UC Open Enrollment presentation

2022 UC Medicare Choice

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Hello and welcome to the 2022 UC Medicare Choice Open enrollment presentation. My Daniel is Daniel Godfrey, Client Service manager for UnitedHealthcare, dedicated to University of California and we are excited to share with you valuable information about the UC Medicare choice plan, a UnitedHealthcare Group Medicare Advantage PPO plan.

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In this presentation, we will cover a brief overview of Original Medicare details about UC Medicare choice benefits, programs, and features and what you can expect next.

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At UnitedHealthcare^® we want you to know we are here for you. We are here to help you make the most of your plan by connecting you to the care you need, when and where you need it, and offering one on one support to get you the care you need. We are able to  provide programs like Renew that offers a variety of useful resources, activities and learning courses at no additional cost.

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We have one of the largest provider networks and one of the most comprehensive drug coverage programs available. With your choice to pick up prescriptions at a local pharmacy or you can utilize the Optum Rx Mail Order pharmacy, which is like having a drugstore at your fingertips. UnitedHealthcare is proud to have been serving the health care needs of people just like you for more than 40 years and you can count on us to be here when you need us.

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We will now take a moment to review Original Medicare.

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You become eligible for Original Medicare parts A and B when you reach age 65 and worked full time for at least ten 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 five consecutive years.  Your eligibility for Medicare is not related to your income or health status.

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

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Keep in mind that  Original Medicare the coverage has deductibles and coinsurance that are applied for covered services. Some retirees may choose to enroll in a Medicare Supplement plan that would help cover the remaining balances from Original Medicare as well as a Part D plan to cover prescriptions. Another option is to choose a Medicare Advantage plan, also known as a Part C plan. The UC Medicare Choice plan is a Medicare Advantage plan.

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Let’s take a moment to review 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 enroll into another plan, you will be automatically disenrolled from any other Medicare Advantage plan or part D plan.  If you do not enroll in a Medicare part D plan, or a Medicare Advantage plan that includes part D coverage, or if you do not have other creditable prescription drug coverage, you may be subject to a 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 your 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 some time explaining the plan benefits and special features of UC Medicare Choice.

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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. Again, prescription drug coverage is automatically included in UC Medicare Choice. 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, just to name a few.  UC Medicare Choice also offers additional benefits and programs beyond Original Medicare. Keep in mind that you will continue to retain all the rights and privileges of Medicare, but your benefits and claims will be processed by UnitedHealthcare®.

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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 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. Keep in mind that UC Medicare Choice is only available to UC Medicare retirees and their Medicare eligible dependence living in California.

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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.UHCRetire.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.

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This slide shows that there is no annual deductible for UC Medicare Choice and the annual out of pocket maximum for medical expenses is $1,500. As a reminder, the out-of-pocket maximum is the most an individual enrolled in UC Medicare Choice 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 $2,000. This is sperate from the annual medical out of pocket maximum. When your prescription drug out of pocket costs reach $2,000 in a calendar year, the plan will pay 100% of the costs of your covered prescription drugs for the remainder of the year.

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We will now provide highlights of your Medical benefits under the UC Medicare Choice. This chart shows the copayments for doctor visits, urgent and 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. If you are admitted to the hospital after an emergency situation, your inpatient hospitalization copay is $250 for the entire stay and the $65 emergency room copay will be waived. UC Medicare Choice provides coverage for outpatient surgery for a $100 copayment. You can take advantage of medical virtual visits through Amwell, Doctors 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.

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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.

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UC Medicare Choice provides several preventive services for a $0 copay. For example, the annual physical, annual wellness, immunizations, breast cancer screenings, and colon cancer screenings are covered at no cost to you.

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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 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. 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 copay will be assessed instead. Prescription medications are also covered while traveling overseas. For example, UC Medicare Choice covers a 1-to-30-day supply for a $25 copay and a 30+ day supply for a $50 copayment.

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This chart shows the copayments for mental health individual sessions, group sessions, behavior health and virtual visits and services from Amwell and Doctor on Demand, all for a flat $20 copay. The chart also shows how UC Medicare Choice provides comprehensive behavioral health benefits beyond Original Medicare. For example, Medicare does not cover services provided by marriage and family therapists or marriage family child counselors. 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 providers that have opted out of Medicare 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 marriage family therapists, marriage family child counselors, and opted out of Medicare behavioral health providers, minus any copays that may apply.

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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 meters 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.

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Now we’re 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 these 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 the following website: www.UHCretiree.com/uc or you may call UnitedHealthcare’s customer service to review your prescription drug needs.

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This chart describes to three drug payment stages under the prescription drug plan. Remember that the prescription drug plan has no deductible and has a $2,000 out of pocket maximum. You will never pay more than $2,000 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, also known as the donut hole, you continue to pay the same cost share as you did in the initial coverage stage. UC Medicare Choice provides coverage through the donut hole or coverage gap. If you reach the catastrophic coverage stage, you will continue to pay no more than you did in the previous coverage stages.

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depends on which tier your prescription drug falls in to. For example, for a 30-day supply at a retail pharmacy, you will pay $5 for tier 1 preferred generic drugs, $25 for tier 2 preferred brand drugs, $40 for tier 3 non-preferred drugs, and $25 for tier 4 specialty drugs. You can save money on drugs you take on an ongoing basis by utilizing mail order or a retail pharmacy that is contracted to fill a 90-day prescription. For a 31-to-90-day supply for a prescription drugs, you will pay $10 for tier 1 generic drugs, $50 for tier 2 preferred brand drugs, $80 for tier 3 non-preferred drugs, and $50 for tier 4 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.

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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, just 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.

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

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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 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.

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Let’s take a moment to review the vaccination benefit under UC Medicare Choice. First, UC Medicare Choice covers all vaccinations, including travel vaccinations, for $0. Specifically, some common vaccines covered under Medicare Part B, or outpatient medical services, are flu vaccines, pneumonia, and hepatitis B for individuals at medium to high risk for hepatitis. Other vaccines are covered under Medicare Part D, prescription drug, such as shingles, T-dap, hepatitis A and Hepatitis B for individuals at low risk for hepatitis. You will have a $0 cost-share on FDA-authorized COVID-19 vaccines at both network and out-of-network providers because of the CDC COVID-19 Vaccination Program Provider Agreement currently running through December 31. Once the program is complete the COVID-19 vaccine will be covered through your Part B vaccine benefit.

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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 and certain health screenings, and a discussion of your health concerns. A summary of your HouseCalls 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.

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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.

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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 you 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.

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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 medications and have it sent to your pharmacy. If a prescription is needed as a result of a Virtual Visit, the applicable cost share would apply for the medication.

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Telephonic Nurse Support was designed specifically to help you make your health decisions simple and convenient, by providing immediate answers to  your health questions anytime, anywhere, 24 hours a day, 7 days  a week, at no additional cost. Our nurses are there to help you. They can help you with things like choose where to go for care, whether that’s self-care,  a doctor’s visit or urgent care. They can help find a doctor or hospital that meets your needs and preferences. They also. understand your diagnosis and will explore treatment options with you.

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UnitedHealthcare Hearing allows you to receive hearing exams and provides you with a wide selection of brand name and private label custom programmed hearing aids at significant savings.  You can choose from many major manufacturer and receive your hearing aids in person or via home delivery. You will receive personalized care and a 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 our Customer Service.

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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 your doctor’s appointments as well as to pick up prescription drugs. Keep in mind that transportation cannot be used for emergency related situations.

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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 discharged 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.

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Here’s what to expect next.

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Here’s what you can expect next after enrollment into UC Medicare Choice. You will receive your UnitedHealthcare®  member ID card and you can start using your benefits on January 1^st, 2022. You will receive a Quick Start Guide that gives you information on how your 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 to make sure you have everything you need to make the most of your plan. You will also receive a welcome newsletter with helpful information as well.

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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.

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How to use your new UC Medicare Choice plan. Once your plan is effective on January 1, 2022, you can put your red, white and blue Medicare ID card away for safe keeping. When you go to your healthcare provider or pharmacy, all you need to do is show them your UnitedHealthcare®  member ID card. On the back of the card of the member ID are phone number for the providers and you to call if they have any questions or concerns. You can also contact member services by the member services number on the back of the ID card.

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If you have any questions about your provider or pharmacy being in-network, you can go to the following website, 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 card and request a new one if needed. You can search for drugs to see how much they would cost under your plan. You can also search network providers and pharmacies. Explore Renew by UnitedHealthcare®  for information on health and wellness and get your explanation of benefits online.

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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 advocate from your representative that will connect you to resources that promote health and wellness while saving you time and money.

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For general questions about UC Medicare Choice or for questions related to the information presented here today, please contact member services at 1-866-887-9533.

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I would like to thank each of you for taking the time to learn about your UnitedHealthcare®  Medicare Choice with me today and we are excited to welcome you to the UnitedHealthcare family. Thank you again.