Frequently Asked Questions
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 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 coinsurance 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, but are only offered through an employer group or plan sponsor. 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. Employer groups and plan sponsors commonly offer both a Senior Supplement plan and a separate Medicare Part D prescription drug plan.
Yes. You must be enrolled in Medicare Part A and Part B to be eligible for our retiree plans and you must continue to pay your Part B premium to the government. This is a requirement for your PwC Medicare Advantage plan. If you stop paying your Part B premium, you may be disenrolled from your plan.
To find doctors or hospitals in our network, click on “Find a Provider” in the navigation at the top of the page. 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.
Click on the Resources tab in the menu at the top of your screen, then on the Appeals & Grievances link. This page provides detailed information about the appeals process.
This information is accessible within the member portion of the site. Once logged in, click the "Coverage & Benefits" link in the menu at the top of your screen. This page will provide your annual deductible and out-of-pocket costs for your health as applicable.
This information is accessible within the member portion of the site. Once logged in, click the "Claims" link in the menu at the top of your screen. The Claims page will enable you to search for medical and/or drug claims by date range and will provide an overview of each claim searched.
This information is accessible within the member portion of the site. Once logged in, click on the "View and Print Member ID Card" link on the home page.
If you are unable to find the links noted above, please call customer service using the number listed on your plan materials or the number noted for Plan Members on the Contact Us page.
No.
Yes, this plan offers nationwide coverage.
The plan covers emergency and urgent care coverage worldwide, as long as the travel lasts less than 6 months.
UnitedHealthcare has contracted with more than 1 million providers who accept Medicare to create a network of “in-network” providers for the UnitedHealthcare® Group Medicare Advantage (PPO) plan. UnitedHealthcare works closely with our network of doctors so they have access to resources and tools like our easy to navigate provider website, which contains monthly bulletins that include the latest news and policy updates, a resource library and training opportunities, all of which can help them stay informed and make better treatment decisions on your behalf.
You do have the flexibility to visit doctors who are out-of-network, provided they have agreed to accept Medicare. While considered “out-of-network,” you will pay the same share of the cost for the care as you would have if the provider participated in the network.
For a list of participating network providers, contact a UnitedHealthcare Customer Service representative at 1-844-876-6172, TTY 711, 8 a.m. – 8 p.m. local time, Monday - Friday.
If your doctor has opted out of Medicare, the services provided by the doctor will not be covered under the UnitedHealthcare® Group Medicare Advantage (PPO) plan, and you will be responsible for 100% of the cost. This is different than your current medical plan.
Less than 1% of doctors nationally have opted out of the Medicare program. You may want to consider selecting a new provider. If you need help finding a doctor, UnitedHealthcare can help you find a doctor based on your needs. Contact a UnitedHealthcare Customer Service representative at 1-844-876-6172, TTY 711, 8 a.m. – 8 p.m. local time, Monday- Friday.
There are many different types of Medicare Advantage plans, so it depends on what your doctor does not accept.
The UnitedHealthcare® Group Medicare Advantage (PPO) plan does not require a doctor to have a contract with UnitedHealthcare. This plan works like traditional PPO plans, which doctors have been familiar with for a long time. Under the plan, the doctor will be paid the same as Medicare would have paid.
If you contact UnitedHealthcare, we will be happy to reach out to your provider to discuss how the plan works and how the provider will be paid the same as Medicare. Most doctors accept this type of plan once they understand they do not need a contract, and they will be paid the same as Medicare. If the doctor refuses to accept this plan, you can continue to see the doctor, pay for the services up front and then submit the bill to UnitedHealthcare for reimbursement. You will only be responsible for the same copayment or coinsurance as if you had stayed in the network.
There are very few hospitals that are not in the UnitedHealthcare network. For a full list of hospitals, you can contact a UnitedHealthcare Customer Service representative at 1-844-876-6172, TTY 711, 8 a.m. – 8 p.m. local time, Monday - Friday.
And remember, since this is a PPO plan, the hospital does not have to be in-network in order for you to receive services under this plan.