2018 UCare for Seniors

Transcription

1 2018 UCare for Seniors Minneapolis Public Schools U3204 (04/17)

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 for Seniors 9 out of 10 overall Nonprofit insurer with Medicare Advantage contract

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 for Seniors is a 4.5 Star Plan!

4 Who can join UCare for Seniors? 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.

5 UCare for Seniors Premium Rates High: $332 Core: $164 Basic: $73 Rates are per member, per month through 12/31/18

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

7 All UCare for Seniors plans include: Preventive Care visits $0 copay Preventive screenings $0 copay Preventive Dental 3 cleanings/year 100% coverage Prescription Drug coverage Medicare Part D Medical Out-of-Pocket Maximum $3400 Coverage out of area up to 6 months no need to notify Worldwide Emergency coverage;plus out of network nonemergency coverage 80%

8 Primary and Specialist Visits Primary Office Visit High $15 copay Core $15 copay Basic $15 copay Specialist Office Visit High $15 copay Core $30 copay Basic $40 copay

9 Doctor Visits No Referral Needed Primary Care Clinic Keep your doctor, your clinic Pick one as a home base Search Primary Care Clinic Listing See any Specialist No referral needed Simply make an appointment Search FIND A DOCTOR at UCare.org

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

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

12 Emergency Services Worldwide Emergency Care: High - $50 copay Core - $75 copay Basic - $75 copay Ambulance Services: 100% coverage after: High - $100 copay Core - $100 copay Basic - $200 copay

13 Vision and Hearing Benefits High and Core Plans include: Vision exam $0 copay $150 eyewear credit each year Hearing Exam $0 copay $500 hearing aid credit every 3 years EPIC hearing aid discounts Basic plan includes: Vision exam $40 copay Hearing exam $40 copay

14 Additional Dental Benefits Preventive Dental included in all plans 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 Prescription Drug Coverage Part D Formulary List of Covered Drugs Search online by name 4 tiers Generic, Preferred Brand, Non-preferred, and Specialty Mail Order or Preferred Pharmacy network Two Copays for 90-day supply Preferred Pharmacies are: CVS/Target, Costco, CUB, Shopko and others

16 Initial Coverage Stage From $0 to $3,750 in annual prescription drug costs High Core Basic Annual deductible $100 $150 $250 Tier 1 Generic $10 copay $15 copay $15 copay Tier 2 Preferred Brand $40 copay $45 copay $45 copay Tier 3 Non-preferred $90 copay $100 copay $100 copay Tier 4 Specialty 30% coinsurance 30% coinsurance 25% coinsurance

17 Coverage Gap Stage Donut Hole Once you have reached $3,750 in annual prescription drug costs Coverage in Gap High Core Basic Coverage through the gap paying copays. Tier 1 Generics covered thru the gap with $15 copay You pay 44% of Generic drugs Once you reach $5000 in out of pocket costs: You pay 35% of brand name drugs You pay 35% of brand name drugs Catastrophic Coverage 5% coinsurance or $3.35 for generics and $8.35 for brand name whichever is greater No Donut Hole Smaller Donut Hole Larger Donut Hole

18 UCare for Seniors Fitness Programs Silver Sneakers Free membership to a fitness center 13,000 locations nationally - use it anywhere! YMCA, LA Fitness, Snap, YWCA, Curves Health Club Savings (Lifetime and others) $20 per month toward your membership No minimum number of visits required.

19 UCare for Seniors Wellness Services Community Education Classes $15 discount, one class per year WholeHealth Living discount program Savings on non-covered wellness services Massage, acupuncture, therapies and more Easy to use online listing

20 UCare for Seniors Health Management Disease Management Programs Diabetes Heart Disease Cancer UCare 24/7 Nurse Line Tobacco Quit Line

21 How do I join UCare for Seniors? Retirees and Spouses May enroll when Medicare-eligible (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

22 Contact Group UCare for Seniors Contact information Phone: Toll Free: Visit our offices 500 Stinson Blvd. NE, Minneapolis, MN Find us online: ucare.org

23 THANK YOU Happy Retirement!