CORE is a high-deductible catastrophic plan.

Plan changes

There is a change to the prescription drug formulary for the CORE plan for next year. There are no changes to the CORE plan deductible, coinsurance or annual out-of-pocket limits.

The new features/changes described below are effective Jan. 1, 2020.

Changes to prescription drug formulary 

To help keep prescription drug costs and premiums affordable, CORE will transition from the current Anthem National Drug List to the Anthem Essential Drug List. The Essential Drug List focuses on less costly medications with the same effectiveness as more expensive — and often brand name — medications.

The majority of members currently taking medications will not notice differences as a result of this change. Some members will have either a higher or lower copay if they are on a medication that moves to a different tier. To minimize the impact on members, any current medications not on the new drug list will be grandfathered (in current form and dosage), meaning members can continue taking them without disruption while they use that specific medication and dosage. Visit ucppoplans.com for more information about the change.

New ID Cards

If you change your plan during Open Enrollment, you and each covered family member will get one ID card from Anthem in late December that you’ll use beginning Jan. 1, 2020, for medical, prescription drug and behavioral health services. The new ID cards have updated information your pharmacist will need in order to process your pharmacy claims in 2020.

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 a plan referral
  • 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%