America's Benefit Specialist November 2022

MEDICARE MATTERS

Medicare-approved items and services like hearing aid copays, prescription sunglasses, out-of-network dental charges and more. Benefit Stability: Ninety-nine percent of members in standard and Chronic Special Needs Plans (C-SNPs) will have stable or reduced premiums—including nearly 3.3 million members with a $0 premium—and all will have stable or improved core and prescription drug benefits. Additionally, all Medicare Advantage members will see stable ancillary benefits, with 91% receiving better-than-ever ancillary benefits like den tal, hearing, OTC and prescription drug coverage. $0 Copays: Ninety-seven percent of members are enrolled in a standard plan or C-SNP with a $0 PCP copay, up from 83% in 2022, and nearly all eligibles will have access to a plan with a $0 PCP copay. Many members will also see decreased copays on specialist visits and physical, occupational and speech therapies—and $0 copays when the visit is virtual. Dental: The company will offer its richest enhanced comprehensive dental benefit ever, with one simplified coverage level available to 96% of people in standard plans, covering all non-cosmetic dental care including dentures and implants, and no out-of-pocket costs up to the annual cover age limit on most plans. Members will have access to a large, national Medicare Advan tage dental network, and all plans with the enhanced comprehensive dental benefit will allow members to see out-of-network den tists to receive the coverage they need. OTC, Healthy Food and Utilities Credit: D-SNP members with this combined benefit will see an average increase of 42%, amounting to an average allowance of more than $2,200, with some members having up to $3,600 per year to spend across covered OTC products and healthy foods between shopping trips or online delivery orders, plus eligible utilities expenses. PLAN UPDATES

Vision and Hearing: All plans with vision coverage will maintain a $0 routine annual eye exam, and most will have an eyewear allowance. Standard lenses are covered at no cost and more than 92% of members will have an annual benefit, up from 59% in 2022. Additionally, the majority of plans will offer a $0 hearing exam and all mem bers will have a hearing aid benefit, typically annual, and access to custom-programmed hearing aids through UnitedHealthcare Hearing, including retail and home- delivery options. $0 Copays and Deductibles: More plans than ever will lower tier 1 retail copays to $0, giving nearly all members in standard plans and C-SNPs free access to the most common adherence medications. And 100% of members will have $0 tier 1 and 2 copays through Optum Home Delivery, up from 93% in 2022. Additionally, 87% of members will have no Rx deductibles, up from 59% in 2022. Formulary Investments: The company’s Medicare Advantage formulary will have more drugs in tier 1 than ever before and move even more commonly used drugs to lower tiers, which target conditions such as cardiovascular disease, depression, osteo arthritis, glaucoma and overactive bladder, among others. Additionally, several drugs used before or after dental procedures have moved to tier 1, helping to eliminate out-of pocket costs for these drugs on most plans. Chronic Condition Support: All members without Extra Help enrolled in C-SNPs will have access to insulin at $25 ($10 less than standard plans) in addition to diabetic sup plies on tier 2, giving access to $0 copays for supplies when using home delivery. C-SNP members will also have access to eight medications on a lower drug tier that target cardiovascular disease. Part D Coverage Gap: All standard plans will continue to provide tier 1 gap coverage, eliminating increased costs during the cov

erage gap and helping to ensure cost is not a barrier for members to stay adherent with their medications. $0 Drug Copays on Dual Special Needs Plans (D-SNP): UnitedHealthcare will con tinue to expand access to $0 copays on cov ered drugs to 96% of our members enrolled in D-SNPs—bringing needed savings to more Dual members than any other carrier. A national rollout to more than 6.4 mil lion individual Medicare Advantage mem bers brings together the member ID with enhanced payment technology to create a single, integrated card that not only pro vides access to health care, but also allows members to shop with their benefits, spend earned rewards and more. Key features of the UCard: • Members with an OTC, or OTC, healthy food and utilities combined benefit can spend the credit on their UCard on thousands of covered items at more than 35,000 retail locations nationwide—a first for most members in standard plans and C-SNPs. • All members with a UCard and Renew Active fitness benefit can use the UCard to access their free gym membership on their first visit to any of the 22,000+ Renew Active network gyms and fitness locations. • Earned rewards are loaded onto a mem ber’s UCard after they complete eligible activities like getting a flu shot or a mammogram, having a UnitedHealthcare HouseCalls visit, or achieving monthly activity goals. • The UCard Hub on the UnitedHealthcare member website and mobile app will give members real-time access to available balances, a store locator and more, with additional support from customer service as needed.

40 ABS | benefitspecialistmagazine.com