Medicare [1]
CU Health Plan — Medicare, provided by Anthem Blue Cross Blue Shield, is available to Medicare-eligible participants 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 claim.
- CU Health Plan — Medicare pays secondary for services covered by Medicare.
- The plan will not cover services that Medicare does not pay.
- CU 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 [3] (7 pages)
- CU Health Plan - Medicare Benefits Booklet [4](72 pages)
- Anthem Preventative Care Guidelines [5]
Covered providers and medications
- Find a doctor or urgent care [6]
- Call 1-800-735-6072
- Access the CVS Formulary [7]
- For pharmacy questions, call 1-888-964-0121
- Find an in-network pharmacy [8]
- New for July 1: Generic drug coverage expanded [9]
Over/Under Option
CU Health Plan — Medicare/High Deductible is available only to covered CU 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] 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 deductible at CVS Retail Network Pharmacies as well as UCHealth Pharmacies 5% coinsurance after deductible at CVS Retail Pharmacies, CVS Mail Order Pharmacy as well as UCHealth Pharmacies or mail order service |
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Tier 2 |
20% coinsurance after deductible at CVS Retail Network Pharmacies as well as UCHealth Pharmacies 15% coinsurance after deductible at CVS Retail Pharmacies, CVS Mail Order Pharmacy as well as UCHealth Pharmacies or mail order service |
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Tier 3 |
20% coinsurance after deductible at CVS Retail Network Pharmacies as well as UCHealth Pharmacies 15% coinusrance after deductible at CVS Retail Pharmacies, CVS Mail Order Pharmacy as well as UCHealth Pharmacies or mail order service |
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Tier 4 |
20% coinsurance after deductible at CVS Retail Network Pharmacies as well as UCHealth Pharmacies 15% coinsuranceafter deductible for up to a 30-day supply at CVS Retail Pharmacies, CVS Mail Order Pharmacy as well as UCHealth Pharmacies and mail order service |
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Maintenance medications may be purchased at a CVS Network Retail Pharmacy. After three fills, a CVS Retail Pharmacies, CVS Mail Order Pharmacy as well as UCHealth Pharmacies or mail order service 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, UCHealth Pharmacies or UCHealth mail order service must be used. |