LSU First Retirees – Review plan benefits
UnitedHealthcare®
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Review plan benefits & costs

Get a quick overview of your plan benefits and costs and find more detailed information about additional coverage and benefit services.


LSU First Medicare Retiree plan administered by UnitedHealthcare®

 

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Benefits and costs

LSU First Medicare Retiree plan administered by UnitedHealthcare®

Annual medical deductible

None

Office and clinic visits

$0 copay

Hospital services (inpatient)

$0 copay

Hospital services (outpatient)

$0 copay

Emergency room services $50 copay

Prescription drug coverage

Retail:
Tier 1 - Generic:  $0 copay
Tier 2 - Preferred Brand:  $40 copay
Tier 3 - Non-Preferred Brand: $70 copay
Tier 4 - Specialty: $100 copay

Mail Service:
Tier 1 - Generic:  $0 copay
Tier 2 - Preferred Brand:  $120 copay
Tier 3 - Non-Preferred Brand:  $210 copay
Tier 4 - Specialty: $300 copay

After your total out-of-pocket costs reach $6,550, you enter the Catastrophic Coverage stage.  In this stage, you pay a small copay, of $3.70 for generic drugs and $9.20 for brand name and specialty drugs and you stay in this stage for the rest of the plan year.

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LSU First

Group retiree benefits for
LSU First Medicare retirees

This is not my group.
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IMPORTANT DATES

2021 Open Enrollment Period

Began: October 1, 2020
Ended: November 15, 2020

Benefits effective January 1, 2021.

Virtual Education Center


It’s all the information you need to help you understand and access your MA/ MAPD plan benefits — in one place, at any time, from your favorite device. Let’s get started.

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Last updated: 09.02.2020 at 12:01 AM CT  H2001_090220BMR