What’s New for 2022

There are no changes to the plans’ copay or coinsurance structure or to what the plans cover.

However, you should take note of the other important changes that affect all plans.

MEDICARE PPO AND MEDICARE HIGH OPTION SUPPLEMENT

New Pharmacy Benefit Manager

Navitus Health Solutions (Navitus) is replacing Anthem IngenioRx as the pharmacy benefit manager of the UC Medicare PPO plan’s prescription drug benefit. As the pharmacy benefit manager, Navitus sets clinical policy and guidelines for medications and processes pharmacy-related claims.

UC regularly reviews the administrators of its health and welfare plans to ensure members receive the highest levels of service at the most competitive prices. After a thorough process, a committee representing UC faculty, staff and retirees determined that Navitus would offer significant advantages as the pharmacy benefit manager for UC’s self-insured PPO plans.

Continued Focus on Service and Convenience

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Navitus MedicareRx (the name of the Navitus Medicare prescription drug plan) offers a large retail pharmacy network, including Costco, CVS, Walgreens, Walmart, and Safeway/Vons, pharmacies located within University of California (UC) Health medical centers, and many independent pharmacies.

  • 24/7 Customer Care. Beginning October 1, Navitus Customer Care can answer your pharmacy benefit questions, advise you about taking your medications correctly, and help you get additional care if needed. Their toll-free number is (866) 270-3877 and they are available 24 hours a day, 7 days a week, except on Thanksgiving and Christmas Day. TTY users can call 711.
  • Online tools to make the most of your prescription benefit, including a pharmacy locator, cost compare tool, and educational resources to help you manage your health.

Learn more about what’s covered, your costs, and find in-network pharmacies near you.

Costs and Formulary Changes

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There are no changes to the plans’ standard cost-sharing amounts (copayments or coinsurance) for prescription drugs. However, every pharmacy benefit manager uses its own formulary. While the Anthem IngenioRx and Navitus formularies are similar, there are some differences. For example, both the Anthem IngenioRx and Navitus formularies feature four tiers of medications, including generic and brand-name drugs, with the lowest out-of-pocket costs in Tier 1. However, the medications that are included in the Navitus MedicareRx formulary might differ from those included in the Anthem formulary.

This means that you might pay more, or less, for your prescriptions than you do today. And in some cases, your current medication might not be covered. But don’t worry. If you are currently taking a drug that will not be covered in 2022, that medication may continue to be covered for a period of time. And, if you are affected, Navitus MedicareRx will contact you to explain your options.

No-Cost Generics and More

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Many commonly prescribed generic drugs — such as those to treat conditions like diabetes, hypertension and high cholesterol — will be available for $0 out-of-pocket cost at Navitus MedicareRx retail network pharmacies, UC Health Medical Center pharmacies, and through the Navitus MedicareRx mail-order pharmacy (Costco Pharmacy).

Your UC coverage also includes certain additional drugs not covered by Medicare Part D plans.

Transition Tips

Get a refill for your daily medications. Refill current medications to last through the holidays and new year.

Check the Navitus formulary and drug costs. Review the Navitus formulary to confirm the status of your current medications. You can use the Navitus Cost Compare tool to view 2022 prescription costs.

Find an in-network pharmacy near you. View the Navitus network.

MEDICARE PPO AND MEDICARE HIGH OPTION SUPPLEMENT PLANS

New ID Cards

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. You will not receive a new medical plan ID card from Anthem (unless you change health plans).

New Mental Health Resource

Learn to Live will replace the myStrength app in January 2022. Built on the proven principles of cognitive behavioral therapy (CBT), Learn to Live digital tools are available anywhere, anytime. They can help you identify thoughts and behavior patterns that affect your emotional well-being — and work through them. You’ll learn effective ways to manage stress, depression, anxiety, substance use and sleep issues. Benefits include:

  • Personalized, one-on-one coaching by teaming up with an experienced coach who can provide support and encouragement by email, text or phone
  • Add friends or family members as “teammates” to help you stay motivated and accountable while you work through programs
  • Live and on-demand webinars to learn how to improve mental well-being with useful tips and advice from experts