UM System Retirees Associations

What if I am out of the country during the enrollment period with no secure internet connection?
If you will be out of the country during the Annual Enrollment period, you can complete and submit the change paperwork before leaving the country, even if that means submitting it before the Annual Enrollment period begins. Access the Retiree AE form (PDF).

I turn 65 soon. When should I contact the university about moving from non-Medicare coverage to a Medicare Advantage and what is the process?
In order to transition to the University Medicare Advantage Plan, apply for Medicare no earlier than three months before your eligibility date. The application process can be completed through your local Social Security office or online. University Medicare Advantage plans include enrollment in an eligible Part D prescription plan, so only enroll in Medicare Part A and Medicare Part B.

As you approach your enrollment date, the university will only send you information regarding Medicare Advantage plan enrollment. That packet will include an enrollment form you will need to return to us, along with a copy of your Medicare card. You can get more details on the Medicare website.

I want to cancel life insurance for my spouse and/or myself. What do I need to do and by when?
You can cancel life insurance coverage at any point. In fact, you may reduce or cancel any coverage, including medical, at any time during the year and are not limited to retiree Annual Enrollment. If coverage is reduced or cancelled, it cannot be reinstated at a later date. To do so, just complete the Retiree Benefits Change Form (PDF).

If I drop down from the Enhanced plan to the Base plan, would I be able to go back to the Enhanced plan again next year?
Yes, you would have the option of selecting the Medicare Advantage Enhanced Plan again in the future, but only during the Annual Enrollment period.

If a non-Medicare eligible spouse turns 65 mid-year, how does that affect premiums?
Premiums will be adjusted based on which Medicare Advantage plan is selected, Base or Enhanced (Buy-Up Plan). The HR Service Center can help determine what your new premium will be upon turning age 65.  

What happens if you return to work part-time?
Retirees who are rehired in a part-time position at the university and receive retiree insurance from the university (i.e. medical, dental, vision, etc.) and wish to continue their enrollment in these plans are advised to work no more than a .74 full-time equivalency (FTE) in all concurrent jobs.

Exceeding this FTE will result in loss of eligibility for retiree insurance benefits and being offered active medical plan coverage only (see Patient Protection and Affordable Care Act). Worked hours for rehired retirees will be tracked using the same methods as for other employees.

Retirees should contact their campus HR Generalist with any questions.

How do I access myHR?
For step-by step instructions on accessing information, visit the myHR Training resources for retirees.

Will we have a new vendor in 2024?
The University will have a new vendor, MetLife, for its life and disability insurance plans beginning January 1, 2024. Insurance carriers for medical, dental and vision plans are the same as in 2023.

What types of facilities are in-network with UnitedHealthcare? Does it include inpatient, skilled nursing, inpatient rehab?
UnitedHealthcare’s network includes general care clinics, urgent care clinics, medical and surgical hospitals, emergency rooms, specialty centers like those that provide dialysis, skilled nursing and physical therapy services, labs, medical suppliers and more. You can review all in-network providers through the UnitedHealthcare website at retiree.uhc.com/umsystem/find-a-provider.

When will I receive information on my premiums for 2024?
All retirees will receive a letter from the university to their mailing address that provides information on the plans available to them as well as their personalized premiums and additional information on the Annual Enrollment period.

Do retirees call the HR Service Center or UnitedHealthcare for benefits questions?
Retirees can call the HR Service Center for information about the Annual Enrollment period or plan eligibility. For information on specific health plans offered by UnitedHealthcare, retirees can reach out to UnitedHealthcare directly using the customer service phone number on the back of their insurance card.

How does the university determine what premiums will be year-to-year?
The landscape of health insurance is constantly changing. Each year, the university evaluates plans and works with our providers as well as the Total Rewards Advisory Committee (TRAC) and the UM System Office of Finance to keep premium increases lower than they otherwise would be. In addition, we conduct regular, competitive bids to ensure we’re providing high-quality plans at manageable costs.

Why are my premiums increasing and will they continue to do so?
Premiums are dependent on many factors, including age, years of service at retirement and more. For 2024, some retirees will see similar premiums as they had in 2023 but changes to other aspects of their plans. For others, they may see an increase in premiums as the university works to align premiums and actual plan costs.

Recognizing the market is likely to continue to evolve and mature, the University continues to monitor and explore opportunities to improve choice and reduce costs for current (as well as future) pre-Medicare-eligible UM retirees.

What coverage do I have or can I get for an ambulance to return me to my local hospital?
All retiree medical insurance plan options through the university have a broad, nationwide network of providers, including for emergency and non-emergency ambulance services.

Retirees can reach out to UnitedHealthcare to discuss available options related to their specific case and medical insurance plan and learn more about in-network providers nearby at retiree.uhc.com/umsystem/find-a-provider.

How are rehab services covered?
All retiree medical insurance plan options through the university include coverage for qualified outpatient rehabilitation (e.g., physical, occupational or speech/language therapy):

• Retiree Healthy Savings Plan: 15% after annual deductible
• Retiree Health PPO Plan: 30% after annual deductible
• Medicare Advantage Base Plan: $25 copay
• Medicare Advantage PPO Plan: $0 copay

Will my coverage change if I move?
In general, your medical insurance coverage will stay the same regardless of where you live in the United States. The biggest difference will be that healthcare providers in your area will be different. Learn more about in-network providers near you at retiree.uhc.com/umsystem/find-a-provider.

If I am Medicare-eligible, do I need to be enrolled in a University plan to provide coverage for my non-Medicare eligible dependents through the University?
All medical plan options include self-coverage. A retiree would need to be enrolled in a University plan to provide coverage for eligible dependents.

Do the medical plans include nutrition coverage?
Retirees interested in nutritional services should reach out to UnitedHealthcare to discuss available options related to their specific case and medical insurance plan.

How can non-Medicare retirees identify the best value across providers?
The cost of care is dependent on provider, the services provided and may also vary based on how the services are billed by the provider. UnitedHealthcare can help you check cost estimates before you choose where to get care so you can save on health care costs. Sign in on myuhc.com to get personalized cost estimates and see how much you can expect to pay for your specific plan and specific in-network providers.

What are the medical plan design changes to the non-Medicare retiree plans in 2024?
For the Retiree Health PPO Plan, enrollees will see increases to medical out-of-pocket maximums for out-of-network expenses from $4,400/individual; $8,800/family in 2023 to $6,000/individual; $12,000/family in 2024. Prescription flat dollar copay amounts also will increase; see the Retiree Health PPO Plan webpage for full plan information.

There are no plan design changes to the Retiree Healthy Savings Plan in 2024. See the Retiree Healthy Savings Plan webpage for full plan information.

What coverage do non-Medicare retirees have when travelling outside of the country?
Your medical plan covers services received outside the continental United States like it would while in the country, just at the out-of-network rate. The exception to this is for covered emergency services, which are covered at the in-network rate.

For retirees enrolled in a university life insurance plan, additional travel assistance services are provided through MetLife. Find informational brochures on the Life Insurance webpage.

How does the cap on insulin work? Do the Advantage Plans have the same cap as Medicare Part D?
The University’s Medicare Advantage plans utilize Medicare Part D coverage. The $35 cap on insulin is for all Part D covered insulin and is applied per prescription per month.

How are durable medical goods covered like insulin pump supplies?
For Medicare retirees when using one of the approved meters and supplies, your cost-share is a $0 copay.  To switch to one of the preferred brands, you may be required to get a new prescription from your doctor.

For non-Medicare retirees in the Retiree Health PPO Plan members may obtain diabetic durable medical equipment through their medical insurance at no cost.  For non-Medicare retirees in the Healthy Savings Plan, members will be subject to the applicable plan deductible and co-insurance costs.

Why does my 30-day supply of a generic drug cost more than if I bought directly from a commercial pharmacy?
The cost of prescriptions is typically determined by the manufacturer of the prescriptions. To help keep prescription prices as low as possible for the university and plan members, UnitedHealthcare negotiates guaranteed discounts with retail pharmacies and provides discounts through their own mail order process.

What is the out of pocket maximum for prescriptions?
The prescription out-of-pocket maximums vary by plan:

• Retiree Healthy Savings Plan: (Combined medical/Rx  out of pocket limit) $3,750/self*; $7,500/family*
• Retiree Health PPO Plan: $3,800/self; $7,600/family
• Medicare Advantage Base Plan: $4,130
• Medicare Advantage Enhanced Plan: $4,130

See the individual plan page for each plan option to learn more.

What travel coverage is offered through Medicare when traveling internationally?
Both the Medicare Base and Enhanced plans include a $200,000 lifetime maximum travel benefit for any non-emergent medical expenses incurred outside of the United States. Medical evacuation is covered under the plan. Urgent Care and Emergency Room services are already covered worldwide and fall under the existing medical benefit.

Does retiree medical insurance function as a Medicare Advantage plan?
Both university-sponsored Medicare plans are Medicare Advantage plans.

I turn 65 in March. Will I receive a new UnitedHealthcare insurance card with the Medicare box on it?
Before you turn 65, the university will send you a packet in the mail with information regarding Medicare Advantage plan enrollment. The packet will include an enrollment form and you will need to return the completed form along with a copy of your Medicare card. When processed, your enrollment will change to your selected Medicare plan and you’ll receive a new UnitedHealthcare insurance card in the mail.

You can get more information about receiving your Medicare card on the Medicare website.

How can we find out the difference in cost between the Medicare Base and Enhanced options?
To learn more about the differences between the Base Plan and the Enhanced Plan, visit retiree.uhc.com/umsystem/coverage-and-benefits.

What’s new for the Medicare Advantage plans in 2024?
Due to changes implemented by the federal Centers of Medicare and Medicaid Services (CMS), Medicare Advantage and Part D drug plans will see changes in 2024.

• Members will notice an enriched Medicare Part D drug plan when reaching the “catastrophic coverage” phase of their Medicare Part D, where their cost share becomes $0 for both their Medicare Advantage and Medicare Part D drug plan.
• Medicare Advantage plans will receive smaller reimbursements from CMS for several diagnostic codes, increasing the cost of care to the plan.

UM System retirees on these plans will also see changes to their Base Plan or Enhanced Plan as a result of the federal CMS changes:

• Base Plan: Premiums remain the same as in 2023. In order to maintain this premium cost, the annual out-of-pocket maximum increases to $3,400 and the deductible increases to $300.
• Enhanced Plan: The plan design remains the same as in 2023. In order to maintain this plan design, the full monthly premium, before subsidy, increases by approximately $25/month per individual.

Does it matter where I live for in-network coverage?
The UnitedHealthcare Medicare Advantage Plans are PPO plans, which means it includes a broad network and you have lots of flexibility in choosing a provider. Learn more about in-network providers near you at retiree.uhc.com/umsystem/find-a-provider.

What is the difference between University’s Medicare Advantage Plan options and commercially-available Medicare Advantage Plans?
The University of Missouri retiree plan is customized specifically for retirees and include significantly enhanced benefits over the "street" plans that all beneficiaries have access to.  

Do Medicare retirees have any health care insurance coverage when traveling outside of the country?
Members have worldwide coverage for medical services through both Medicare Advantage plan options. You will need to pay for the services you receive and then submit for reimbursement. You can obtain a Direct Member Reimbursement Form by contacting United Healthcare customer service. The applicable copays depending on the plan you are on will be deducted from your reimbursement. 

Do the Advantage plans cover what Medicare does not cover? What is the difference between Medicare and Medicare Advantage Plans?
Visit Medicare.gov’s Compare Original Medicare and Medicare Advantage webpage and the university’s Medicare FAQs for retirees to learn more about how coverage works between the two.

I am enrolled in the university-sponsored Medicare Advantage Plan. Could I switch to traditional Medicare coverage with supplement (Medigap) in the future?
If you wish to purchase coverage outside of the university, you are able to change your election and opt out of a university-sponsored UHC Group Medicare Advantage plan during Annual Enrollment or at any time during the year. Please note, if you drop or cancel your coverage, you will not be able to re-enroll at a later date.

Does the university offer OTC benefits?
Most over-the-counter (OTC) products are not covered by the prescription benefit, however, there are some exceptions to comply with requirements of the Patient Protection and Affordable Care Act (PPACA).

Do we get cards for dental and vision coverage?
You may access and print a copy of your ID card from DeltaDental, however, it is not required; your benefits are accessible and in-effect without a card. Your dental office can look your coverage up with some basic personal information.

Insurance ID cards are not issued for the vision plan and are not required at time of service. At your appointment, let your in-network provider know that you have coverage through VSP to utilize your benefits. A VSP provider can look up member benefits using the last four digits of your social security number or your unique VSP ID number. If you need your unique VSP ID number, please contact the HR Service Center.

How do we find out which hearing aid companies are covered under the health insurance plans?
Medicare retirees can visit UHCHearing.com/Retiree or call 1-866-445-2071, TTY 711 8 a.m to 8 p.m. Central Time, Monday through Friday. Non-Medicare retirees can visit retiree.uhc.com/umsystem/. or call 866-899-5903.

If I cancel vision coverage, can I enroll in vision coverage in a future year?
Yes our current vision plan allows retirees to add or drop vision coverage each year during Annual Enrollment.

If a retiree didn’t select dental coverage upon retirement, can it be added during Annual Enrollment
No, dental coverage for retirees is based on enrollment and election upon date of retirement.

What are the key differences between the Dental Base Plan and the Buy Up Plan?
The Dental Buy-Up Plan has a lower deductible and a higher annual maximum, and expands coverage to include orthodontics ($1,500 lifetime maximum) in addition to the same three categories of preventive, basic and major services available through the Dental Base Plan.

How does the provider network work for the Dental Plans? Are there benefits for using certain providers?
The dental plan utilizes a passive network, which means you have the ability to receive services from network or non-network providers. No matter your provider, your deductible and coinsurance remain the same as long as charges are reasonable and customary.

• October 18, 2022 - Fall 2022 Retiree Town Hall
• May 18, 2022 - Spring 2022 Retiree Town Hall

UM Connection is produced quarterly for the retirees of the four-campus University of Missouri System. The publication is a partnership between the Office of Engagement, the Office of Human Resources and the UM Retirees Association Leaders.

2023

• UM Connection - Winter 2023
• UM Connection - Spring 2023

2022

• UM Connection - Fall 2022
• UM Connection - Summer 2022
• UM Connection - Spring 2022
• UM Connection - Winter 2022