cover eligible dependents, everyone must enroll in the same medical plan *Star rating applies to all plans offered by SCAN Health Plan 2018-2021 except SCAN Healthy at Home (HMO SNP) and VillageHealth (HMO-POS SNP) plans. 1 0 obj This is a Medicare Advantage HMO plan that replaces traditional Medicare benefits (Part A and Part B). Washington State Health Technology (HTCC) Assessments . Be sure to call the plans you are interested in to ask about provider availability in your county. 3 0 obj The certificate of coverage (COC) for the member's plan is the source of coverage provisions offered under the plans. Get medical insurance for your life and budget. Uniform Managed Care Manual at hhs.texas.gov > Services > ... • All other health care providers should fax the form to: UnitedHealthcare Community Plan, 855-500-3356 Annual Notice of Changes for 2020 . Do I live in the medical plan's service area? What are my plan options? This page contains benefit information for 2020. Remember, if you do not pick a plan within 30 days of receiving your health plan information mailer, Medi-Cal will pick a plan for you. Every year, Medicare evaluates plans based on a 5-star rating system. SqrH��U��/kx�z�o���|������O�fTTE�EhF����4g!0{�����?�����@,b�������3�sx��"��zi��"ɀ85����������.����yZ�]J���~S }������Ԗ���;�~��������,9�g��f����X�k���8��KU� ��� �ϲ��H�,3��q�����d:���rXӳ��ߢ�P�4��0�*�LY���a¨i�����p~�oE�z������IP��*�h:�nPj�.�%�bZ7�"��#$Q�!�(�3�c ?�� ����U4d��0�7e�T����[+}m~lAmȦ������"�V=/@N �i�����ƞ��y�R1aM��@^�(���o? Frequently Asked Questions. Learn more about the plans. Review and submit medical claims. With the Uniform Medical Plan, you may choose from the plans listed below. Looking for 2020 school employee monthly premiums? A formulary is a list of prescription medications that are covered under Scan Health Plan's 2020 Medicare Advantage Plan in California. UCare Classic (HMO-POS) offered by UCare Minnesota. %���� For additional information about your prescription drug benefit, see the current UMP Classic Certificate of Coverage (COC). Below is the Formulary, or drug list, for SCAN Classic (HMO) from Scan Health Plan. Uniform Medical Plan (UMP) is a self-funded health plan offered through the Washington State Health Care Authority’s Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program. All school employees are offered a selection of plans based on their county of residence or the county where their school district, charter school, or educational service district is based. !�� ���*�,ʳ�.^\� �Be�5�.��ߑ�Ɋ�KeP��{��v��~���R��`���٧��V�� �S4�`Z�E��5��)S1���/��Zed1� ���Y�$�Bn�������2��c� �� x�ϱ�ژu�X WSRxS – Washington State Rx (prescription drug) Services. The Regence MedAdvantage + Rx Classic (PPO) has a monthly premium of $78.00 and has an in-network Maximum Out-of-Pocket limit of … UMP is the state’s self-funded medical option for eligible members enrolled in the Public Employees Benefits Board (PEBB) Program. Provider Experience. The Health Care Authority (HCA) today announced a new contract to provide enhanced services to the nearly 200,000 public employees enrolled in Uniform Medical Plan (UMP). ... 11/13/2020 … Awards and recognition are subject to change each year. With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers. The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. Acute inpatient medical and behavioral health hospital stays require concurrent review. You are currently enrolled as a member of UCare Classic. Delta Dental is the plan administrator for the dental insurance plans. The Scripps Classic offered by SCAN Health Plan (HMO) has a monthly premium of $- and has an in-network Maximum Out-of-Pocket limit of … F%?��19�X>���M8��i�?>?���Ҍwg��)��i�����H�Y���0粋�$q8s Z6*`A�pn=���T��R���? This means that all benefits eligible employees will have access to diagnostic, preventive and basic dental services in 2020. After a two-year competitive process, HCA selected Regence BlueShield as […] Regence MedAdvantage + Rx Classic (PPO) H5009-008 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Regence BlueShield available to residents in Washington. endobj If you need assistance, call us at 1-855-266-4865 This booklet tells about the changes. UMP Achieve 1 UMP Achieve 2 UMP High Deductible UMP Plus—Puget Sound High Value Network UMP Plus—UW Medicine Accountable Care Network UMP Plus— Puget … Some drugs may show that they are "not covered." 0yU�2�I�A��j"��������P5���7$��1�4i@{U�/�&�U�0���@�e U'� o Y��+K�\_P4�Յ=IzDv�zjGu��!���W+Ɣ�����t'��������ߓ|#Ch��L�ym�ݑGJ�(tL�_��+��\�U�b���������x�c~M��w�[K�Uy%Ӭ�շ��vD�[/b�Zq��LZ� K�|F�>|ĵ8`t{�M��R��:�U0�}�%���QZ�8��U�OŢ������o~R�Rx(��6����؝� 6�����l�����;����7:bS���i��"ȭ"G��?g���5���ETZ�\�ظ�ʲI�u��mI�nC[�=&*h�?C�����Xȓs����@*n�xa�6��S�� �8����b�ɟ������r{ ���+����Xaj �����i}��j2*. LONG BEACH, Calif., Oct. 1, 2019—SCAN Health Plan ®, today announced its 2020 health plan benefits for Southern California, which are designed for seniors with a variety of health and wellness needs.Seniors and those eligible for Medicare in Los Angeles, Orange, Riverside, San Bernardino, … This plan includes additional Medicare prescription drug (Part-D) coverage. Pediatric primary care as well as adult and pediatric specialty care remains available in the Olympia area. In most cases, you must live or work in the medical plan’s service area to join the plan. <> Uniform Medical Plan Classic (Medicare) Coverage Period: 01/01/2017 - 12/31/2017 Summary of Benefits and Coverage: What This Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO Questions: Call 1-888-849-3681 (TTY 711) for medical. See the 2020 Preferred Drug List. Search Doctors & Drugs ... Enrollment in Oscar depends on contract renewal. For in-depth descriptions of benefits and coverage, see What are the full benefits of each plan? Leading Medicare Advantage Plan’s New Offerings Address a More Holistic View of Health . "����{��1# �`���"��@-��8M�Hq:�0�����J6���f}u�gɏ�P,�o����8O ��$or��X�"�D)s�w��޾��L���I�?�KR�� UMP is administered by Regence BlueShield and Washington State Rx Services. All appointment times are guaranteed by our Uniform Medical Plan Family Physicians & Providers. This benefit includes coverage for hearing aids for members on our Enhanced PPO plans through the TruHearing provider network. The following documents — called a Summary of Benefits and Coverage — provide summaries of what each plan covers and what it costs. (UMP Achieve 1, UMP Achieve 2, UMP High Deductible, UMP Plus)Online: Uniform Medical Plan for school employeesPhone: 1-800-628-3481TRS: 711, UMP Plus–Puget Sound High Value NetworkOnline: UMP Plus–Puget Sound High Value Network for school employeesPhone: 1-877-345-8760, UMP Plus–UW Medicine Accountable Care NetworkOnline: UMP Plus–UW Medicine Accountable Care Network for school employeesPhone: 1-855-520-9400TRS: 711, UMP administered by Washington State Rx Services (Prescription drugs only)Online: Prescription drug information for school employeesPhone: 1-888-361-1611TRS: 711, Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. It's free! Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, UMP Plus—UW Medicine Accountable Care Network, Is there a quick way to see benefits and costs, Uniform Medical Plan for school employees, UMP Plus–Puget Sound High Value Network for school employees, UMP Plus–UW Medicine Accountable Care Network for school employees, Prescription drug information for school employees, Medical plans available by county (SEBB) 2021, Medical benefits comparison and school employee premiums (SEBB) 2021, School employee monthly premiums, deductibles, and out-of-pocket maximums 2021, Website feedback: Tell us how we’re doing. Make an appointment online instantly with Eye Doctors that accept Uniform Medical Plan insurance. Find Uniform Medical Plan Family Physicians & Providers with verified reviews. The Silver Plan pays 70% of covered medical costs for a typical enrollee. 2020 SCAN Classic (HMO) Formulary. Health First Health Plans cannot require out-of-network providers to see our members. If you enroll in State Group Health Insurance, you may elect Uniform Dental. 4 0 obj Make an appointment online instantly with Family Physicians that accept Uniform Medical Plan insurance. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Under state law, the Uniform Medical Plans (UMP Achieve 1, UMP Achieve 2, UMP Classic, UMP Is there a quick way to see benefits and costs? Some school employees may have more plan options if they work in a district that crosses county lines. The SCAN Classic (HMO) plan … It's free! <>/Metadata 2568 0 R/ViewerPreferences 2569 0 R>> Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. Enrollment in Medical Mutual's MedMutual Advantage Classic HMO depends on contract renewal. The UCare Classic (HMO-POS) has a monthly premium of $185.00 and has an in-network Maximum Out-of-Pocket limit of $3,400 (MOOP). October 1, 2020. Medical. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan … <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R 81 0 R 82 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> This benefit is also available as part of the optional benefits coverage on our Medicare HMO plans. Plan Year Jan. 1 - Dec. 31, 2020 MEDICARE SUPPLEMENT PLANS. About MedMutual Advantage Classic HMO • Medical Mutual's MedMutual Advantage Classic HMO is a HMO plan with a Medicare contract. The plan with the lowest out of pocket expense is $900 and the highest out of pocket is $6700. Hearing aid benefits. 2 0 obj Visit one of UMP's online provider directories. Find Uniform Medical Plan Eye Doctors & Providers with verified reviews. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. 2020 UMP Classic (PEBB) Certificate of Coverage 6. If you find multiple health plans listed, please explore each plan and choose the one that suits you and your family’s needs. If information given here is inconsistent with the applicable COC, the rules in the applicable COC will apply. With the Uniform Medical Plan, you may choose from the plans listed below. There are 39 Medicare Advantage Plans available in San Diego County CA from 15 different health insurance providers. 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