Get answers to commonly asked questions about Medicare, your plan and UnitedHealthcare ®.
- What is the difference between Original Medicare, Medicare Advantage plans, Medicare Supplement plans, and Senior Supplement plans?
- Is this the same Medicare Advantage plan that is advertised on TV?
- Can I change my HealthSelectSM Medicare Advantage Plan coverage at any time?
- When enrolled in the HealthSelectSM Medicare Advantage Plan, do I have to continue paying my Medicare Part B monthly premiums?
- Is my doctor included in the UnitedHealthcare Medicare Advantage Network?
- Where can I learn more about the appeals process?
- How do I know what changes there will be to my plan for the next year?
What is the difference between Original Medicare, Medicare Advantage plans, Medicare Supplement plans, and Senior Supplement plans?
Medicare Part A and Part B are usually referred to as "Original Medicare". Part A offers coverage for your hospital stays, while Part B offers coverage for doctor visits and outpatient care. You receive your benefits directly from the government. Medicare then pays fees for your care directly to the doctors and hospitals you visit.
Medicare Part C plans are usually referred to as Medicare Advantage plans. All Medicare Advantage plans are provided by private insurance companies, like UnitedHealthcare Insurance Company, and they all combine coverage for hospital stays (Medicare Part A) with coverage for doctor visits and other outpatient care (Medicare Part B) into one plan. Some plans include prescription drug coverage (Medicare Part D), plus extra benefits like vision, hearing and dental coverage. Under Medicare Part C, the Medicare Advantage plan pays the fees for your care directly to the doctors and hospitals that you visit.
Medicare Supplement plans act as a supplement to "Original Medicare" (Parts A and B). Medicare Supplement plans help to pay for some of the costs, like co-insurance and deductibles that Original Medicare does not cover. If you enroll in a Medicare Supplement plan and need prescription drug coverage, you will need to enroll in a Medicare Part D prescription drug plan also.
Senior Supplement plans also act as a supplement to Original Medicare. They may have similar benefits as the Federal Medicare Supplement plans, but may also cover state-mandated benefits. If you enroll in a Senior Supplement plan and need prescription drug coverage, you will need to enroll in a Part D prescription drug plan also.
Is this the same Medicare Advantage plan that is advertised on TV?
No, this Medicare Advantage plan is not the same as what is advertised on TV. HealthSelectSM Medicare Advantage Plan is a custom Group Medicare Advantage PPO plan designed exclusively for ERS retirees, survivors and eligible dependents. This plan is different and should not be confused with individual UnitedHealthcare Medicare Advantage plans that might be available in the area through an Exchange.
What happens if I don’t join the HealthSelect MA PPO plan?
You aren’t required to enroll in this plan. If you do not want HealthSelect MA PPO plan as your health plan provider, you can opt out of coverage for yourself and/or any Medicare-enrolled dependents before the effective date of the coverage. If you are currently enrolled in the HealthSelect MA PPO, you will be automatically enrolled in this HealthSelect MA PPO offered by UnitedHealthcare on January 1, 2021 unless you opt out of coverage or make a coverage change to a different health plan.
If you don’t want to enroll, or if you want to make a coverage change:
- Access your ERS Online account at www.ers.texas.gov, click on Medicare Plan Options and opt out of the HealthSelect MA PPO plan.
- You can also call ERS toll free at (877) 275-4377, (TTY: 711) 8 a.m. – 5 p.m. CT Monday through Friday.
Can I change my HealthSelectSM Medicare Advantage Plan coverage at any time?
Yes. Retirees, survivors and their eligible dependents can switch between HealthSelect Medicare Advantage and their previous non-Medicare Advantage plan at any time; you do not need to wait for the fall enrollment period. Any changes in coverage you make will be effective on the first day of the month following the change. Contact ERS toll-free at (877) 275-4377 for more information.
When enrolled in HealthSelect Medicare Advantage Plan, do I have to continue paying my Medicare Part B monthly premiums?
Yes. You must be enrolled in Medicare Part A and Part B to be eligible for HealthSelect Medicare Advantage Plan and you must continue to pay your Part B premium to the federal government. This is a requirement for Medicare Advantage and Medicare Part D prescription drug plans. If you stop paying your Part B premium, you may be disenrolled from your plan.
Is my doctor included in the UnitedHealthcare Medicare Advantage Network?
To find doctors or hospitals in our network, see the online Provider Directory. This directory is updated regularly to provide you with the current listing of network providers. If you would like help finding a network doctor or to request a written copy of the Provider Directory, please call Customer Service at (855) 853-0453, 7 a.m. – 7 p.m. CT, Monday through Friday or 7 a.m. – 3 p.m. on Saturday. TTY user, call 711.
Where can I learn more about the appeals process?
Navigate to the Find and Learn tab in the menu at the top of your screen and click on the File Appeals & Grievances option in the sub-navigation. This page provides detailed information about the appeals process.
How do I know what changes there will be to my plan for the next year?
You will receive a HealthSelect MA PPO plan guide and Quick Start Guide in the mail in the coming months for the MA PPO plan administered by UnitedHealthcare beginning January 1, 2021. These documents will provide detailed information about your benefits and coverage and any new programs available to you. Starting with calendar year 2022, for each year that you are a member of HealthSelect Medicare Advantage Plan, you will receive an Annual Notice of Changes (ANOC) from UnitedHealthcare about six weeks before your plan's effective date. The ANOC explains any changes in coverage, costs, and benefits that will be effective for the upcoming year. You may also contact us with any questions.
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