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University-sponsored: Medicare Advantage Enhanced Plan

The Medicare Advantage Enhanced Plan is a group plan available to Medicare-eligible retirees and their dependents.

However, if you are a pre-1990 retiree who never enrolled in Medicare due to your pre-1990 status, or are a Federal Civil Service retiree and are not eligible for Medicare, you will have the same plan options as retirees or dependents that are not Medicare eligible. Those plan options are listed on the retiree benefits overview webpage.


  2024 Medicare Advantage Enhanced Plan  

About the Plan

The Medicare Advantage Base Plan will move to an integrated Medicare Advantage plan with Part D prescription drug coverage through UnitedHealthcare, Group #13797. For complete plan details, visit the UnitedHealthcare Coverage for UM System Retirees website (exit UM System site).


Costs

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💲 Monthly premiums

Your share of insurance premiums is determined by a formula that considers your age and years of service at retirement and the program under which your benefits are payable. For more information about retiree insurance eligibility and premiums, visit the Retiree benefits overview webpage.

For additional details, see the SPD for this plan on the All Summary Plan Description (SPD) Documents webpage.

Note: You still need to pay your Original Medicare Part B premiums, in addition to the premiums for the university-sponsored Medicare Advantage Enhanced Plan. In most cases, there is no premium requirement for Original Medicare Part A. If, however, you are not eligible for no-cost Medicare Part A coverage and are paying for this coverage, you are required to continue to pay this premium when enrolled in the university-sponsored Medicare Advantage Enhanced Plan.

 

🩺 Covered Services

What you pay for covered expenses is as follows:

  • Primary care office visit: $0
  • Specialist office visit: $0
  • Inpatient hospital stay: $0
  • Outpatient surgery: $0
  • Ambulance service: $0
  • Emergency room: $0
  • Urgent care: $0
  • Durable medical equipment: $0
  • Lab services X-ray: $0
  • Preventive care: $0

*For a full schedule of benefit coverages, refer to the UnitedHealthcare (UHC) Medicare Advantage Plan Guide.

 

Annual deductible

The Medicare Advantage Enhanced Plan does not have an annual deductible for medical or prescription costs.

  • Medical deductible: $0 per person
  • Rx deductible: $0 (retail and mail order)
 

🧾 Out-of-pocket limit

The university-sponsored Medicare Advantage Enhanced Plan has two out-of-pocket limits: one for medical and a second for prescription drug costs.

  • Medical out-of-pocket limit: $0
  • Rx out-of-pocket limit: $4,130
 

Making the Most of Your Plan

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📋 Preauthorization

In some cases, prior authorization is necessary for non-emergency use of certain facilities, diagnostic testing, and other health services before care is provided. You can access the preauthorization list for active employees (PDF, 14KB) to see a similar list of services/treatments.

 

🏥 Network Providers

As long as your doctor, hospital, or other provider participates in (i.e., accepts payment from) Medicare, you will receive the same level of coverage whether or not your provider is a member of the UHC Group National PPO Network. The university-sponsored group Medicare Advantage Base Plan and Medicare Advantage Enhanced Plan provide the flexibility to see providers in or out of network at the same cost.

Looking for plan providers or health care providers? Visit our plan contacts page for more information.

 

Forms and guides

* In the event of a difference between this webpage and the plan document or summary plan description, the plan document and plan description prevail.

Many documents on this webpage require Adobe Acrobat. A free reader is available to everyone. Read more about PDFs.

Reviewed 2024-02-28

 

Notice of Nondiscrimination

If you speak another language, assistance services, free of charge, are available to you. Call UnitedHealthcare at 1-844-634-1237 for translation assistance.

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