380 likes | 652 Vues
The Viacom Active Plan Options. What can I expect from UnitedHealthcare?. Dedicated Customer Care: telephone and online services. Personal Messages: e.g. preventive care reminders. One of the largest networks in the U.S. Help Finding: quality and affordable doctors, hospitals, and services.
E N D
What can I expect from UnitedHealthcare? Dedicated Customer Care: telephone and online services Personal Messages: e.g. preventive care reminders One of the largest networks in the U.S. Help Finding: quality and affordable doctors, hospitals, and services 24/7 Personal Support: from nurses and health coaches Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
You probably have a lot of questions Is my doctor in the network? What health care coverage best fits my needs? What is my total cost of health care including premiums? What extras do I get with my health plan? Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare Choice Plus Network Key Features A network doctor, pharmacy, hospital and convenience care clinic are likely nearby. You can see any doctor you want You do not need referrals You’ll save money when you use the UnitedHealthcare network Source: UnitedHealthcare Network and national network data provided by Strenuous and industry standard access requirements for hospitals and primary care physicians, May 2012 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Find A Network Doctor Or Hospital Visit www.myuhc.com/groups/viacom • Search by: • Name or specialty • Procedure • Office hours • Gender • Education • Driving directions • Languages spoken Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HealthFund Option (HSA) What health care coverage best fits my needs? Choice Plus II Option Choice Plus Option 6
Everyone Has Different Needs Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 7
Your Medical Plan Options Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance HealthFund Option Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 9
Your Medical Benefits at a Glance Choice Plus Option Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 10
Your Medical Benefits at a Glance Choice Plus II Option Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 11
Viacom Options include: • Freedom to choose any network doctor, including specialists, without referrals • Coverage for non-network care • No need to choose a primary care physician • 100% preventive care coverage in our network • Care management if you require hospital stay or surgery • Copayments, coinsurance and/or deductible You have coverage if you receive care outside our network. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HealthFund Option Health Savings Account (HSA)
What is an HSA? Health Savings Accounts (HSAs) are designed to help you save and pay for your health care. An HSA is a component of the Viacom HealthFund option 14
HSA Overview Used to pay for qualified health care expenses immediately Require a High Deductible Health Plan (i.e. the Viacom HealthFund) Funded by you, your employer or others • Account funds belong to you • Grows over time and can be invested Investments are not FDIC insured, are not guaranteed by OptumHealth Bank and may lose value. 15
Your HSA Is Your Money If you leave your employer or change health plans, you take your HSA with you. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Any money deposited into your HSA is yours to keep. There is no “use it or lose it” rule. 16
What You Need to Know About An HSA You’re in charge of managing your HSA Annual contribution limits set by the IRS and deposits can be made at any time Funds can be used to pay for current health care expenses, or can be saved for future health care expenses All deposits are income tax free and withdrawals are not taxed 17
Contribution Limits The IRS determines how much you can fund. Amount of Funding Rules • For 2013 the IRS allow you to contribute up to $3,250 for Individuals and $6,450 for families. Those 55 years of age or higher, but not entitled to Medicare benefits, can fund an additional $1,000/year “catch-up” contribution! Additional Funding 18
How to Use Your HSA Funds Use Your HSA Funds Now or Save for the Future • Build balances to cover your HDHP deductible • Use the funds in your HSA • Save for the future and grow funds tax free 19 19
HSA Qualified Medical Expenses Use HSA dollars to pay for medical expenses for your spouse or dependents – even if they aren’t covered by your HDHP medical plan Medical plan deductibles and coinsurance Medical, prescription drugdental and vision care services Any money you take out of your HSA for eligible medical expenses is income-tax free 20
Other HSA-Qualified Medical Expenses 1 • Health coverage while receiving unemployment benefits 2 4 • Medicare premiums and out-of-pocket expenses • COBRA continuation coverage 3 • Eligible • long-term care premiums 21
Paying for Non-Qualified Expenses EXCEPTION: The penalty does not apply to account holders age 65 and older, those who become disabled or enroll in Medicare or die. Any funds used for purposes other than to pay for eligible medical expenses are: Taxable as income Subject to a 20 percent tax penalty 22
Access Your HSA Funds Use your UnitedHealthcare Health Savings Account Debit MasterCard®. Debit Card can be used at doctor’s office, pharmacy, anywhere MasterCard is accepted. Use the free online bill pay function for both one time and recurring expenses Order HSA checks for this account ($10 for book of 25) Pay for an expense with personal funds and reimburse yourself from your HSA 23
Access Your HSA Funds Use your UnitedHealthcare Health Savings Account Debit MasterCard®. Debit Card can be used at doctor’s office, pharmacy, anywhere MasterCard is accepted. Use the free online bill pay function for both one time and recurring expenses Order HSA checks for this account ($10 for book of 25) Pay for an expense with personal funds and reimburse yourself from your HSA 24
Making Deposits Payroll Contributions • You can elect to make pre-tax payroll contributions to your account on a per pay period basis. You can also make contributions on-line at myuhc.com – transfer funds from your personal account to your HSA. Or, you can send in a check contribution. Deposit forms available online at myuhc.com and in your welcome kit. e-Contribute* Check* *contributions made outside of payroll are after-tax, however these can be claimed on your federal tax return as an above-the-line item deduction. 25
The plan is designed to help you: Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 26
Open Your Account and Deposit Early Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 27 • Open and deposit money into your HSA early. • You’ll be prepared for health expenses. • Viacom offers automatic payroll deposit into your HSA. • Viacom contributes to the HSA: $500 Individual or $1,000 Family. • Don’t leave free money on the table. You can only collect the money by opening your HSA account.
The Plan in Action Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. • This is Mary. The HealthFund Option gives her: • Lower monthly premiums • Viacom’s contribution of $500 to her HSA • Ability to choose any doctor • Unspent HSA dollars can roll over • Possibly no out-of-pocket costs 28
The Plan in Action 1. Mary’s annual deductible is $1,300. • Viacom is funding $500 in the HSA. • Mary contributes $500 to the HSA. • Mary is responsible for her deductible. • Preventive care is covered 100% in network. 1. Deductible $1,300 Mary chooses to pay out of her pocket OR with her HSA Preventive care is covered 100% in the network. Example assumes services are received in network. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 29 A snapshot of Mary’s plan:
The Plan in Action 2. After her deductible is met, Mary’s coverage is 90% / 10%. • Mary’s plan will pay 90%. • Mary will pay 10%. • This is called coinsurance. 1. 2. Deductible $1,300 Coverage 90 / 10 Mary’s plan pays 90% Mary pays 10% Mary chooses to pay out of her pocket OR with her HSA + coinsurance Preventive care is covered 100% in the network. Example assumes services are received in network. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. A snapshot of Mary’s plan: 30
The Plan in Action 3. Mary’s out-of-pocket maximum amount is $2,600. • When Mary reaches her out-of-pocket maximum, the plan pays 100%. • Mary is protected. 1. 2. 3. Deductible $1,300 Coverage 90 / 10 Out-of-pocket Maximum $2,600 Mary’s plan pays 90% Mary pays 10% Mary chooses to pay out of her pocket OR with her HSA Mary is protected + When Mary reaches her out-of-pocket maximum, her plan pays 100%. coinsurance Preventive care is covered 100% in the network. Example assumes services are received in network. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. A snapshot of Mary’s plan: 31
Introduction to OptumRX • Who is OptumRx? • OptumRx is a UnitedHealth Group company, • offering high quality pharmacy benefit services. Viacom members • will enjoy additional advantages, such as an easy online • experience, option to set up mobile text refill reminders, superior • customer service and access to the OptumRx Mail Service • Pharmacy. • What happens if my question is not answered here? • For more information, visit us today at http://welcometouhc.com/viacom. • After 1/1/13, you can call customer service at the member phone • number listed on the back of your ID card or visit myuhc.com.
Welcome to your OptumRX Pharmacy Benefit Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Welcome to your OptumRX Pharmacy Benefit Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Viacom’s Pharmacy Plan will Transition to UnitedHealthcare effective 1/1/13, UHC’s pharmacy is OptumRx Will my prescription records transfer? Yes, your pharmacy claims records will be securely transferred to UnitedHealthcare from Express Scripts. Can I go to the same pharmacy? You will have access to over 64,000 retail pharmacies including all large national chains, and many local, community pharmacies and the OptumRx Mail Service Pharmacy. To locate a network pharmacy, log into our Pharmacy locator atwww.welcometouhc.com/viacom. Will my mail service prescription(s) transfer to OptumRx? Most mail service prescriptions with remaining refills will automatically transfer. Prescriptions for certain medications will not transfer. Examples include certain painkillers and prescriptions that have expired. In these cases, you’ll need a new prescription from your doctor. Once I place a mail service order, how quickly will I get my medication? New prescription orders are delivered by standard U.S. mail and will arrive around 10 business days from the date OptumRx receives the order. Refills are sent the same way and normally arrive within 7 business days. If you have an email address on file, you can expect to receive an email when your prescription ships. If you don’t have an email address on file, you’ll receive a phone call. OptumRX Frequently Asked Questions Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 35
OptumRX Frequently Asked Questions • I receive a specialty medication through a Specialty • Pharmacy. How does this impact me? Do I need to take any • action? • Most specialty medications are managed through our OptumRx • Specialty Pharmacy Program. Your Curascript / ESI Specialty • Pharmacy Rx will be transferred to OptumRX and you will receive a letter • and phone call from OptumRX with further information. Once your Rx is • transferred, you can call the OptumRx Specialty Pharmacy, at 1-888-739- • 5820, and talk to a patient care coordinator to assist you. Our specialty • pharmacy program offers on-call pharmacists available 24 hours a day, • information about lower-cost medication options and additional resources.
HSA Eligibility You are eligible to open and contribute to an HSA if: You are covered by an eligible high deductible health plan You are not covered by any other health plan that is not a high deductible plan You are not entitled to Medicare, TRICARE or TRICARE for Life You have not received VA benefits within the past 3 months You are not claimed as a dependent on someone else’s tax return You are not covered by a health care FSA, nor have a balance in your FSA on 12/31/12 37