Overview of Medicare UnitedHealthcare Retiree Solutions Texas - PowerPoint PPT Presentation

Overview of Medicare UnitedHealthcare Retiree Solutions Texas Association of Counties County Management & Risk Conference April 11, 2019

Medicare Basics 1 Medicare Options 2 TAC HEBP County Choice Silver Post-65 Retiree Options 3 Q & A 4 2

The ABCs of Medicare

When are you eligible for Medicare? You’re eligible for Original Medicare (Parts A and B) if you are: • 65 years old, or • under 65 and qualify on the basis of disability • All ages with end-stage renal disease - and you are - • a U.S. citizen or a legal resident who has lived in the United States for at least five consecutive years 4 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Medicare Parts A & B (Original Medicare) 5 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Prescription drug plans Help with the cost of prescription drugs • Offered through private insurance companies • Prescription drug coverage varies by plan • Each plan has list of drugs covered (formulary drug list) Types of Retiree Drug Plans • Retiree Drug Subsidy • EGWP PDP (Group Part D) • Individual PDP 6 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Medicare Part D Drug Coverage Stages Annual deductible If your plan has a deductible, you pay the total cost of your drugs until you reach the deducible amount set by your plan. Then you move to the initial coverage stage In this drug payment stage: After your total drug costs reach After your out-of-pocket $3,820: costs reach $5,100 You pay a copay or coinsurance You pay 25% of the cost of brand name You pay a small copay or (percentage of a drug’s total cost) drugs and 37% of the cost of coinsurance The plan pays the rest. generic drugs You stay in this stage until your You stay in this stage until your You stay in this stage for out-of-pocket costs reach total drug costs reach $3,820 the rest of the plan year $5,100 7 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Part D updates The recent Federal Spending agreement included a provision that closes the donut-hole effective 1/1/19 (one year early) and increases the manufacturers brand name discounts in the coverage gap from 50% to 70% for brand name medications. CMS has proposed a rule that would require Part D plans to reimburse a portion of the rebate at the Point of Sale (POS) to beneficiaries directly. 8 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Medicare choices After you enroll in Original Medicare (Parts A and B), there are two ways to get additional coverage. STEP STEP Decide if you need additional coverage. You have 1 2 Enroll in Original Medicare. two ways to get it. OPTION 1 OR OPTION 2 Original Medicare Choose a Add one or both of the following to Provided by the Medicare Advantage plan: Original Medicare: federal government Medicare Supplement Insurance Medicare Advantage (Part C) Part A Offered by private companies Offered by private companies covers hospital Covers some of the stays Part C combines costs not paid by Part A (hospital) and Original Medicare Part B (doctor) Part B covers Parts A and B doctor and outpatient Most plans cover visits Medicare Part D Plan prescription Offered by private companies drugs Provides additional Part D covers benefits, services prescription drugs and programs . 9 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Option 1: Keep Original Medicare and add: Medicare Part D (Prescription Drug Plans) Medicare Supplement insurance plans 10 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Option 2: Medicare Part C (Medicare Advantage Plans) The advantages of a single plan. Medicare Advantage (Part C) plans are provided through private insurers, like UnitedHealthcare. They include Part A and Part B coverage and often Part D — all in one plan. Medicare Advantage plans also generally offer additional benefits beyond doctor and hospital visits. All the benefits of Part A All the benefits of Part • Hospital stays • Doctor’s visits • Skilled nursing • Outpatient care • Home health • Screenings and shots • Lab tests Prescription drug coverage Additional benefits • Included in many • May be bundled with the plan Medicare Advantage plans . 11 11 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

TAC HEBP County Choice Silver Post-65 Retiree Options

Medicare Advantage PPO Plans • Customized medical benefits all in one plan that are easy to understand • One ID card for medical and Rx - all the rights and privileges of Traditional Medicare ( no need to show red, white and blue Medicare card ) • All eligible retirees can join the plan regardless of where they live in U.S. • Freedom of choice to access both UnitedHealthcare network providers and out-of-network Medicare providers that accept the plan on a national basis • Clinical programs to support those with chronic conditions such has diabetes or heart failure • Fitness benefit, HouseCalls and Member Rewards • Additional benefits not typically covered by Medicare or supplement plans • The Group Medicare Advantage PPO plan travels with the retiree and allows the retiree to access services throughout the U.S. and all U.S. territories with no referrals 13 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Group Medicare Advantage PPO • Nationwide PPO solution covers all Medicare retirees regardless of where they live in United States including U.S. territories • Custom “passive” PPO plan design with same benefits and retiree cost share in and out-of-network • No PCP selection required, no referrals required to see a specialist • Value added benefits for retirees - Silver Sneakers fitness benefit, hiHealth Innovations hearing aids, Solution for Caregivers 14 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Benefit enhancements Member Silver hi Health Routine Rew ards Sneakers innovations Podiatry Programs Older adults may be We encourage members to With hi SilverSneakers is a free susceptible to a number participate in important HealthInnovations, fitness membership that of foot conditions. As part health screenings and tests. members will have a includes group exercise of the plan we would $500 hearing aid Members receive a merchant classes, workouts, basic cover up to six routine allowance and exclusive gift card for completing their membership to podiatry visits per year discounts on quality annual wellness visit participating gyms hearing aids Our plan also includes a Solutions for Caregivers benefit 15 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

TAC HEBP Medicare Advantage Plans 16 Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Sr. Supplement Plans • Private health insurance designed to supplement Medicare Parts A and B • Covers many costs Original Medicare doesn't cover. Examples: deductibles and coinsurances • See any provider who accepts Medicare • No referrals or prior authorization needed for covered services • Portability • 24-hour nurse line, fitness benefit and hearing aid discounts included Medicare: Pays primary Supplement: Pays secondary Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 17

Sr. Supplement Plan Options Plan Design Plan F Plan D Plan K Plan 2 Member Pays Member Pays Member Member Pays Pays Plan Deductible N/A N/A N/A $2000 Max Out of Pocket N/A N/A $4940 N/A Part A coinsurance & hospital benefits Days 1-60 0% $0 0% 0% Days 61-90 0% $0 0% 0% Part A deductible 0% $0 50% 0% Part B deductible 0% 50% 50% 0% Physician Office Visit $0 $0 50% $0 Specialist Office Visit $0 $0 50% $0 Preventive Care (Medicare- $0 $0 $0 $0 Covered Benefits) Foreign travel emergency After $250 After $250 100% 100% deductible member deductible member pays 20%, up to pays 20%, up to lifetime maximum lifetime maximum of of $50,000 $50,000 Emergency Room $0 $0 50% $0 Ambulance Services $0 $0 50% $0 Skilled nursing facility care Days 1-20 0% $0 0% 0% Days 21-100 0% $0 50% 0% Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.