your part B premium. Medicare allows you to be enrolled in only one Medicare Advantage plan at a time. If you enrolled into another plan, you will be automatically disenrolled from any other Medicare Advantage plan or part D plan.  If you do not enrolled in a Medicare part D plan, or a Medicare Advantage plan that includes part D coverage, or if you don't have other creditable prescription drug coverage – you may be subject to an late enrollment penalty. It’s important that you notify UnitedHealthcare, if you have current prescription drug coverage as well as any future enrollment that includes prescription drug coverage. When you become enrolled in the UC Medicare Choice plan, we encourage you to read the Evidence of coverage, and plan guide which are available at UHCretiree.com/uc. 

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Let’s take a moment to review IRMAA. The income related monthly adjusted amount, known as IRMAA, is an amount you pay in addition to your part B and part D premiums if your income is over a certain amount. It’s important to remember that IRMMA can apply to both part B and part D premium amounts. This extra amount is paid directly to Social Security and not to your plan. Social Security will contact you if you have to pay an IRMMA amount.

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Now that you understand the basics of Medicare, we are going to spend sometime explaining the plan benefits, and special features of UC Medicare Choice.

Slide 14

UC Medicare Choice offered by UnitedHealthcare is a Medicare Part C PPO plan. This plan provides all the benefits of Medicare Part A – which as you know- covers things such as hospital stays, skilled nursing, and home healthcare. As well as all of the benefits of Medicare Part B – which covers things like doctor’s visits, screenings immunizations and lab tests. In addition, the plan also combines coverage for prescription drugs –also called part D. UC Medicare choice also includes additional benefits and features –such as coverage for vision, hearing, an annual in-home health and wellness visit, and routine podiatry to name a few.

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UC Medicare choice is a convenient and easy to use plan combining your medical, behavioral health, and prescription drug coverage under one single plan. The plan also allows you to utilize both in network and out of network providers- this means that your costs are the same if you see non network providers as long as they participate in Medicare and accept the plan. Keep in mind that you are not required to select a primary care physician- although we encourage you to do so, and you do not need to obtain a referral from your primary care provider to see a specialist. We have also included special wellness programs to keep you healthy, and coverage while you are traveling outside the United States. You only need to use your one single UC Medicare choice member ID card when visiting your doctors, hospitals, and pharmacies.

Slide 16

UC Medicare Choice lets you utilize providers in or out of the UnitedHealthcare®  network for the same cost to you as long as the out of network provider participates in Medicare and is willing to bill UnitedHealthcare.

Your current provider may already be in the UnitedHealthcare®  network. To confirm if your provider is in network you can check online at www.UHCRetiree.com/uc  or call the UnitedHealthcare®  customer service line.

If your provider is not in the UnitedHealthcare®  network our customer service team may be able to assist by confirming if the provider participates in Medicare and accepts the plan.

Slide 17

There is no annual deductible for your plan and the annual out of pocket maximum for medical expenses is $1500. As a reminder, the out of pocket maximum is the most an individual  enrolled in the plan will pay for covered medical benefits for the calendar year. After that, the plan pays for all covered medical services at 100%. The plan also has an annual out of pocket maximum for prescription drugs of $2000. This is sperate from the annual medical out of pocket maximum. When your prescription drug out of pocket costs reach $2000 in a calendar year, the plan will pay 100% of the costs of your covered prescription drugs

Slide 18

We will now provide highlights of your Medical benefits under  UC Medicare Choice . This chart shows the copayments for doctor visits, Urgent & Emergency room care, outpatient surgery and inpatient hospitalization.

For example, If you see a primary care doctor, or specialist you will pay a flat $20 copay.

Urgent care services are provided for a $20 copay. And Emergency room services are covered for a $65 copay.

UC Medicare choice provides coverage for outpatient surgery for a $100 copayment and If you admitted to the hospital, your copayment will be $250 for the entire stay. 

You can also take advantage of Medical virtual visits through Am well, Doctor On Demand, and now Teladoc  for 2022 at no cost to you and Virtual visits with your local provider is covered for a $20 copay

Keep in mind that you will pay the same for covered medical services whether you see in-network providers or out-of-network providers- as long as the provider participates in Medicare and accepts the plan.

Slide 19

UC Medicare Choice also provides coverage for Medicare covered podiatry visits, Chiropractic care, Medicare covered vision services, Medicare covered hearing services, and Medicare covered dental services for a flat $20 copay.  Remember that you will pay the same for covered medical services whether you see in-network providers or out-of-network providers- as long as the provider participates in Medicare and accepts the plan.

Slide 20

UC Medicare choice provides several preventive services for $0

For example, the annual physical, annual wellness, immunizations, breast cancer screenings, and colon cancer screening are covered at no cost to you!

Slide 21

As a UC Medicare Choice member, your plan covers care when you’re traveling outside the United States. UnitedHealthcare will reimburse you for any services or prescriptions you may need while traveling minus any copays that may apply.

In general, these benefits are not covered by Medicare if performed outside of the United States, but they are covered by your UC Medicare Choice plan

For example:   Doctor office visits while traveling abroad are covered for a $20 copay, Emergency room visits are covered for a $65 copay, Urgent care services are covered for a $20 copay.

If you are admitted within a 24 hours of an urgent care or emergency room visit, then  the emergency room and  Urgent care copays will be waived, and a $250 inpatient hospitalization copay will be assessed instead.

Prescription medications are also covered while traveling overseas. For example, UC medicare choice covers a 1-30 days supply for a $25 copayment, and a 30 + day supply for a $50 copayment.

Slide 22

UC Medicare Choice provides comprehensive behavioral health benefits that go beyond Original Medicare.

This chart shows the copayments for Mental health individual session, group session, Behavioral health Virtual visits, and services from Am well &Doctor On Demand all for a flat $20 COAPY. 

The chart also shows how UC Medicare choice provides behavioral health coverage beyond original Medicare. For example, Medicare does not cover services provided by Marriage and Family Therapist (MFTs) or Marriage Family Child Councilors MFCCs, but these services are covered under UC Medicare Choice for a $20 copayment on a reimbursement basis.

Also keep in mind that UC Medicare Choice provides behavioral health coverage for services obtained from Opted out of Medicare behavioral health providers for a $20 copayment on a reimbursement basis.

Opted out of Medicare providers are providers that have formally notified original Medicare that they do not wish to participate in the Medicare program.

UnitedHealthcare will reimburse you for all Medicare covered behavioral health services you receive from MFTs, MFCC, and opted out of Medicare behavioral health providers minus any copays that may apply.

Slide 23

One of the programs included in UC Medicare Choice is coverage for diabetic testing and monitoring supplies. These supplies such as lancets, lancing devices, glucose control solutions and meter replacement batteries are covered at a $0 copay when you use OneTouch and ACCU-CHEK approved systems.

If you are not using OneTouch or ACCU-CHEK, please check with your provider to see if one of the systems will work for you. A  temporary supply of your current brand can be requested while you work with your provider to switch to one of the approved systems.

Slide 24

Now we are going to focus on the Medicare prescription drug coverage provided under UC Medicare choice.  United Healthcare has over 67,000 network pharmacies nationwide including many national drug store chains and independent pharmacies. Some of the pharmacies include Costco, CVS, Rite Aid, Safeway, Walgreens, and Walmart. The prescription drug plan provides coverage for thousands of brand name and generic prescription drugs as well as additional supplemental prescription drug coverage. The prescription drug list is available at. www.UHCretiree.com/uc- or you may call UnitedHealthcare’s customer service team to review your prescription drug needs.

Slide 25

This chart describes the three drug payment stages under the prescription drug plan. Remember that the prescription drug plan has no deductible, and has a $2000 out of pocket maximum. You will never pay more than $2000 per plan year for covered prescription drugs.  In the initial drug stage- you pay a flat copayment and the plan pays the rest. In the coverage gap stage- AKA the donut hole- you continue to pay the same cost share as you did in the initial coverage stage. If you reach the catastrophic coverage stage- you will continue to pay no mare than you did in the previous coverage stages.

Slide 26

Under UC Medicare choice, the amount you pay for prescription drugs is determined by which tier your prescription drug falls in to. For a 30 day supply at a retail pharmacy, you will pay $5 for generic drugs, $25 for preferred brand drugs, $40 for non-preferred drugs, and $25 for specialty drugs. You can save money on drugs you take on a ongoing basis by utilizing mail order or a retail pharmacy that is contracted to fill a 90 day prescription. For a 31-90 day supply for a prescription drug, you will pay $10 for generic drugs, $50 for preferred brand drugs, $80 for non-preferred drugs, and $50 for specialty drugs. There are select generics that do not require a copay. These drugs can be found on the drug list that is available at UHCretiree.com/uc or by calling UHC customer service.

Slide 27

UnitedHealthcare is here to support your prescription drug needs and we have a few reminders to help you get the most out of the plan. Remember to review your medications with your doctor at least once per year to ensure you are only taking those prescription drugs you need. Also, fill your prescriptions at participating pharmacies which includes UC Medical center pharmacies, and remember to show your UC Medicare choice ID cards when you are filling prescriptions. To save money and trips to the pharmacy, consider using our mail order pharmacy or retail pharmacies that are contracted to fill a 90 day prescriptions for your covered maintenance drugs.

Slide 28

As we discussed, the plan offers a mail order benefit for eligible drugs you are taking on a long term basis. If you choose to utilize UnitedHealthcare's mail order program through OPTUM RX, your RX order will enter the system and will be reviewed by a pharmacist for safety and accuracy. Your RX will then be filled and sealed in a tamper- evident package and mailed to you directly.

Slide 29

Take charge of your health by scheduling your annual physical and annual wellness visit with your doctor also covered by the plan at no cost to you. These visits are different from the initial one time welcome to Medicare physical exam. Your annual physical and wellness visit can be scheduled together in one appointment which can be a time saver for you and one less trip to the doctor. As a reminder, you can get your annual wellness visit anytime during the calendar year no matter when you had your last visit the previous year.

Slide 30

UC Medicare choice covers ALL vaccinations including travel vaccinations and Covid 19  vaccinations for a $0 copay.

Some common vaccines covered under Medicare Part B (outpatient medical) are Flu, Pneumococcal, and Hepatitis B for individuals at medium to high risk for hepatitis. *You will have a $0 cost-share (copayments, deductibles or coinsurance) on FDA-authorized COVID-19 vaccines at both network and out-of-network providers. Simply show your UnitedHealthcare member ID card to your provider  at the time of your COVID 19 vaccination and UnitedHealthcare will process your claim.

Some other types of vaccines are covered under Medicare Part D (prescription) such as Shingles, Tetanus-diphtheria-pertussis, Hepatitis A, and Hepatitis B for individuals at low risk for hepatitis. You just have to show your one single UC Medicare Choice member ID card at the time of  your visit. Your ID card will contain all the information needed for your provider to submit claims directly to UnitedHealthcare.

Slide 31

UnitedHealthcare Housecalls  is a program that offers an annual in home visit with a nurse practitioner or a physician at no cost to you. The visit includes a review of your medical history, current medications, certain health screenings, and a discussion of your health concerns. A summary of your houscalls visit will be sent to your physician so that they have this additional information regarding the results of your visit. You may be eligible for a reward when you have completed your housecalls visit. You will receive more information about this visit in your plan guide.

Slide 32

Renew by UnitedHealthcare®  is a program set up to help you unlock your unique potential and live your best life!

Renew gives you access to many resources such as Renew magazine, brain games, recipes, Renew Active fitness program, learning courses, videos and more.

Under the Renew Rewards program you may also be eligible to earn rewards by completing certain health care activities such as your annual physical or wellness visit.

Slide 33

Renew Active is the gold standard in Medicare fitness programs for the body and mind.

Renew Active provides you the chance to stay both physically and mentally fit with a free gym membership that allows access to our nationwide network of gyms and fitness locations as well as the brain health program exclusively from AARP Staying Sharp.

It also provides personalized fitness plan, access to on-demand workout videos and live streaming fitness classes.

There are social activities at local health and wellness facilities and classes that allow you to connect with others.

There is also the Fitbit community and Fitbit Premium available at no additional cost to you.

Slide 34

Virtual Visits allow you to have a live video chat with a doctor or behavioral health specialist from your smartphone, tablet or computer, anything with a camera built in and a strong internet connection. Virtual Visits are available 24 hours a day!

Virtual Doctor Visits are included in the plan in (most cases) for a $0 copay. You can speak with a provider, ask questions, receive a diagnosis, and the doctor can even prescribe medication and have it sent to your pharmacy. If a prescription is needed as a result of the Virtual Visit the applicable cost share would apply for the medication.

(Virtual Behavioral Health Visits are usually the same cost share as an in office individual therapy visit.) You can speak with a behavioral health specialist for an initial evaluation, medication management and ongoing counseling.

Slide 35

Telephonic Nurse Support was designed specifically to help make your health decisions simple and convenient by providing immediate answers to  your health questions any time, anywhere — 24 hours a day, 7 days  a week — at no additional cost.

When you call, a registered nurse can help you:

•          Choose where to go for care — whether that’s self-care,  a doctor visit or urgent care

•          Find a doctor or hospital that meets your needs and preferences

•          Understand your diagnosis and exploring treatment options

Slide 36

UnitedHealthcare Hearing allows you to receive a hearing exam and provides you with a wide selection of brand name and private labeled custom programmed hearing aids at significant savings.

You can choose from many major manufacturers and receive your hearing aids in person or via home delivery.

You will receive personalized care and follow-up support in person or with virtual follow-up care through Right2You helping you to hear better and live life to the fullest!

To find a participating provider please call out UnitedHealthcare customer service team

Slide 37

UnitedHealthcare is here to support members that have been hospitalized by offering free routine transportation for up to 30 days after being discharged from the hospital. As an example, you can receive free transportation to and from doctor’s appointments as well as to pick up prescriptions. Keep in mind that transportation can not be used for emergency related situations.

Slide 38

Another benefit available to members who have been hospitalized is our meal delivery program through mom’s meals. We understand that returning home from a hospital stay, it is critical that your nutritional needs are met to promote healing and to regain strength. Once per plan year and after being discharge from the hospital, you are eligible to receive up to 84 nutritious meals delivered to your home at no cost to you. For your convenience, the meals can be refrigerated up to 14 days, or frozen for up to 3 months

Slide 39

Here’s what to expect next.

Slide 40

What you can expect next from UnitedHealthcare® Medicare Advantage plan for UC Medicare Choice •You will receive your UnitedHealthcare® member ID card and you can start using your plan benefits on or after your effective date •You will receive a Quick Start Guide that gives you information on how you benefits works and how to get the most from your plan. •After you have your member ID card, you can register online at www.UHCRetiree.com/uc to get access to your plan information •Soon after your effective date, we will contact you to complete a short health survey and make sure you have everything you need to make the most of your plan. •You will also receive a welcome newsletter with helpful information

Slide 41

Still want to learn more? Visit your UC Medicare Choice Virtual Education Center to continue to explore!

You will learn more about the custom programs available to you and watch videos from real life UHC members who share their personal stories of using several of the programs.

You can access the Virtual education center from any tablet, computer or smartphone

Slide 42

Once you plan starts on [effective date of plan] you can put your red, white and blue Medicare ID card away for safe keeping. When you go to your [healthcare provider and/or pharmacy] all you need to do is show them your UnitedHealthcare® member ID card. On the back of the member ID card are phone number for the providers and you to call if there are any questions.

Slide 43

If you have any questions about your provider or pharmacy being in-network you can go to www.UHCRetiree.com/uc to check.

Once you receive you member ID card you can go to the website to register.

When you have registered you will be able to:

•       Review benefit information and plan materials

•       Look up your claim information after we have received claims to process

•       Print a temporary member ID and request a new one if needed

•       [Search for drugs and see how much they cost under your plan.]

•       [Search for network providers and pharmacies.]

•       Explore Renew by UnitedHealthcare®  for information on Health & Wellness

•       Get your Explanation of Benefits online

Slide 44

Let’s take a moment to review the top advantages of being a UC Medicare Choice plan member. Never pay more than $1,500 per calendar year for your medical expenses and $2,000 per calendar year for covered prescription drugs. Same benefits both in and out of network nationwide. The plan includes wellness programs and rewards to help you live your best life. Preventative care is covered for a $0 copayment and HouseCall visits are covered for a $0 copayment. UC Medicare Choice includes worldwide coverage when you travel. In addition, post inpatient discharge benefits, including meal delivery and transportation for a $0 copay. Routine acupuncture and chiropractic care are covered services. $0 copayment for medical virtual visits through Amwell, Doctors On Demand, and Teledoc. And access to a large premium network of gyms through Renew Active. And lastly, a dedicated advocatere4me presentative that will connect you to resources that promote health and wellness while saving you time and money.

Slide 45

If you have any plan benefit questions regarding UC Medicare choice, Please feel free to contact UnitedHealthcare member services team dedicated to UC retirees at 18668879533 8am-8pm PST M-F

For eligibility and coverage change questions, you contact RASC at 18008888267 830 am-4:30pm PST M-F, or by going to their website retirementatyourservice.ucop.edu.

Slide 46

Thank you all for taking the time to learn about UC Medicare Choice benefits and eligibility. We are excited to welcome you to our UnitedHealthcare® family!