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: MA PPO

The Medicare Advantage (MA) PPO plan is the primary plan for Medicare-enrolled Trust members (those over age 65, or on Medicare because of a disability). Medicare-enrolled members are automatically enrolled in the MA PPO 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 in the MA PPO plan but have the option to select the plan, if they meet all other eligibility criteria.

MA PPO plans provide Medicare members with 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 MA PPO plan provides access to additional programs at no extra cost:

  • Rewards for health activities – Gift cards when you complete certain important health care activities such as getting an annual checkup
  • Personalized nurse support – Resources to help manage chronic conditions
  • SilverSneakers® fitness program – Access to over 16,000 participating gym locations nationwide
  • Healthy home visit – 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 (the office visit copay applies)
  • Nurse help line – Speak with a registered nurse any time, night or day

Learn About Your MA PPO 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 PPO Plan:
Aetna: (800) 663-0885 For all states excluding MI
BCBS: (888) 322-5616 For states of AL, FL, IN, MI, MO & TN

Members NOT currently enrolled in the MA PPO Plan:
Aetna: (855) 406-4062 For all states excluding MI 
BCBS: (877) 336-0377 For states of AL, FL, IN, MI, MO & TN

Your Choice

We believe you will enjoy the MA PPO 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 PPO 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 PPO 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 PPO 

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, Minnesota, 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 PPO plan type is approved by Medicare and administered by a private company (such as Blue Cross Blue Shield or Aetna). These plans provide your Original Medicare, Part A (hospital) and Part B (medical) benefits, and include additional benefits. MA 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 are able to 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 member of the Trust, 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.

Copay elements 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 elements 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.

2022

Benefit Highlights


 

2020

Summary Plan Description
(SPD)

2022

Health Care

Benefit Summary

2022 Benefit Highlights
2022 Health Care Benefits Summary
All Members All Members All Members
Learn about your 2022 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.

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 2020).

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.