Specialty drugs must be purchased through Ardon Health, unless you receive an authorization from Washington State Rx Services. Health Care Flexible Spending Account. Health Care Authority PEBB Program PO Box 42684 Olympia, WA . Description: HCA and DSHS intend to submit Medicaid State Plan Amendment (SPA) 23-0043 in order to increase daily rates for Adult Family Homes, Adult Day Respite, Nurse Delegation, Enhanced Service Facilities, Assisted Living Facilities, Agency Providers, and Consumer Directed . Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans offered through Washington States Public Employees Benefits Board (PEBB) Program. Can I change my plan? Faculty with a quarter-to-quarter appointment who are in a UW paid appointment of at least 50 percent or more are eligible for PEBB insurance on the first day of the month following the start of their second consecutive academic quarter. myStrength is safe, secure, and personalized just for you. 2019 PEBB Health Insurance Rates - Retired Public Health (2 days ago) Web2019 PEBB Health Insurance Rates for Retirees. There are several factors that determine whether a drug is covered and how much itll cost. There is a premium for most Medicare Advantage plans. The plan will not cover a refill or an emergency fill until 84% of the last prescription should be used up. Emergency fills UMP provides access to affordable care and a dedicated team ready to help you make the most of your benefits. UMP Classic is one of the Public Employees Benefits Board's (PEBB) Medicare plans. Youllneed to send your appeal form to the Integrated Service Center for a first-level review, not the Health Care Authority. Insurance during retirement - Benefits - University of Washington Human See Health plans with health savings accounts (HSAs) to learn more about CDHPs. Benefits If you do not meet the immediate eligibility listed above you can obtain eligibility in one of two ways. Travel Assistance by The Standard. When you choose a UMP plan, you get an active partner in your health care. 2023 Regence BlueShield. This campaign is funded by HCA and the SAMHSA State Opioid Response and informed by recommendations from tribal leaders. We must receive the forms no later than the last day of the month before the month you or your dependent enrolls in the Medicare Advantage plan. You can also add or remove a child, spouse, or partner from your coverage. UMP CDHP - Regence Academic staff, professional, and classified staff and librarians are eligible for PEBB insurance if they are appointed to an eligible job class that is at least an average of 80 hours per month (480 hours) UW salaried per month and the appointment is expected to continue for more than six months. UnitedHealthcare PEBB Balance Medicare Part A and Part B are provided to you by the federal government. For those immunizations to be covered as preventive, you must meet the criteria described on the CDC schedule. Once you have met this deductible for the year, you only pay your coinsurance. When you choose a UMP plan, you get an active partner in your health care. You are protected from surprise billing or balance billing when you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center. What is Open Enrollment? You must pay an extra fee in addition to your premium if either of these apply to you: These surcharges dont apply to you if youre enrolled in Medicare Part A or Part B. While deferring coverage, you need to be continuously enrolled in other health care coverage, such as that provided by a spouse's employer. . PEBB purchases and coordinates the health insurance benefits for all state employees, including UW employees. Office locations. PEBB provides life insurance through the Metropolitan Life Insurance Company (MetLife). If you are paid directly from a non-UW entity your benefits eligibility may be affected. SoundChoice. Failure to notify UW may result in loss of eligibility. The plan does not cover over-the-counter drugs, vitamins, and supplements, except for a few that are specifically noted in the UMP Preferred Drug List. 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It ensures the highest level of reimbursement for services when a person is covered by more than one plan. Certain charges (such as your annual deductible, copays, and coinsurance) may count toward your out-of-pocket limit. You will be notified when you become eligible by an electronic notice sent via Workday to your UW email address. Do you need to purchase a Medicare Part D prescription drug plan? While all plans cover the same basic health care services, you may want to know whether or not a certain service is covered by the plan. Log in to your pharmacy account to view your prescription claims history and access the Drug Information Checker to learn how your prescription and over-the-counter drugs interact with each other. You may find out if a drug is a specialty drug by checking the UMP Preferred Drug List. However, they only apply to Tier 2 prescription drugs, so you dont have to pay the deductible if you use prescription drugs from any other tier, which includes most generic and low-cost drugs. The PEBB Program only offers Premera Blue Cross Medicare Supplement Plan G. Plan G only pays when Medicare pays for services billed under Medicare Part A and Part B. UMP Classic, UMP Select, or UMP Plus: Tier 2 cost-share, UMP CDHP: 15% coinsurance after deductible is met. These booklets are long, but they can be helpful if you need to know something specific. 2023 Washington State Tribal Opioid/Fentanyl Summit You are required to notify UW in a timely way of your prior employment at UW or other Washington state higher education institutions in order to establish your eligibility. Be confident about your decisions after you become eligible for Medicare. The enrollment will be effective the first of the month after the date of the event or the date we receive the required forms, whichever is later. If eligible, the subscriber and/or dependents must enroll and maintain enrollment in both Medicare Part A and Part B to qualify for PEBB retiree coverage. Denied coverage? The plan does not cover immunizations for travel or employment, even when recommended by the CDC or required by travel regulations. In most cases, you must live in a medical plan's service area to join the plan. Retiree term life coverage is not available to those who: For more information concerning retiree life insurance options with MetLife please refer to the Certificates of Coverage (COC) for Washington and non-Washington residents. Who to contact for help . What happens to your UW Benefits after big life changes? Washington State Health Care Authority on Twitter: "Interested in new Part-Time University (SB 551) Optional Insurance Plans. If you need more information about the appeal process, seefile an appealon the PEBB website. Covered preventive care services are exempt from the medical plan deductible. Things to think about when choosing a medical plan. Contact Washington State Rx Services to learn more. However, some supplies may be covered under the UMP medical benefit. They include:Continuing your PEBBcoverage by enrollingas an eligible retiree Enrolling in a plan offered by the Public Employees Retirement System (PERS) You must submit an online UW Retirement Application within 6 months of your UW separation date and no later than 60 days after the separation date. If you have UMP CDHP, the prices listed assume you have met your combined (medical and prescription drug) deductible. It is important to consider all of these when choosing a plan. This is called coordination of benefits. How do I notify SEBB that my loved one has passed away? For general information about eligibility, enrollment, or premiums. If you simply want an overview of a plans coverage and costs, take a look at the plan Summary of Benefits and Coverage, an easy-to-read summary that lets you quickly review health plans. Learn how to enroll . For all the plans, you pay coinsurance for prescriptions. You may request no more than two travel overrides per calendar year, including all travel within or outside the United States. Do I have to enroll in Medicare? The surviving spouse, state-registered domestic partner, or dependent children of a deceased eligible employee or retiree. When you retire, you can choose to continue the Public Employees Benefits Board (PEBB) medical, dental, and life insurance you had as an employee. PDF PEBB fact sheet - Oregon.gov To learn more visit Medicare coverage. Review medical and prescription coverage choices tailored to your health and budget. To find out which vaccinations are considered preventive, check the Centers for Disease Control (CDC) immunizations schedules. If the exception is approved, you will pay: Youll get the UMP member discount when you buy prescription drugs through one of UMPs network retail pharmacies, network mail-order pharmacies (Costco Mail Order Pharmacy and Postal Prescription Services), or network specialty drug pharmacy (Ardon Health). Some providers are network providers in one location but not another. How do I notify SEBB that my loved one has passed away? We must receive the forms no later than the last day of the month before the month you or your dependent enrolls in the Medicare Advantage plan. Coverage is also available to: To enroll or defer retiree coverage, PEBB must receive the Retiree Enrollment form (form A) no later than 60 days after the employer-paid coverage, COBRA coverage, or continuation of coverage ends. UMP Plus: UW Medicine Accountable Care Network, UMP Plus UW Medicine Accountable Care Network, UMP Plus Puget Sound High Value Network. DRS Plan 3 members are not required to receive a retirement plan or lump sum payment but must be at least age 55 and have at least 10 years of service under Plan 3. To compare plans and costs, see either the PEBB plan page for retirees who have Medicare or the page for retirees without Medicare. Many people think first about cost and which doctors and hospitals are in the network. See medical plan premiums to see premiums for all medical plans. Your prescription drug benefits are managed by Washington State Rx Services. Kaiser WA plans - Benefits - University of Washington Human Resources