Core is a high-deductible catastrophic plan.

Plan changes

Pharmacy benefits changes

Beginning Jan. 1, 2018, Anthem Blue Cross will administer pharmacy benefits for Core and UC’s other preferred provider organization (PPO) medical plans, and will continue to administer medical and behavioral health benefits. The administrator of your plan processes claims, creates a network of health care providers or pharmacies and sets clinical policies and guidelines.

If you are continuing your enrollment in Core, you and each of your family members will get a new ID card from Anthem Blue Cross that you can use to access medical care, behavioral health services and prescription medications. Your Anthem Health Guide will now be able to answer questions about all of your benefits, at the same number: 844-437-0486, Monday through Friday, 5 a.m. to 8 p.m. (PT). You’ll have a new member website for all of your benefits: ucppoplans.com.

UC and Anthem are working to minimize disruption during this transition. For the most part, open prescriptions will transfer automatically, and prior authorizations will remain in effect after the transition. Anthem will reach out with more information about changes that may affect you.

Still, to make sure you’re prepared for the change, it’s a good idea to:

  • Refill your prescriptions before the end of the year.
  • Check the Anthem formulary and prescription drug costs.

Your current covered medications will continue to be covered, but the cost of your medications may change. You may want to talk to your doctor about an alternative drug that is on the formulary to help you manage your costs.

Core members will have more options for prescription refills next year. You can get a 90-day supply of prescriptions at CVS and selected Anthem Retail90 pharmacies, as well as at UC Medical Center pharmacies, Walgreens, Safeway/Vons and Costco. Oral contraceptives may now be dispensed up to a 12-month supply at one time.

Live Health Online to include psychiatrists

The Live Health Online network of board-certified doctors has been expanded to include psychiatrists. Appointments are available through Live Health Online 24/7, with cost sharing of 20 percent after the deductible. See ucppoplans.com for information about cost, requirements and how to get started.

Cost sharing eliminated for some preventive care

Low- to moderate-dose statins will be covered at $0 copay for cardiovascular disease prevention, provided certain criteria are met. Screenings for preeclampsia using blood pressure measurement throughout pregnancy will also be covered at $0 copay.

How the plan works

  • You can choose any doctor or hospital you wish, worldwide, but Anthem Blue Cross PPO network providers cost less.
  • Preventive care from in-network providers is covered at 100% without the need to meet your deductible.
  • For all other services and prescriptions, you pay 100% of the cost until you meet the deductible ($3,000 for both in-network and out-of-network providers).
  • Once you meet the deductible, you pay 20%.
  • Annual out-of-pocket maximums ($6,350 individual/$12,700 family) limit what you pay. If you reach the annual maximum, the plan pays 100% of your medical and prescription drug costs for the rest of the year.
  • Behavioral health services are provided by Anthem network providers.

Best fit for you if:

  • You want to pay no monthly premium
  • You want direct access to all providers without need for referrals
  • You are willing to risk incurring high out-of-pocket costs
  • You want coverage when you are traveling or living abroad

Plan costs

UC pays the entire premium for Core; there is no additional premium cost to you.

Typical out-of-pocket costs

Once you’ve met the deductible, you pay:

  • Office visit/urgent care visit: 20%; (preventive care from in-network providers has no charge)
  • Emergency room: 20%
  • Hospital stay: 20%
  • Prescription drugs: 20%