This medical plan is a complement to your existing Medicare coverage, and you must receive services from Medicare providers.  

2018 changes: Effective Jan. 1, 2018, Anthem Blue Cross will administer pharmacy benefits for UC Medicare PPO and UC’s other preferred provider organization (PPO) medical plans.

Anthem currently administers medical and behavioral health benefits for UC’s PPO plans, and will continue in that role in 2018. Although UC and OptumRx have worked hard to improve member experience and to address problems with enrollment and authorizations, UC determined that Anthem would be a better fit as pharmacy benefits administrator for UC’s PPO plans moving forward.

More information and answers to your questions will be provided as soon as they’re available, and highlighted in Open Enrollment materials.

OptumRx will continue as the pharmacy benefits administrator for UC’s PPO plans through 2017. If you have questions about your current PPO pharmacy benefits, visit the OptumRx website or call OptumRx at 855-798-4682.

ID cards

You will receive separate ID cards for your medical and pharmacy benefits. You may also print a copy of your ID card from the Anthem or OptumRx website or call Anthem (844-437-0486) or OptumRx (855-489-0651) to request your ID number.

How the plan works

  • You can choose any Medicare doctor or hospital you wish; providers who accept Medicare assignment cost less.
  • Medicare pays benefits first. Then this plan calculates benefits on the Medicare allowable amount, less what Medicare paid.
  • Benefits not covered by Medicare but covered by the plan are reimbursed at 80% of customary and reasonable charges when you use an Anthem Preferred provider. See your plan booklet for details.
  • If your provider does not accept Medicare assignment, they can bill you for up to 15% over the Medicare allowable rate.
  • Behavioral health services are provided by Anthem Blue Cross and Medicare. Beginning in 2017, members will be covered for outpatient services not covered by Medicare from all in- and out-of-network licensed behavioral health providers, including psychiatrists, psychologists, MFTs and MFCCs. Please check with your providers to be sure they are available under this plan.

Best fit for you if:

  • You want direct access to Medicare providers without need for referrals
  • You are willing to pay variable costs per service

Plan costs

Click for retiree plan costs chart