Your Plan Option Explained
UnitedHealthcare Group Medicare Advantage (PPO) Plan
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UHEX11MP3237166_000 Y0066_100802_102041
Your Medicare.
his brochure explains the Medicare Advantage (PPO) plan option available T to you through Alcatel-Lucent for 2011. Medicare Advantage plans, also known as Medicare Part C plans, combine your Medicare Part A (hospital) and Medicare Part B (doctor and out-patient) coverage with additional benefits that contribute to improving your health and wellness.
o physicals or health questions are required to enroll, and pre-existing N conditions do not affect your eligibility. All Medicare Advantage plans are offered by private insurance companies, like UnitedHealthcare, who are required to provide coverage that is as good as Original Medicare or better. The government pays the private insurers a fixed fee for your care, who in turn, handle the payments to doctors and hospitals.
Hospital Doctors
Your UnitedHealthcare. Choosing the right health care plan option is a big decision. It involves looking at the costs, benefits, access to doctors and other health care services and so much more. We want you to feel good about your plan option choice, and to help you get the most out of your health care dollar.
Five reasons to choose a UnitedHealthcare plan. 1. A company you know and trust – With over 25 years of experience, UnitedHealthcare is one of the nation’s largest providers of health care coverage for older adults. Nationally, we serve one in five people eligible for Medicare.1 2. H elping to control your care costs – The Plan helps limit your out-of-pocket expenses by providing an annual limit and affordable copayments. 3. F lexibility – We understand that your choice of doctors, hospitals and other health care providers is important. With this plan option, you will have access to a national network of providers through UnitedHealthcare. Plus, you can see out-of-network providers as long as they participate in Medicare. 4. Additional health and wellness programs that make a difference – This plan option offers the same coverage as Medicare Parts A and B, plus other services that contribute to your health and wellness. 5. D edicated Customer Service – We have a dedicated customer service team that is knowledgeable about your employer group-sponsored plan. With one simple phone call, you can get answers to all your health plan benefit questions.
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Your Plan Option. This plan option is a Preferred Provider Organization (PPO) plan. This type of plan helps keep health care decisions in your hands. You can see any provider that participates in Medicare. You can take advantage of our large group of in-network doctors. If a doctor is in-network, that means he/she has a contract with UnitedHealthcare for this plan. You also have the flexibility to see doctors that are out-of-network. These doctors do not have a contract with UnitedHealthcare for this plan. Unlike most PPO plans, with this plan you pay the same copay or coinsurance whether you see an in or out-of-network doctor.
Plan highlights:
• The plan covers health services provided to you by any doctor or medical professional who participates in Medicare.
• You can enjoy predictable copayments (a flat dollar amount) or coinsurance (a percentage) that represents your share of the cost. This may help make budgeting for health care costs easier.
• You can take advantage of a $0 copayment for some Medicare-covered preventive services, including an Annual Wellness Visit.
• You’ll pay a limited amount out-of-pocket for the year.
Frequently asked questions.
Will the doctor or hospital accept my plan? What is my copay or coinsurance?
In-Network
Out-of-Network
Yes
Has the choice to accept the plan (except for emergencies)
You pay the same copayment whether you see a provider in or out-of-network
Do I need to choose a Primary Care Physician (PCP)?
No
No
Do I need a referral to see a specialist?
No
No
For more information about your plan details including copayments and plan benefits — refer to the Benefit Highlights booklet.
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Your Doctor.
eeing a doctor is easy. With our large network, most likely your doctor is S already part of the plan. However, even if your doctor is not part of our network, we have made it easy for your doctor to accept this plan.
• Different from PFFS plans, PPO plans have been around a long time. Doctors are used to working with PPOs.
• We pay as Medicare pays so your doctor will receive the same payment as under Medicare.
• If your doctor does not accept Medicare assignment, we will pay the excess charges.
To find out about the doctors or hospitals in the network, see the online Provider Directory at www.UHCRetiree.com. This directory is updated regularly to provide you with the current listing of network providers.
If you would like help finding a doctor, or to request a copy of the Provider Directory please call Customer Service at 1-888-980-8117, TTY 711, 8 a.m. – 8 p.m. local time, 7 days a week.
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Important Notes and Next Steps.
1. Once you are officially enrolled in the plan, you will receive a Welcome Kit from UnitedHealthcare with complete details about the benefits and services of your new health plan.
2. You will receive your new member ID card in late December.
3. You can begin using your new member ID card to enjoy your benefits and services on January 1, 2011.
4. If you drop your group-sponsored retiree health coverage in the future, you may not be able to re-enroll until the next annual open enrollment period or unless you have a qualified status change.
Questions? Call Customer Service toll-free about your plan:
1-888-980-8117, TTY 711
8 a.m. – 8 p.m. local time, 7 days a week
When you contact customer service, have your group number available. You can find your group number on the front of the Benefit Highlights booklet.
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Notes
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1
2008 UnitedHealth Group Annual Report
UnitedHealthcare® Medicare Advantage plans are offered by UnitedHealthcare Insurance Company and its affiliated companies, a Medicare Advantage organization with a Medicare contract. Limitations, copayments and coinsurance may apply. Benefits may vary by employer group.
