- Retirees
- Benefits for retirees
- Retiree health & home benefits
- Medical plans for retirees
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UC Medicare Choice
UC Medicare Choice
Insured through UnitedHealthcare
UC Medicare Choice is a Medicare Advantage PPO plan (also known as Part C) that generally replaces your Medicare coverage and includes Medicare Parts A, B and D. It also offers some extra benefits that Original Medicare does not cover. When you enroll in this plan, you agree to let UnitedHealthcare manage your Medicare benefits.
- Full Full eligibility not available
- Mid Mid eligibility not available
- Core Core eligibility not available
- Retirees Retirees eligibility not available
How the plan works
UC Medicare Choice delivers all the benefits of Original Medicare (Parts A and B), includes prescription drug coverage (Part D), and offers additional benefits beyond Medicare.
Because UC Medicare Choice is a Preferred Provider Organization (PPO) plan, you have access to any provider, in-network or out-of-network, at the same cost to you, as long as providers accept the plan and have not opted out of or been excluded from Medicare.
UC Medicare Choice is the “partner plan” of UC Blue & Gold HMO. That means that if you are a retiree enrolled in UC Blue & Gold HMO, you’ll be transferred into UC Medicare Choice when you turn 65, once Medicare has approved your enrollment form (UBEN 121).
- The ability to seek necessary care from specialists without prior authorization from your primary care provider
- Gym memberships through Silver Sneakers
- Annual in-home preventive care visit at no cost to you
- Benefits after a hospital stay, including transportation and meals
Best fit for you if:
- You prefer a Medicare Advantage plan (also known as Part C) that generally replaces your Medicare coverage and includes some extra benefits that Original Medicare does not cover.
- You would prefer to let UnitedHealthcare manage your Medicare benefits.
- You want the flexibility to see providers both in and out-of-network.
Understanding your costs
UC Medicare Choice has no deductible and the out-of-pocket maximum is $1,500.
Typical out-of-pocket costs:
- Office visits/Urgent care: $30
- Emergency room visits: $100
- Hospital stay: $350
- Prescription drugs:
- $10, generic; $30, brand name; $45, non-formulary
- $30 copay to Part B drugs, matching the office visit copay; Part B chemotherapy drugs and vaccines continue to be covered without a copay.
- For Medicare Part D Prescription Drugs, there is a combined $100 deductible for Tiers 3 and 4 (non-preferred brand and specialty medications) except for covered insulin products and most adult Part D vaccines.
- The copay for Tier 4 specialty drugs is 30% of the total cost, up to $150 per script. There is an exception for insulin on these tiers, which is capped at $35 per month out-of-pocket before the deductible is met.
If you need medical care or prescription medication while you are traveling outside the United States, you’ll need to pay for services and request reimbursement using the direct member reimbursement process. Medical claims will be paid at 100% of billed charges minus a $20 copayment per office visit, or a $250 copayment per admission as an inpatient. For prescription drug costs incurred during international travel, you’ll have a copayment of $25 for a 30-day supply and $50 for a 30+ day supply. Please see the plan documents or call UnitedHealthcare for details.
Moving outside California?
UC offers a Medicare Coordinator Program (administered by Via Benefits) to retirees and to families whose members are all eligible for or enrolled in Medicare and live in a state outside California.
Plan contacts
- UnitedHealthcare website
- UnitedHealthcare: 866-887-9533
- UnitedHealthcare Behavioral Health: 800-453-8440