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

2018 plan changes

Pharmacy benefits changes

For 2018, Anthem Blue Cross administers pharmacy benefits for UC Medicare PPO and UC’s other preferred provider organization (PPO) medical plans, and continues 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.

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, and you can find answers to some commonly asked questions here.

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.

Through the Select Generics program, generic versions of select drugs for chronic conditions are now covered with a $0 copay for members of UC Medicare PPO.

Medicare costs

Prescription Drug Part D TrOOP (True Out-Of-Pocket) costs have increased from $4,950 to $5,000. Copayments for certain services have increased slightly for low-income subsidy-eligible Medicare enrollees.

ID cards

Whether you are new to UC Medicare PPO or continuing your enrollment, 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 and behavioral health services. Anthem began mailing ID cards on Dec. 18, 2017. An additional card for your Part D pharmacy benefit was mailed the week of Dec. 4, 2017. 

You may also print a copy of your ID card from the Anthem website or call Anthem (844-437-0486) 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. Members are 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