What to do during OPEN enrollment

For those enrolled in Original Medicare Parts A and B, three different Medicare supplement PPO plans are available. With a Medicare supplement plan, Medicare is your primary insurance. Your UC coverage is secondary. When you have a Medicare-covered expense, Medicare pays its share of the cost. The UC plan then pays some or all of the remaining cost, based on the plan and the Medicare-approved amount for that service. Generally, services not covered by Medicare are not covered by the UC Medicare supplement plans.

know your options

All the plans cover services such as doctor’s office visits, telehealth services, hospitalization, behavioral health, and coverage around the U.S. and internationally. And all plans provide in-network access to expertise across six world-class academic medical centers. Choosing a UC Medicare supplement plan means in-network access to the highest-quality care at any UC Health center. However, there are differences between the plans, including:

What you pay for coverage: Each plan has a different monthly premium. Your premium is based on the plan you choose and whether you cover any family members in addition to yourself. See what you pay for coverage each month.

What you pay for care (doctor’s office visits, prescriptions, etc.): The combination of your deductible plus copayments or coinsurance, up to the plan’s out-of-pocket maximum. Compare your cost for care.

Pharmacy coverage: All plans include prescription drug coverage, except the UC Medicare PPO without Prescription Drugs.

Get the Facts

See how the plans compare.

UC Medicare PPO

Lower premium in exchange for some out-of-pocket costs for Medicare-covered services. The plan covers 80% of remaining costs after Medicare pays its share.

Also included are Benefits Beyond Medicare, which covers certain services not covered by Medicare Parts A & B, such as acupuncture, virtual visits with a doctor or therapist, hearing aids, inpatient hospital care beyond Medicare limits, behavioral health services from providers who don’t accept Medicare (Medicare opt-out providers), and more.

Medicare’s true out-of-pocket maximum (TrOOP) of $7,050 for prescription drugs. This is separate from the annual $1,500 out-of-pocket maximum for medical care.

Prescription drug coverage through Navitus MedicareRx (Navitus), including no copayment for certain generic drugs used to treat common chronic conditions.

Coverage for certain lifestyle drugs, over-the-counter medications and vitamins that Medicare Part D doesn’t cover. See the prescription drug formulary.

For details, see the benefit summaries.

UC Medicare PPO Without Prescription Drugs

UC covers 100% of the premium for eligible retirees.

Designed for people enrolled in a prescription drug plan outside of UC, such as through a spouse, a current or former employer, or TRICARE. This plan does not provide prescription drug coverage.

Covers 80% of the remaining cost of Medicare-covered medical services after Medicare pays its share. Prescription drugs are not covered.

Also included are Benefits Beyond Medicare, which covers certain services not covered by Medicare Parts A & B, such as acupuncture, virtual visits with a doctor or therapist, hearing aids, inpatient hospital care beyond Medicare limits, behavioral health services from providers who don’t accept Medicare (Medicare opt-out providers), and more.

For details, see the benefit summaries.

UC High Option Supplement to Medicare

Higher premium in exchange for no out-of-pocket costs for Medicare-covered services. The plan covers 100% of remaining costs after Medicare pays its share.

Also included are Benefits Beyond Medicare, which covers certain services not covered by Medicare Parts A & B, such as acupuncture, virtual visits with a doctor or therapist, hearing aids, inpatient hospital care beyond Medicare limits, behavioral health services from providers who don’t accept Medicare (Medicare opt-out providers), and more.

Lowest prescription drug out-of-pocket maximum ($1,000). This is separate from the annual $1,050 out-of-pocket maximum for medical care.

Prescription drug coverage through Navitus MedicareRx (Navitus), including no copayment for certain generic drugs used to treat common chronic conditions.

Coverage for certain lifestyle drugs, over-the-counter medications and vitamins that Medicare Part D doesn’t cover. See the prescription drug formulary.

For details, see the benefit summaries.

Compare Your Costs

What you pay for coverage depends on the plan you choose, your salary band and the family members you cover.

Check the Network

The UC Medicare Supplement plans include in-network coverage for Benefits Beyond Medicare services at all UC Health centers, plus expanded coverage around the country and the globe through the Anthem national network.

Medicare Covered Services

Go to medicare.gov to find providers near you that accept Medicare.

Benefits Beyond Medicare

Choose Anthem network providers to minimize out-of-pocket costs. Learn more.

Current members: Log in to anthem.com/ca and select Find Care under the Care menu option.

Prospective members: Go to anthem.com/ca/find-care.

  1. Click the Guests option.
  2. Select type of care (e.g., Medical).
  3. Select a state (e.g., California).
  4. Select type of plan (e.g., Medical [Employer-Sponsored]).
  5. Select a plan/network (e.g., UC Medicare PPO with Prescription Drugs).

Or get help from an Anthem Health Guide. Call toll-free at (844) 437-0486, Monday through Friday, 5 a.m. to 8 p.m. PT.

more to explore

UC also offers other medical options for retirees with Medicare.

Check the Boxes

During Open Enrollment

October 28 – November 19, 2021

All Members

  • Consider all your medical plan options. Learn more about all the plans on UCnet.

Prospective Members

  • For Benefits Beyond Medicare, check to see if your current providers are in the Anthem network.

After Open Enrollment

  • Watch for new ID cards in the mail. All Medicare PPO and High Option Supplement to Medicare plan enrollees will receive a new prescription drug ID card from Navitus in December. You should begin using this new prescription drug card beginning January 1, 2022.

    You should continue to use your Anthem medical plan ID card for medical services (for example, when you have a doctor or hospital visit). You will not receive a new medical plan ID card from Anthem (unless you change health plans).

On or After January 1, 2022

  • If you’re a new Anthem member, register with Anthem for the most current benefit updates, personalized claims data (including your deductible met to date), electronic ID cards, online chat with customer service, virtual care when you need it, and quick access to free health and wellness tools. (Tip: Have your member ID card handy.)
  • Register on the Navitus secure member portal to access your pharmacy information. You’ll also need to set up your account with Costco to use the mail order pharmacy.
  • Bookmark the UC PPO plans website for quick answers to plan questions: ucppoplans.com.
  • Download the Sydney Health mobile app to have access to medical plan information and wellness tools right on your mobile device. Sydney Health can be found on both Google Play and the App Store.
  • Provide your new ID card to your provider(s) and in-network pharmacy on your first visit.

If you changed plans for 2022:

  • If you have a new family doctor, make an appointment for an office visit to get to know each other and to review your current health and health history. Work with your former doctor or behavioral health provider to transfer your medical records to your new doctor.

Prescription Drug Transition List

  • Check the Navitus formulary and prescription drug costs. If needed, talk to your doctor about alternatives to lower your cost. 
  • If you’re taking a drug that’s not on the Navitus drug list or have other questions, call Navitus Customer Care at (866) 270-3877, 24 hours a day, 7 days a week, except Thanksgiving and Christmas Day.

Before December 31

  • Get a refill of any current medications to last through the holidays and the new year. This will ensure your treatment is not interrupted during the transition to Navitus.
  • If your refills will expire on or around January 1, ask your doctor to write a new prescription (with refills) that you can submit to Navitus in January.

After January 1