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- Benefits for retirees
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UC Care for retirees
UC Care for retirees
UC Care is administered by Blue Shield of California (medical) and Navitus (pharmacy); supported by Accolade Health Care Advocate
UC Care is a PPO plan created just for UC to ensure the best possible access to world-class UC hospitals and physicians.
For convenience and flexibility, you also have access to the Blue Shield network of providers, as well as coverage for non-network providers.
The information below is a summary. See plan documents for details.
- Full Full eligibility available
- Mid Mid eligibility available
- Core Core eligibility available
- Retirees Retirees eligibility available
How the plan works
For questions about medical coverage, claims, finding providers and more, start with Accolade. Call (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) or visit the Accolade member portal.
For questions about prescription drug coverage and costs, call Navitus Customer Care at (833) 837-4308 or visit the Navitus member portal.
Register for a monthly Accolade webinar to learn how your PPO works and how Accolade can help. Find all your plan details on the UC Faculty and Staff PPO plans website.
- You may choose any doctor or care facility, worldwide. You pay less for care within the Blue Shield Tier 1 (UC Select) or Tier 2 networks.
- Annual out-of-pocket maximums limit what you pay. If you reach the annual maximum, the plan pays 100% of your covered medical costs for the rest of the year.
- Behavioral health benefits are provided through Blue Shield.
- Learn more about getting care outside California and the U.S.
- See updated information about coverage for COVID tests.
Best fit for you if:
- You want direct access to most providers without a referral
- You want no deductible and fixed copays for using providers in the Tier 1 (UC Select) network
- You want coverage when you are traveling or living abroad
- You and/or your family members live outside California
Understanding your costs
When choosing a plan, make sure to consider all your costs, including your monthly premiums and what you can expect to pay out-of-pocket for care. ALEX will ask you a few questions to help you estimate how much you may need to spend.
Learn more about what you pay for care on the UC Faculty and Staff PPO plans website.
- Blue Shield Tier 1 (UC Select) network (available only in California): You pay set copayments for covered services, and there’s no deductible. The annual out-of-pocket maximum is $6,100 for individual coverage and $9,700 for family coverage.
- Office visits/urgent care: $30
- Emergency room visits: $300
- Hospital stay: $250
- Navitus network pharmacies:
- Tier 1: $10
- Tier 2: $30
- Tier 3: $50
- Blue Shield Tier 2 network: You pay 30% of the cost of service after the deductible has been met.
- Individual coverage: $500 deductible; $7,600 out-of-pocket maximum
- Coverage for a family of three or more: $1,000 deductible; $14,200 out-of-pocket maximum
- Non-preferred or out-of-network: After the deductible has been met, you pay 50% of the allowable cost of service plus any billed charges that exceed the allowed amount.
- Individual coverage: $750 deductible; $9,600 out-of-pocket maximum
- Coverage for a family of three or more: $1,750 deductible; $20,200 out-of-pocket maximum
*UC Care deductible and out-of-pocket maximums do not cross-accumulate for in-network and out-of-network services. The UC Select and Anthem Preferred (transitioning to Blue Shield next year) out-of-pocket maximum do cross-accumulate.
| Pay Band (full-time salary rate) | Self | Self + Child(ren) | Self + Adult | Family |
|---|---|---|---|---|
| $73,000 and under | $130.85 | $235.52 | $403.08 | $507.76 |
| $73,001–$145,000 | $189.17 | $340.50 | $525.55 | $676.89 |
| $145,001–$217,000 | $247.49 | $445.47 | $648.02 | $846.01 |
| $217,001 and above | $305.80 | $550.44 | $770.48 | $1,015.13 |
Enrolling in Medicare
UC Medicare PPO is considered the “partner plan” of UC Care. That means that if you are a retiree enrolled in UC Care, you’ll be transferred into UC Medicare PPO when you turn 65, once Medicare has approved your enrollment form.
Plan documents and contacts
- Documents and forms
- UC Faculty and Staff PPO Plans website
- Accolade member portal
- Accolade Health Care Advocate: 866-406-1182
- Navitus: 833-837-4308