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UC Medicare PPO

Administered by Anthem Blue Cross (medical) and Navitus (pharmacy)

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

  • Full Full eligibility not available
  • Mid Mid eligibility not available
  • Core Core eligibility not available
  • Retirees Retirees eligibility not available

How the plan works

You can choose any Medicare doctor or hospital you wish; providers who accept Medicare assignment cost less. If your provider does not accept Medicare assignment, they can bill you for up to 15% over the Medicare allowable rate.

The plan covers some services that Medicare does not cover (called Benefits Beyond Medicare). The plan covers 80% of Anthem-allowed charges for these services. See the plan benefits booklet for more details.

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.

See updated information about coverage for COVID tests.

Best fit for you if:

  • You want direct access to Medicare providers without the need for referrals.
  • You are willing to pay costs for services that may vary.

Understanding your costs

UC Medicare PPO has a deductible of $100 for services not covered by Medicare. The out-of-pocket maximum for medical benefits is $1,500.

Monthly premium costs for retirees

Moving outside California?

UC offers a Medicare Coordinator Program (administered by Via Benefits) to retirees and to families whose members are all eligible for or enrolled in Medicare and live in a state outside California.