Medicare Retirees
Prescription Drug Part D TrOOP (true out-of-pocket) maximums will increase from $6,550 to $7,050 for 2022. Copayments for certain services will increase slightly for low-income subsidy-eligible Medicare enrollees.
Kaiser Senior Advantage (Kaiser Permanente)
House calls (previously offered with no copay) will now have the same copay as a similar office visit.
UC Medicare Choice PPO (UnitedHealthcare)
- Renew Active, the nation’s largest Medicare gym network, will replace Silver Sneakers, with additional services and gym options at no cost to members.
- Telehealth services will be available with a $0 copay from Teladoc doctors in addition to Doctors on Demand and Amwell.
- New discounts for members on products and services, including home-delivered meals, fitness, vision services and more.
UC High Option Supplement to Medicare, UC Medicare PPO and UC Medicare PPO without Prescription Drugs (Anthem Blue Cross)
Navitus is the new pharmacy benefit manager for UC Medicare PPO and UC High Option Supplement to Medicare plans.
Questions? Visit the Navitus pre-enrollment website or call the Navitus 24/7 customer care team at 866-270-3877 (closed Thanksgiving and Christmas).
When a generic drug is available and the member or physician chooses the brand-name drug, the member must pay the applicable brand copay plus the difference between the cost of the brand-name drug and the generic equivalent.
With prior authorization, exceptions for medical necessity can be made. In this case, the member pays the Tier 3 (non-preferred) copay.
Non-Medicare Retirees
Kaiser HMO (Kaiser)
House calls (previously offered with no copay) will now have the same copay as a similar office visit.
UC Blue & Gold HMO (Health Net)
- Flu shots for covered family members and other vaccinations for adults will be available from Health Net-contracted pharmacies at $0 copay.
- Members can obtain a 2-week supply of select high-cost medications at $0 copay, to determine medication tolerance before getting a full prescription filled.
CORE, UC Care and UC Health Savings Plan (Anthem Blue Cross)
Navitus Health Solutions is the new pharmacy benefit manager for all of UC’s PPO plans administered by Anthem. See Frequently asked questions about Navitus.
To learn more about your prescriptions, visit the Navitus pre-enrollment website or call the Navitus 24/7 customer care team at 855-673-6504 (closed Thanksgiving and Christmas).
When a generic drug is available and the member or physician chooses the brand-name drug, the member must pay the applicable brand copay plus the difference between the cost of the brand-name drug and the generic equivalent.
With prior authorization, exceptions for medical necessity can be made. In this case, the member pays the Tier 3 (non-preferred) copay.