Your Plan Explained

UnitedHealthcare® Group Medicare Advantage (PPO) Exclusively for UAW Trust Members.

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Your Medicare. This brochure explains your Medicare Advantage plan option, a type of health plan also known as Medicare Part C. Medicare Advantage plans combine your Medicare Part A (hospital) and Medicare Part B (doctor and out-patient) coverage. They also provide additional benefits that can help improve your health and wellness. You have to be enrolled in Medicare Part A and purchase Medicare Part B to be eligible to enroll in this plan. If you’re not sure if you are enrolled, check with your local Social Security office. You must continue paying your Medicare Part B premium to keep your coverage under this group-sponsored plan. If you stop your payments, you may be disenrolled from this plan. No physicals or health questions are required to enroll, and pre-existing conditions do not affect your eligibility. All Medicare Advantage plans are offered by private companies, like UnitedHealthcare® Insurance Company, who are required to offer coverage that is as good as Original Medicare or better. The government pays us a fixed fee for your care. UnitedHealthcare then handles the payments to doctors and hospitals.

Your UnitedHealthcare.

Hospital

Doctors

Additional Benefits

Choosing the right health care plan 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 to help you get the most out of your health care dollar so you can feel good about your health plan choice.

Five reasons to choose a UnitedHealthcare® plan.

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Get coverage from a National Leader – 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 Help controlling your care costs – This plan helps limit your out-of-pocket expenses by providing an annual limit and affordable copays. Flexibility – We understand that your choice of doctors, hospitals and other health care providers is important. With this plan, you have a large network of doctors, hospitals and other health care providers affiliated with the plan. There’s a good chance your doctor is already part of our network.

 dditional health and wellness programs that make a difference – This plan offers the same benefits A as Medicare Parts A and B, plus extras that contribute to your health and wellness.



 edicated Customer Service – We have created a helpful customer service team that has been trained D on your specific group-sponsored plan. With one simple phone call, you can get answers to all your health plan benefit questions.

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Your New Plan Option. Your new plan option is a Preferred Provider Organization (PPO) plan. This type of plan generally provides more flexibility to let you choose your doctors and hospitals. The plan typically does not require you to have a referral to see a specialist, and you can see doctors outside the network without having to pay the entire cost yourself. When you sign up for a UnitedHealthcare Group Medicare Advantage (PPO) plan, all of your health care coverage is combined into a single plan. You get coverage for hospital and doctor care from one company, with one member ID card. It’s an easier way for you to manage your benefits.

Plan highlights:

• You have the flexibility to choose your own doctor from our large network. In fact, there’s a good chance your doctor is already a part of our network.



• If your doctor is “in-network” (has a contract with UnitedHealthcare for this plan) he or she must accept this plan.



• If your doctor is “out-of-network” (does not have a contract with UnitedHealthcare for this plan), you may pay a larger share of the cost of your care.



• You can enjoy predictable copays (a flat dollar amount) or coinsurance (a percentage) that represent your share of the cost.



• There is a limit on your out-of-pocket spending for the year.



• Worldwide Emergency and Urgently Needed Services are covered and never require prior authorization.

Consider these in-network plan benefits:

• 100% coverage on preventive services



• $25 copay for doctor office visits



• $25 copay for urgent care services



• $50 copay for emergency room visits

Plus additional benefits like:

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• Hearing aid coverage



• SilverSneakers® Fitness program



• Solutions for Caregivers



• 24-hour NurseLineSM Services

Your Doctor. Seeing a doctor is easy. When you enroll in this plan, you have access to a broad network of doctors and hospitals. Providing members with a large network of health care providers is just another example of how we help you take control of your health care decisions, by increasing your options and choices in getting care. With our large network, most likely your doctor is already part of the plan.

To find doctors or hospitals in our 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 network doctor or to request a written copy of the Provider Directory, please call UnitedHealthcare Customer Service at 1-877-776-1469, TTY 711, 8 a.m. – 8 p.m. local time, 7 days a week.

Frequently Asked Questions. In-Network

Out-of-Network

Yes

Has the choice to accept plan (except for emergencies)

Standard plan copay or coinsurance applies

You may pay a larger share of the cost for your care

Do I need to choose a Primary Care Physician (PCP)?

No

No

Do I need a referral to see a specialist?

No

No

Will the doctor or hospital accept my plan? What is my copay or coinsurance?

Depending on where you live, you may be eligible for covered benefits that have the same copay or coinsurance whether you receive services in or out-of-network. Call UnitedHealthcare Customer Service to see if this benefit is available in your zip code. 5

Additional Benefits and Programs. This plan provides the same coverage as Medicare Parts A and B, plus many additional benefits and programs that contribute to your health and wellness. They may include:

NurseLine Services SM

Speak with a registered nurse, 24 hours a day, 7 days a week.

• Discuss your health and diet.



• Review or discuss your medications.



• Receive information about illnesses and injuries.



• Get tips on working with your doctor.

SilverSneakers® Fitness Program Stay physically fit and active with the SilverSneakers Fitness Program. This fitness program is available to you at no additional cost. With the SilverSneakers Fitness Program you’ll receive:

• A basic fitness center membership at more than 11,000 participating locations.



• Access to all amenities, programs and services that are standard with a basic fitness center membership.



• Nationwide access to any participating fitness location (find locations at www.silversneakers.com).



• Many women-only locations, including Curves,® are available nationwide.

If the nearest participating location is 15 miles or more away from your home, you can register for the SilverSneakers® Steps program. This is a personalized program that provides tools such as resistance bands, exercise DVDs and “how-to” material to help you measure, track and increase your daily activity.

The products and services described below are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the UnitedHealthcare grievance process.

Solutions for Caregivers Providing care for a loved one can be demanding and overwhelming. This plan gives you access to Solutions for Caregivers – a program that supports you, your family and your loved ones. Services provided by Solutions for Caregivers include:

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• On-site assessment and development of a personalized care plan for you or your loved one.



• Unlimited phone access to a Care Specialist who can provide counsel on individual, medical, financial, safety, emotional and social needs.



• Connections with professionals, including home health aides, nurses, lawyers and financial advisors.

Next Steps. 1. If you are interested in enrolling please call Retiree Health Care Connect (RHCC) at the number below. 2. RHCC will make sure you are eligible for the plan. 3. RHCC will send your enrollment information to UnitedHealthcare. 4. Your effective date is the first day of the second month after you enroll, no earlier than January 1, 2012. 5. You will receive your new member ID card before your effective date. 6. Once you are officially enrolled in the plan, you will receive a Welcome Kit. 7. Begin using your new member ID card on your effective date.

Important Notes. The Centers for Medicare and Medicaid Services, (CMS) requires that we provide our members with new or updated plan materials. Providing you with new and updated plan information can help you understand your plan better, so you can take advantage of all the benefits available to you.

• Evidence of Coverage (EOC) – included in your Welcome Kit, provides complete details about the benefits and services included with your new plan.



• Annual Notice of Changes (ANOC) – mailed every year before your renewal, describes changes to your benefits for the next year.



• Updated Provider Directories – mailed every 1-3 years.

For more information about your plan details, including copays and plan benefits, refer to the Benefits at-a-Glance brochure or Summary of Benefits. Your prescription drug coverage is administered separately by Medco.

Questions?

Retiree Health Care Connect (RHCC) GM/Chrysler Trust members: 1-866-637-7555 Ford Trust members: 1-877-829-9444 UnitedHealthcare Customer Service:

1-877-776-1469, TTY 711

8 a.m. – 8 p.m. local time, 7 days a week

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2010 UnitedHealth Group Annual Report

OptumHealthSM is a health and well-being company that provides information and support as part of your health plan. NurseLineSM nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor’s care. NurseLineSM services are not an insurance program and may be discontinued at any time. SilverSneakers® is a registered mark of Healthways, Inc. The SilverSneakers® program is made available as part of this plan’s benefits to those insured through this plan. UnitedHealthcare does not endorse and is not responsible for the services or information provided by this program. Consult a health care professional before beginning any exercise program. Solutions for Caregivers assists in coordinating community and in-home resources. The final decision about your care arrangements must be made by you. In addition, the quality of a particular provider must be solely determined and monitored by you. Information provided to you about a particular provider does not imply and is in no way an endorsement of that particular provider by Solutions for Caregivers. The information on and the selection of a particular provider has been supplied by the provider and is subject to change without written consent of Solutions for Caregivers. UnitedHealthcare® Medicare Advantage plans are insured through UnitedHealthcare Insurance Company and its affiliated companies, a Medicare Advantage organization with a Medicare contract. Members may enroll in the plan only during specific times of the year. Contact UnitedHealthcare for more information. You must have both Medicare Parts A and B to enroll in the plan. Retiree plan prospects must meet the eligibility requirements to enroll for group coverage. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Limitations, copayments, and restrictions may apply. Reimbursement is provided for all covered benefits regardless of whether they are received in or out-of-network. For some PPO plans out-of-network services may cost more than in-network services.