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

Plan changes

Medicare changes

  • Prescription Drug Part D TrOOP (True Out-Of-Pocket) costs will increase from $5,000 to $5,100.
  • Copayments for certain services will increase slightly for low-income subsidy-eligible Medicare enrollees.
  • Federal regulations to close the Medicare Part D 'donut hole' will go into effect, increasing the Coverage Gap Discount Program (CGDP) from 50 percent to 70 percent. These regulations will also remove some exclusions from the CGDP for biosimilar drugs (drugs that are almost identical to the original).

UC Vita™ replaces Castlight and Mobile Health Consumer app

UC Vita is a personalized digital health care assistant offering all the features of Castlight and more! UC Vita will be accessible via the internet from any computer, as well as through the free app that you can download directly to your mobile devices. With UC Vita, you’ll be able to:

  • Quickly access a comprehensive list of UC benefit programs available to you.
  • Keep your focus on prevention and overall well-being to prevent future health issues.
  • View personalized information relevant to you and your health care needs and preferences.
  • See what’s covered by your medical plan and view coverage and claim details.
  • Find doctors. Search for in-network care. See quality scores and reviews for doctors and hospitals, and write your own reviews.
  • Get information during an emergency. Keep your medical insurance card as close as your smartphone. Find urgent care numbers anytime.

You’ll hear more about UC Vita (Engage Wellbeing) in early 2019. Search for “Engage Wellbeing” in your app store to find and download the app.

Live Health Online

Costs for telehealth visits through Live Health Online will decrease from $49 to a $20 copay for a doctor or psychiatrist visit. The copay is not subject to, and will not count toward, your deductible. The copay will count toward your out-of-pocket maximum.

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. 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

Retiree plan costs chart »