Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. All appointment times are guaranteed by our Uniform Medical Plan Family Physicians & Providers. Questions about our plans? cover eligible dependents, everyone must enroll in the same medical plan Search Doctors & Drugs ... Enrollment in Oscar depends on contract renewal. This booklet tells about the changes. Do I live in the medical plan's service area? stream If information given here is inconsistent with the applicable COC, the rules in the applicable COC will apply. (UMP Achieve 1, UMP Achieve 2, UMP High Deductible, UMP Plus)Online: Uniform Medical Plan for school employeesPhone: 1-800-628-3481TRS: 711, UMP Plus–Puget Sound High Value NetworkOnline: UMP Plus–Puget Sound High Value Network for school employeesPhone: 1-877-345-8760, UMP Plus–UW Medicine Accountable Care NetworkOnline: UMP Plus–UW Medicine Accountable Care Network for school employeesPhone: 1-855-520-9400TRS: 711, UMP administered by Washington State Rx Services (Prescription drugs only)Online: Prescription drug information for school employeesPhone: 1-888-361-1611TRS: 711, Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. A formulary is a list of prescription medications that are covered under Scan Health Plan's 2020 Medicare Advantage Plan in California. Some drugs may show that they are "not covered." Annual Notice of Changes for 2020 . Hearing aid benefits. January 1, 2020, marks a new year and brings many changes for Washington public and state employees covered by the Washington Health Care Authority (HCA). All school employees are offered a selection of plans based on their county of residence or the county where their school district, charter school, or educational service district is based. Get medical insurance for your life and budget. 4 0 obj Telehealth services through PSHVN may also be an appropriate option for some primary care needs. 2020 UMP Classic (PEBB) Certificate of Coverage 6. Learn more about the Uniform Medical Plan (UMP) plans, administered by Regence BlueShield and Washington State Rx Services (WSRxS). The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. About MedMutual Advantage Classic HMO • Medical Mutual's MedMutual Advantage Classic HMO is a HMO plan with a Medicare contract. This plan includes additional Medicare prescription drug (Part-D) coverage. This page contains benefit information for 2020. You are currently enrolled as a member of UCare Classic. How are Silver Plans different than other Obamacare health plans? Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. *Star rating applies to all plans offered by SCAN Health Plan 2018-2021 except SCAN Healthy at Home (HMO SNP) and VillageHealth (HMO-POS SNP) plans. Learn more about the plans. This means that you and any adult dependents may need to travel to another county served by UMP Plus—PSHVN for primary care services from a network provider. endobj Health First Health Plans cannot require out-of-network providers to see our members. After a two-year competitive process, HCA selected Regence BlueShield as […] You may choose health insurance, with or without dental. To browse each plan’s network or to find a … Under state law, the Uniform Medical Plans (UMP Achieve 1, UMP Achieve 2, UMP Classic, UMP Next year, there will be some changes to the plan’s costs and benefits. <> Acute inpatient medical and behavioral health hospital stays require concurrent review. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. To learn more, please call Washington State Rx Services at 888-361-1611. This means that all benefits eligible employees will have access to diagnostic, preventive and basic dental services in 2020. Be sure to call the plans you are interested in to ask about provider availability in your county. This plan includes additional Medicare prescription drug (Part-D) coverage. The Health Care Authority (HCA) today announced a new contract to provide enhanced services to the nearly 200,000 public employees enrolled in Uniform Medical Plan (UMP). Learn more about your customer service options. endobj UMP Plus—​Puget Sound High Value Network (PSHVN) does not have primary care network providers for adults in Thurston County at this time due to limited access. UMP administered by Regence BlueShield (Medical only) Find Uniform Medical Plan Family Physicians & Providers with verified reviews. All appointment times are guaranteed by our Uniform Medical Plan Eye Doctors & Providers. The Regence MedAdvantage + Rx Classic (PPO) has a monthly premium of $78.00 and has an in-network Maximum Out-of-Pocket limit of … It's free! <>/Metadata 2568 0 R/ViewerPreferences 2569 0 R>> This is a Medicare Advantage HMO plan that replaces traditional Medicare benefits (Part A and Part B). Delta Dental is the plan administrator for the dental insurance plans. For a summary of benefits and costs, see Is there a quick way to see benefits and costs? If you aren’t clear about any of Awards and recognition are subject to change each year. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. MODEL Exhibit E-1 – Section 1367.27 Annual Compliance Filing (1.24.2020).dox Dear Health Plan Representative, Please find attached All Plan Letter 20-003 (OPL) Provider Directory Annual Filings 2020, Provider ... and account for, the Department’s Uniform Provider Directory Standards effective Call us Monday - Friday 9am - 8pm ET. Every year, Medicare evaluates plans based on a 5-star rating system. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Plan Year Jan. 1 - Dec. 31, 2020 MEDICARE SUPPLEMENT PLANS. Washington State Health Technology (HTCC) Assessments . "����{��1# �`���"��@-��8M�Hq:�0�����J6���f}u�gɏ�P,�o����8O ��$or��X�"�D)s�w��޾��L���I�?�KR�� Alert: All specialty drugs require preauthorization. Below is the Formulary, or drug list, for SCAN Classic (HMO) from Scan Health Plan. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2020 – 12/31/2020 Uniform Medical Plan (UMP) Classic (Non-Medicare) (PEBB) Coverage for: Individual/Family | Plan Type: PPO 1 of 9 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. UMP is the state’s self-funded medical option for eligible members enrolled in the Public Employees Benefits Board (PEBB) Program. 2 0 obj UMP is administered by Regence BlueShield and Washington State Rx Services. The UCare Classic (HMO-POS) has a monthly premium of $185.00 and has an in-network Maximum Out-of-Pocket limit of $3,400 (MOOP). Hearing aid benefits. What are my plan options? Remember, if you do not pick a plan within 30 days of receiving your health plan information mailer, Medi-Cal will pick a plan for you. ... UMP – Uniform Medical Plan . Make an appointment online instantly with Eye Doctors that accept Uniform Medical Plan insurance. %���� With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers. Some school employees may have more plan options if they work in a district that crosses county lines. Read answers to frequently asked questions about the concurrent review requirements. Health First Health Plans effective January 1, 2020 . WSRxS – Washington State Rx (prescription drug) Services. Regence health coverage opens doors to quality, local care paired with a national network powered by Blue®. The following documents — called a Summary of Benefits and Coverage — provide summaries of what each plan covers and what it costs. There are 39 Medicare Advantage Plans available in San Diego County CA from 15 different health insurance providers. Pediatric primary care as well as adult and pediatric specialty care remains available in the Olympia area. 0yU�2�I�A��j"��������P5���7$��1�4i@{U�/�&�U�0���@�e U'� o Y��+K�\_P4�Յ=IzDv�zjGu��!���W+Ɣ�����t'��������ߓ|#Ch��L�ym�ݑGJ�(tL�_��+��\�U�b���������x�c~M��w�[K�Uy%Ӭ�շ��vD�[/b�Zq��LZ� K�|F�>|ĵ8`t{�M��R��:�U0�}�%���QZ�8��U�OŢ������o~R�Rx(��6����؝� 6�����l�����;����7:bS���i��"ȭ"G��?g���5���ETZ�\�ظ�ʲI�u��mI�nC[�=&*h�?C�����Xȓs����@*n�xa�6��S�� �8����b�ɟ������r{ ���+����Xaj �����i}��j2*. Find providers in your plan’s network. *Star rating applies to all plans offered by SCAN Health Plan 2018-2021 except SCAN Healthy at Home (HMO SNP) and VillageHealth (HMO-POS SNP) plans. Resources. SqrH��U��/kx�z�o���|������O�fTTE�EhF����4g!0{�����?�����@,b�������3�sx��"��zi��"ɀ85����������.����yZ�]J���~S }������Ԗ���;�~��������,9�g��f����X�k���8��KU� ��� �ϲ��H�,3��q�����d:���rXӳ��ߢ�P�4��0�*�LY���a¨i�����p~�oE�z������IP��*�h:�nPj�.�%�bZ7�"��#$Q�!�(�3�c ?�� ����U4d��0�7e�T����[+}m~lAmȦ������"�V=/@N �i�����ƞ��y�R1aM��@^�(���o? The following documents — called a Certificate of Coverage — provide in-depth descriptions of the health care benefits for each plan. %PDF-1.7 This page contains information about Scripps Classic offered by SCAN Health Plan which serves San Diego County, California residents only. See the 2020 Preferred Drug List. Uniform Medical Plan (UMP) is a self-funded health plan offered through the Washington State Health Care Authority’s Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program. UMP has issued a COVID-19 summary of changes for their Certificates of Coverage. For in-depth descriptions of benefits and coverage, see What are the full benefits of each plan? If you find multiple health plans listed, please explore each plan and choose the one that suits you and your family’s needs. UCare Classic (HMO-POS) offered by UCare Minnesota. Learn more about the plans. The Silver Plan pays 70% of covered medical costs for a typical enrollee. Uniform Managed Care Manual at hhs.texas.gov > Services > ... • All other health care providers should fax the form to: UnitedHealthcare Community Plan, 855-500-3356 Provider Experience. UCare Classic (HMO-POS) H2459-021 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by UCare available to residents in Minnesota. The certificate of coverage (COC) for the member's plan is the source of coverage provisions offered under the plans. This plan includes additional Medicare prescription drug (Part-D) coverage. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, UMP Plus—UW Medicine Accountable Care Network, Is there a quick way to see benefits and costs, Uniform Medical Plan for school employees, UMP Plus–Puget Sound High Value Network for school employees, UMP Plus–UW Medicine Accountable Care Network for school employees, Prescription drug information for school employees, Medical plans available by county (SEBB) 2021, Medical benefits comparison and school employee premiums (SEBB) 2021, School employee monthly premiums, deductibles, and out-of-pocket maximums 2021, Website feedback: Tell us how we’re doing. Regence MedAdvantage + Rx Classic (PPO) H5009-008 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Regence BlueShield available to residents in Washington. 2020 SCAN Classic (HMO) Formulary. If you enroll in State Group Health Insurance, you may elect Uniform Dental. Effective January 1, 2020: If you waive State Group Health or select the Health Opt-Out Incentive, you are eligible for Preventive Dental. Call WA State Rx Services at 1-888-361-1611 for pharmacy. The Scripps Classic offered by SCAN Health Plan (HMO) has a monthly premium of $- and has an in-network Maximum Out-of-Pocket limit of … Find Uniform Medical Plan Eye Doctors & Providers with verified reviews. x��}ko䶒���?����{1�E��� �Ef��f�ٓ�3���~�i�zO���۞�����Ѓ�$K�O�x�nJU,��������zsL�����q���8O������Ͼ���'~�����M�f�cU�'YR�y"Y��_�}���ܾ}����7g�X~�|����,aI!Qɴ�Oo`�ϟ��� oK��J����7�u�yu���X�'��㊟��F����dŲ����z����}���;��o�������s��sȳ*�y�����W�d�X����#�e{H~C\v�[��� For additional information about your prescription drug benefit, see the current UMP Classic Certificate of Coverage (COC). SCAN Health Plan is an HMO plan with a Medicare contract. Awards and recognition are subject to change each year. Is there a quick way to see benefits and costs? The SCAN Classic (HMO) plan … LONG BEACH, Calif., Oct. 1, 2019—SCAN Health Plan ®, today announced its 2020 health plan benefits for Southern California, which are designed for seniors with a variety of health and wellness needs.Seniors and those eligible for Medicare in Los Angeles, Orange, Riverside, San Bernardino, … Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. October 1, 2020. Unless your plan includes POS benefits, you must use plan providers except in emergency or urgent care situations, or for out-of-area renal dialysis. Due to COVID-19, HCA’s lobby is closed. Medical. ... 11/13/2020 … SCAN Health Plan is an HMO plan with a Medicare contract. 20 of these Medicare Advantage plans offer additional gap coverage. Visit one of UMP's online provider directories. The plan with the lowest out of pocket expense is $900 and the highest out of pocket is $6700. <> Scripps Classic offered by SCAN Health Plan (HMO) H5425-005 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by SCAN Health Plan available to residents in California. 3 0 obj Provider Center. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R 81 0 R 82 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> It's free! !�� ���*�,ʳ�.^\� �Be�5�.��ߑ�Ɋ�KeP��{��v��~���R��`���٧��V�� �S4�`Z�E��5��)S1���/��Zed1� ���Y�$�Bn�������2��c� �� x�ϱ�ژu�X With the Uniform Medical Plan, you may choose from the plans listed below. UMP Achieve 1 UMP Achieve 2 UMP High Deductible UMP Plus—Puget Sound High Value Network UMP Plus—UW Medicine Accountable Care Network UMP Plus— Puget … 1 0 obj Uniform Medical Plan Classic (Medicare) Coverage Period: 01/01/2017 - 12/31/2017 Summary of Benefits and Coverage: What This Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO Questions: Call 1-888-849-3681 (TTY 711) for medical. • When this booklet says "we," "us," or "our," it means Medical Mutual of Ohio (Medical Mutual). Make an appointment online instantly with Family Physicians that accept Uniform Medical Plan insurance. If you need assistance, call us at 1-855-266-4865 F%?��19�X>���M8��i�?>?���Ҍwg��)��i�����H�Y���0粋�$q8s Z6*`A�pn=���T��R���? If you move out of your plan's service area, you may need to change plans. Review and submit medical claims. If you do not see your drug listed, call Washington State Rx Services at 1‑888‑361‑1611. endobj Enrollment in Medical Mutual's MedMutual Advantage Classic HMO depends on contract renewal. With the Uniform Medical Plan, you may choose from the plans listed below. Benefits Classic Plan (HMO-POS) Value Plan (HMO) Rewards Plan (HMO) ... from in-network providers $10,000 for services you receive ... Classic Plan (HMO-POS) Value Plan (HMO) Rewards Plan (HMO) Outpatient Hospital Coverage Top Every year, Medicare evaluates plans based on a 5-star rating system. Frequently Asked Questions. Looking for 2020 school employee monthly premiums? The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Leading Medicare Advantage Plan’s New Offerings Address a More Holistic View of Health . This benefit includes coverage for hearing aids for members on our Enhanced PPO plans through the TruHearing provider network. You must report your new address to your payroll or benefits office no later than 60 days after your move. Medicare. This benefit is also available as part of the optional benefits coverage on our Medicare HMO plans. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan … There is no out-of-network benefit for hearing aids. In most cases, you must live or work in the medical plan’s service area to join the plan. Year, there will be significantly lower than if you do not your... 'S plan is an HMO plan with a Medicare contract to learn more about the Uniform Medical plan insurance covers... Payroll or benefits office no later than 60 days after your move s service area Olympia area UMP administered... & providers with verified reviews coverage, see the current UMP Classic Certificate of coverage provide! 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