CU-Health Plan - Medicare [1]
CU Health Plan — Medicare, provided by Anthem Blue Cross Blue Shield, is available to Medicare-eligible retirees and their spouses/dependentsDependentAn employee’s spouse, common-law spouse, civil union partner, domestic partner, children under the age of 27, and qualifying disabled children over age 27 of the employee or of the spouse/partner who are biological, legally adopted or for whom there are parental responsibility documents issued by a court. [2] who are enrolled in Medicare Parts A and B. You cannot participate in this plan if you are not enrolled in Medicare Parts A and B. This is not a Medicare supplement or MediGap plan.
Medicare Parts A and B is your primary coverage for any claimClaimA written request such as a reimbursement of a health care expense made by you or your health care provider to the plan administrator whether is medical, dental, vision or a flexible spending account. [3]. CU Health Plan — Medicare pays secondary for services covered by Medicare. The plan will not cover services that Medicare does not pay. CU Health Plan — Medicare will pay up to the allowable amount set by Medicare Parts A and B for that specific service. Most medical services or supplies not covered under Medicare are not covered benefits under this plan.
Plan details
- CU Health Plan - Medicare Benefits Coverage Summary [4] (7 pages)
- CU Health Plan - Medicare Benefits Booklet [5](74 pages)
- Anthem Preventative Care Guidelines [6]
Covered providers and medications
- Find a doctor [7]
- Call 1-800-735-6072.
- Pharmacy coverage [8]
- CVS Caremark Formulary [9]
- For pharmacy questions, call 1-888-964-0121.
Over/Under Plan
CU Health Plan — Medicare/High Deductible is available only to covered CU retirees and their spouses/dependents when at least one member is eligible for Medicare and at least one member is non-Medicare eligible. The partner who is not Medicare-eligible must enroll in CU Health Plan - High Deductible to keep their CU medical coverage. Please review details of both the Medicare and High Deductible Plans if you are a considering this option.
You cannot pair the University of Colorado's Health Savings AccountHSA (Health Savings Account)A tax-savings account that must be paired with a High-Deductible Health Plan, which can be used to pay for qualified health care expenses now or in the future. An HSA is a savings account that you own. The funds in an HSA carry forward year after year, even if you change employers or retire. [10] with the Over/Under plan, but you may enroll in a HSAHSA (Health Savings Account)A tax-savings account that must be paired with a High-Deductible Health Plan, which can be used to pay for qualified health care expenses now or in the future. An HSA is a savings account that you own. The funds in an HSA carry forward year after year, even if you change employers or retire. [10] outside of CU.
Prescription Benefits
Plan coverage is determined by medication type, supply amount and pharmacy services:
Up to a 90-day supplyy | |||
Tier 1 |
10% coinsurance after deducitble at CVS Retail Network Pharmacies 5% coinsurance after deducitble at CVS Retail Pharmacies or CVS Mail Order Pharmacy |
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Tier 2 |
20% coinsurance after deducitble at CVS Retail Network Pharmacies 15% coinsurance after deducitble at CVS Retail Pharmacies or CVS Mail Order Pharmacy |
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Tier 3 |
20% coinsurance after deductible at CVS Retail Network Pharmacies 15% coinusrance after deducitble at CVS Retail Pharmacies or CVS Mail Order Pharmacy |
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Tier 4 |
20% coinsurance after deductible for up to a 30-day supply at CVS Retail Network Pharmacies 15% coinsuranceafter deducitble for up to a 30-day supply a at CVS Retail Pharmacies or CVS Mail Order Pharmacy |
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Maintenance medications may be purchased at a CVS Network Retail Pharmacy. After three fills, a CVS Retail Pharmacy or CVS Mail Order must be used for up to a 90-day supply. Specialty medications (Tier 4) may be purchased at a CVS Network Retail Pharmacy. After three fills, CVS Specialty Pharmacy must be used. |