Medicare Benefits & Plan Types

Your Benefits & Medicare

Watch this video to learn more about how your UAW Retiree Medical Benefits Trust coverage works when you enroll in Medicare. 

 

Primary Plan: Medicare Advantage (MA) PPO

with Prescription Drug Coverage (PD)

The Medicare Advantage (MA) PPO plan is the primary plan for Medicare-enrolled Trust members (those over age 65, or due to disability). An MA PPO plan is approved by Medicare and provides Original Medicare, Part A (hospital), Part B (medical), and additional benefits. The Trust’s offered plans also provide Part D (prescription drug). This comprehensive plan is called an MA-PD plan.

Most Trust Medicare-enrolled members are automatically enrolled in an MA-PD plan on January 1, following the year they qualify for Medicare. Certain Medicare members, such as Protected members and those enrolled in an HMO plan may not be automatically enrolled but have the option to select the plan if they meet all other eligibility criteria.

Important

As a Trust member, it is important you understand you cannot enroll in two Medicare Advantage (Part C) or Prescription drug (Part D) plans. If you enroll in an MA PPO or MA-PD plan outside of the Trust-offered plans, it may automatically kick you and your dependents out of Trust coverage.

 

MA-PD Plan Value

The MA-PD plan provides greater value than other plan offerings while preserving coverage levels and access to doctors and hospitals. These plans also have lower cost share than the Traditional Care Network (TCN) plan.

The plan provides access to additional programs at no extra cost:

  • Rewards for health activities – Gift cards when you complete certain important healthcare activities such as getting an annual checkup.
  • Personalized clinical and disease management support – Resources to help manage chronic conditions.
  • Healthy home visit – Annual in-home visit from a licensed doctor or nurse to assess health and safety needs.
  • Virtual doctor visits – Phone or video consult with a board-certified doctor (your office visit copay may apply).
  • Nurse help line – Speak with a registered nurse any time, night or day.

Learn About Your MA-PD Plan Option

For specific health plan information such as coverage details, participating providers, and covered preventive services, contact your health plan carrier.

Members currently enrolled in the MA-PD Plan:
UnitedHealthcare (UHC): (844) 320-5021 For all states excluding MI
Blue Cross Blue Shield (BCBS): (877) 336-0377 For states of AL, FL, IN, MI, MO & TN

Members NOT currently enrolled in the MA-PD Plan:
BCBS TCN: (877) 832-2829 National
BCN: (880) 222-5992 MI Regional

Your Choice

We believe you will enjoy the MA-PD plan, its programs, and lower out-of-pocket costs, but know you still have a choice in health care. If you are enrolled in the MA-PD plan but prefer the TCN plan (or another available option in your area), contact Retiree Health Care Connect (RHCC) at 866-637-7555. If you change out of the MA-PD plan mid-year, cost amounts applied toward your deductible and out-of-pocket maximum will not carry over to your new plan selection.

Plan Types

It’s important to understand that the plan options available to you depend on where you live and can vary based on your Medicare enrollment. Also, plan options are reviewed annually to determine if they will be renewed. Often, there are annual changes communicated to you in the Benefit Highlights newsletter mailed every fall.

MA-PD

TCN

HMO 

Medicare Advantage*

Traditional Care Network

 Health Maintenance Organization*

Eligibility

Medicare members enrolled in Part A and Part B

Eligibility

Medicare members

For Medicare members in this plan, Medicare is primary and TCN coverage is secondary.

 

 

 

Eligibility

Medicare (and Non-Medicare members) living in regions within these states: California, Colorado, Georgia, Maryland, Michigan, Oregon, Washington D.C., Washington (state), and Virginia where an HMO is offered.
 
Must be living in areas where an HMO plan is offered.

About the Plan

This is the primary plan for Medicare members. An MA-PD plan type is approved by Medicare and administered by a private company (such as Blue Cross Blue Shield or United Healthcare). These plans provide your Original Medicare, Part A (hospital), Part B (medical) benefits, and include additional benefits. The Trust’s offered plans also provide Part D (prescription drug).

MA-PD plans are based on a nationwide network of providers and allow services to be performed both in-network and out-of-network.

About the Plan

This is a nationwide plan option available to Medicare members.  Based on a nationwide network of providers, the TCN plan allows services to be performed both in-network and out-of-network.

 

 

 

 

 

About the Plan

While HMO plans have been a popular choice among members, they are only offered in limited areas where they can be competitive with the Traditional Care Network (TCN) plan. HMO plan options are based on a regional network of providers and do not offer out-of-network benefits (although emergency services may be covered out-of-network).

 

Cost


May have copays, deductibles, coinsurance, and out-of-pocket maximums—refer to Benefit Highlights.

In order to receive the highest level of benefits with the lowest out-of-pocket cost, you should receive services from an in-network provider.

Cost

May have copays, deductibles, coinsurance, and out-of-pocket maximums—refer to Benefit Highlights.

In order to receive the highest level of benefits with the lowest out-of-pocket cost, you need to receive services from an in-network provider.


Cost

May have copays and deductibles but do not have coinsurance or out-of-pocket maximums—refer to Benefit Highlights.

 

 

 

 

More Info

Refer to the Summary Plan Description (SPD). Contact your health plan carrier for information about your specific medical benefits at the number on the back of your medical ID card.

More Info

Refer to your evidence of coverage or contact your plan carrier at the number on the back of your medical ID card.

 

More Info

Refer to your certificate of coverage or contact your plan carrier at the number on the back of your medical ID card.

 
*To stay eligible for this plan, you must continue to pay your monthly Medicare Part B premium.

Cost Share

Before reviewing more details on your available plan options, it’s important to understand all Trust-provided plans have copay and cost-share elements. As a Trust member, you are responsible for paying certain health care coverage costs including a monthly contribution, annual deductible, coinsurance, copayment, and annual out-of-pocket maximum. Understanding how these work will help you know when they apply and how much you will have to pay for care.

Copays are fixed dollar amounts for services such as Primary Care Physician (PCP) office visits, specialist visits, urgent care visits, and emergency room visits.

Cost-share can include deductibles, coinsurance, and out-of-pocket maximums.

Want more detail on what these terms mean? Visit the Health Care Glossary. 

 

Benefit Materials for Download

Below are the main documents you will need to understand and utilize your benefits.

2024

Benefit Highlights


 

2023

Summary Plan Description
(SPD)

2023

Health Care

Benefit Summary

2023 Healthcare Benefits Summary
All Members All Members All Members
Learn about your 2024 cost share and benefit coverage updates.

 

An addendum to the SPD, Benefit Highlights includes year-to-year changes in cost share and benefit coverage, mailed every fall.

Para español, haga clic aquí.

A summary of the Plan Document. This is written to be more easily understood and is typically updated and mailed to Trust members every five years (the current version was published in 2023).

Para español, haga clic aquí.

Changes made in the years between the Summary Plan Description (SPD) and the current Benefit Highlights are detailed in the Health Care Benefits Summary.