2019 UCARE. Group Medicare. Minneapolis School Retirees

Transcription

1 2019 UCARE Group Medicare Minneapolis School Retirees

2 ABOUT UCARE Serve 80,000 Medicare members in Minnesota and western Wisconsin Friendly customer service with a real person, located in Northeast Minneapolis Members rate UCare 9 out of 10 overall Nonprofit insurer with Medicare Advantage contract UCare is not a Cost Plan! 2

3 STAR RATINGS Medicare Quality Program uses a 5-star rating system Score based on five health service categories: Keeping healthy through screenings, tests and vaccines Managing chronic conditions Satisfaction Operational performance Customer service UCare is a 4.5 Star Plan! Every year Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated yearly and may change from one year to the next. 3

4 Who can join UCare Group Medicare? Retirees and their spouses who: Have Medicare Part A and Part B Continue to pay Part B premium Live in Minnesota or within 26 counties in Wisconsin Do not have end-stage renal disease 4

5 UCare Group Medicare Premium Rates High $339 Core $175 Basic $79 Rates are per member, per month through 12/31/19 5

6 LARGE PROVIDER NETWORK Allina Health CentraCare Clinics Essentia Health Fairview Clinics HealthEast HCMC North Memorial Mayo Health System Park Nicollet Clinics Ridgeview Clinics Stillwater Clinics St. Luke s U of M Physicians And MANY MORE 96% of providers are within the UCare Network! 6

7 UCare Group Medicare plans include: Preventive Services $0 copay Annual Physical, Routine Tests Preventive Dental 100% coverage 3 cleanings, 2 exams, annual bitewing X-rays Prescription Drug coverage Medicare Part D Medical Out-of-Pocket Maximum $3400 7

8 Primary Doctor Visits Choose a Primary Care Clinic Keep your doctor, your clinic Find in Primary Care Clinic Listing Change clinic anytime Just a home base Primary Office Visit $15 copay on all plans

9 Specialist Doctor Visits See any Specialist No referral needed Simply make an appointment Use Find a Doctor tool Specialist Office Visit High - $15 copay Core - $30 copay Basic - $40 copay 9

10 Inpatient Hospital Covered at 100% after copay High $100 copay per admission Core $200 copay per admission Basic $300 copay per day, days 1 through 5 We coordinate with all providers, no paperwork 10

11 Outpatient Services and Skilled Nursing Outpatient Surgery and Outpatient Hospital High $200 copay Core $250 copay Basic $250 copay Skilled Nursing and Rehabilitation No three-day in-patient hospital stay requirement $0 for days 1 through 20 $100 per day for days 21 through

12 Worldwide Emergency Care High $50 copay Core $75 copay Basic $75 copay Emergency Services Ambulance covered 100% High After $100 copay Core After $100 copay Basic After $200 copay 12

13 Out of Network Benefits UCare Anywhere same copay in or out of network Primary, Specialty, OT/PT, Mental Health Visits 80% coverage for non-emergency/non-urgent Anywhere in the United States Travel out of the service area up to 6 consecutive months No need to notify us of your comings and goings 13

14 Vision and Hearing Benefits High and Core Plans include: Vision exam $0 copay $150 eyewear reimbursement each year Hearing exam $0 copay $500 hearing aid reimbursement every 3 years Basic plan includes: Vision exam $40 copay Hearing exam $40 copay 14

15 Additional Dental Benefits Preventive dental included 3 cleanings, 2 exams, annual bitewing x-rays Additional dental coverage for $21 per month Coverage for fillings, crowns, dentures Full mouth x-rays $50 deductible $1200 annual maximum 15

16 Prescription Drug Coverage Part D Formulary List of Covered Drugs Search online by name 4 tiers Generic, Preferred Brand, Non-Preferred and Specialty Large Pharmacy network or mail order Preferred Pharmacies 90 day supply for 2 copays Includes Walmart/Sam s Club, Cub, Costco, CVS, more! More than 200 Preferred Pharmacies added in

17 From $0 to $3820 in annual prescription drug costs Initial Coverage Stage High Core Basic Annual deductible $100* $200* $400* Tier 1 Generic $10 copay $12 copay $12 copay Tier 2 Preferred Brand $40 copay $45 copay $45 copay Tier 3 Brand $100 copay $100 copay $100 copay Tier 4 Specialty 30% coinsurance 25% coinsurance 25% coinsurance *Tier 1 Generic drugs are not subject to meeting the deductible

18 Coverage Gap Stage Donut Hole Once you have reached $3,820 in annual prescription drug costs High Core Basic Once you reach $5100 in out of pocket costs: Unlimited Drug Coverage Continue to pay Tier 1 copays as usual You pay 37% of generic drugs Catastrophic Coverage You pay 5% coinsurance or $3.40 for generics and $8.50 for brand name whichever is greater Continue to pay copays as usual No Donut Hole You pay 25% of brand name drugs Smaller Donut Hole You pay 25% of brand name drugs Larger Donut Hole

19 UCare Group Medicare Fitness SilverSneakers Fitness Free membership to a fitness center 13,000 locations nationally use it anywhere! LA Fitness, Snap, YWCA, Curves, Anytime, more Now includes Lifetime (Bronze and Gold only) Health Club Savings (Lifetime and others) $20 per month toward your membership No minimum number of visits required 19

20 HOW DO I JOIN UCARE GROUP MEDICARE? Retirees and Spouses May enroll when Medicareeligible (generally age 65) Each fills out an application and plan choice Enrollment Folders Includes 2 applications and 2 plan choice forms Mail forms in the green envelope provided 20

21 Welcome to UCare! Confirmation of enrollment Member ID card Customer Service UCare 24/7 Nurse Line Disease Management Programs Member Portal at UCare.org 21

22 Questions about UCare Group Medicare Contact us Phone: Toll Free: Visit our offices 500 Stinson Blvd. NE, Minneapolis, MN

23 THANK YOU Happy Retirement! 23