1 Anthem Medicare Advantage Preferred (PPO) University of Chicago Y0114_19_36552_I_M 08/14/2018 73574MUSENMUB
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Anthem Medicare
Advantage
Preferred (PPO)
University of Chicago
Y0114_19_36552_I_M 08/14/2018 73574MUSENMUB
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Anthem’s Medicare Benefits2
Today’s Discussion
A few basics: Medicare 1011
Questions5
How We’ll Help You Make Staying Healthy Simpler3
How Auto-Enrollment Works For You4
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By your side – every step of the way
GrowthExperience
Knowledge You
Can Trust
• 75+ years of
dedication
GrowthGrowthSimplicity
Easy for You
• Doctors you
know & trust
• Power of One
• One phone
number to call
Care
The Attention You
Deserve
• Holistic health &
wellness care
• Additional care
benefits
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First Impressions Line
833-214-8951
Monday – Friday 8am-9pm ET
Understanding
Plan Benefits
Guidance &
Medical Continuity
Enrollment Support
• Interactive Voice Response (IVR)-free experience
• Senior sensitivity certified
• Single point-of-contact for implementation-related
questions
• Helps answer questions about network, benefits, etc.
Confidence & Care
• Trained to address questions about prescriptions &
network
• Available to assist you with questions about doctors and
coverage under our plan
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Original MedicareMedicare Advantage
Part C
Part AHospital Insurance
Part BMedical Insurance
+
Part AHospital Insurance
Part BMedical Insurance
+
+
Holistic Care Benefits+ Transparent Quality Metrics
SilverSneakers fitness program
Routine vision care
Routine hearing services
Hearing aid coverage
Video doctor visits (no charge)
Routine foot care
Additional annual physical exam
How does Medicare Advantage work?
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Cost
Management
Additional
BenefitsEmergency and
Urgent Services
Get all health services
offered by Medicare,
plus additional
preventive screening
services and benefits
not provided by
Medicare
Copays allow you to
know your out-of-
pocket cost up front
Access to large
network of in and out
of network primary
care physicians
(PCPs) who can help
guide your care
What is a Medicare Advantage PPO Plan?
Physician
Services
Emergency and urgent
care are covered from
out-of-network
providers if an in-
network provider is not
available or accessible
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Are you eligible?
A few considerations to enroll in a Medicare Advantage plan
Note:
• If you enroll in a different Medicare Advantage Part C plan, Medicare will automatically disenroll you
from your University of Chicago Retiree Medical Plan.
• You will lose both medical and prescription drug coverage and will not be able to re-enroll in the
University of Chicago Retiree Medical Plan at a later date.
Be enrolled in
Medicare Part A
and Medicare
Part B
Live in Anthem’s
service area
Continue to pay
monthly Part B
premium
Be eligible for
your group’s
retiree health
benefits
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Our network is growing, giving retirees greater options and more flexibility than ever before
Anthem’s national network allows you to see the doctors you know and trust.
>800MA PPO network counties across 14 Anthem states
>1,700MA PPO network counties across Anthem/BlueCard
footprint
>500kContracted MA PPO providers
across all 50 states1
Anthem Medicare provider analysis, August 2018
Anthem’s strong national network
National Medicare Advantage PPO Network
1. Provider count includes PCPs, Specialists, & hospitals as of 2018. May include overlap across categories / states.
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In-network Providers Out-of-network Providers
Your plan includes a network of two types of providers:In-network providers and Out-of-network providers
Providers who participate in our
network
Providers who do not
participate in our network
Note: We can only pay providers who accept Medicare, please check with your provider if they accept Medicare.
Freedom to see any provider that accepts Medicare
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3 ways Anthem makes it easy to find a doctor
Multiple ways to find doctors in your provider network
Anthem.com
Visit the “Doctor & Hospital Finder” at www.anthem.com to find a Blue Medicare
Advantage PPO provider
Call 1-800-810-BLUE
Call 1-800-810-BLUE to ask for help finding your doctor
Customer Service
Call our toll-free Customer Service number listed
on your membership card
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Anthem Medicare Advantage
Everything that’s covered – all in one plan
Doctors
• Preventive services
• Coverage overseas
Hospitals
• SilverSneakers
• 24/7 Nurseline
• LiveHealth Online
• Special Offers
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National PPO Medical Benefits Summary
Summary of Rates
Covered Services 2018 In-network 2019 In-network 2019 Out-of-network
Deductible
Physician services, including doctor’s
office visits (Medicare-covered services)
• Physician visits
• Specialist visits
Inpatient Hospital Care
Hospital days are unlimited. Covered
services include, but are not limited to a
semi-private room (or a private room if
medically necessary)
Emergency Outpatient Care
(waived if admitted within 72 hours)
Preventive Care and Screenings
• Bone mass measurement
• Colorectal screening
• Cardiovascular screening
• Diabetes screening
• Mammogram screening
• Prostate screening
• Physical exams
• Annual wellness visit
Out of Pocket Maximum
$300
50% coinsurance per visit to a
Primary Care Physician
(PCP) or specialist for
Medicare covered services.
Deductible applies.
50% coinsurance for Hospital
Services.
80% coinsurance per
admission.
Deductible applies.
50% coinsurance per visit
after Medicare payment.
Deductible does not apply.
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
$1,750
$300
10% coinsurance per visit to a
Primary Care Physician (PCP)
or specialist for Medicare
covered services. Deductible
applies.
$250 copay per admission.
$0 copay for Medicare-
covered physician services
Deductible applies.
$100 copay per Medicare-
covered emergency room visit,
Deductible does not apply.
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
$1,750
$300
10% coinsurance per visit to a
Primary Care Physician (PCP)
or specialist for Medicare
covered services. Deductible
applies.
$250 copay per admission.
$0 copay for Medicare-covered
physician services.
Deductible applies.
$100 copay per Medicare-
covered emergency room visit,
Deductible does not apply.
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
Covered by plan
$1,750
Note: Hearing and Vision benefits are also included in your plan. Please see your full benefit chart for details.
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Retiree support along the health spectrum
Healthy Managing Conditions and Major Health Events
Silver Sneakers
National Council on Aging support
Preventive care programs
Provider collaborations
MyHealth Advantage
Medicare Diabetes Prevention Program
Case Management
Cancer resources and programs
Virtual Second Opinion
Rare disease management
Clinical appropriateness review for OT/PT, cardiology, sleep, radiology, etc.
NurseLineLiveHealth OnlineSilver Sneakers
A suite of care programs for a healthier you
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SilverSneakers
• Access to 14,000+ fitness
locations nationwide
• Use of amenities plus senior-
focused group fitness classes
• SilverSneakers FLEX™
Community Fitness Classes and
BOOM® Fitness Classes, plus
many others
• Member website to stay
connected with the
SilverSneakers community
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LiveHealth Online
Medical Support
Easy and convenient
care for conditions
such as cold, flu and
infections
24/7 Access
Visit with an in-network
board certified doctor
24 hours a day, 7 days
a week, 365 days a
year
Emotional Support
Talk to an in-network
licensed therapist or
board certified to
discuss feelings of
depression, stress or
anxiousness
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Help assess symptoms
Ensure you receive the right care in the right
setting
Day or night, help to put your mind at
ease
Increase understanding of condition +
course of treatment
Registered nurses available 24/7
Registered nurses are ready and waiting to help you – over the
phone – with your health concerns.
24/7 NurseLine
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Health Survey
You’ll receive a call to
complete a Health Survey
so we can assist with
medical conditions and get
you the care you need
Health Plan
Integrated health plan that
addresses your physical,
social and emotional well-
being
Managed Care
Helps you manage ongoing
health conditions and
increase quality of life
Care Management
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MyHealth Advantage
• Helps you keep track of your health
and progress
• Includes reminders to make preventive
care appointments
• We review your health claims, routine
tests and checkups on a regular basis
• Recent claims, personalized messages
and money-saving tips
Benefits of MyHealth Note:
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Plus, access Special Offers for additional savings
Vendors and offers are subject to change without prior notice. ABCBS does not endorse and is not responsible for the products, services or information offered by the vendors or providers. We negotiated the arrangements and discounts with each independent vendor or provider in order to assist our members. The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the grievance process.
Sample of Special Offers Available to Anthem’s Group Medicare Advantage Members
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Online resources at anthem.com
Access online resources anytime from your computer or smartphone
Print a temporary ID Card
View claims
Find a doctor
Estimate your costs
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Enrolling
As part of your plan, you have been
automatically enrolled.
How to Enroll How to Opt Out
Need to opt out? Just mail in the opt-
out form by November 28, 2018 to:
The University of Chicago
Attn: Maria Garcia
6054 S. Drexel Ave.
Chicago, IL 60637
Opting OutEnrollment
Note: If you opt out of the Anthem Medicare Preferred (PPO) retiree plan, offered through your group sponsor, you will not
be allowed to re-enroll in your group sponsored retiree plan in the future.
How to enroll in your new plan:
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For your doctor and hospital visits, bring your Anthem ID card
What you need to know:
• Use it at all provider locations
• Your old Blue Cross Blue
Shield ID card will no longer be
valid after December 31, 2018.
• You don’t need to show your
Medicare card
• If you need a temporary card,
contact customer service or go to
www.anthem.com to order one
Your Anthem ID Card
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Questions?
First Impressions
Welcome Line
833-214-8951Monday to Friday
8:00 am to 9:00 pm, ET
Except holidays
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Thank you for joining us
Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc.
HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance
Companies, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Kentucky: Anthem Health Plans of
Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area):
RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT
and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri,
Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In
Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO
Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health
Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance
Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its
service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In
Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), underwrites or administers PPO and indemnity policies and
underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation
(Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS
policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and
Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.
This information is not a complete description of benefits. Call 833-214-8951/711 for more information.