Q: Why is UC switching to Anthem and Optum Rx?
Anthem is well-positioned to support UC as a long-term partner through a constantly changing health care landscape. Optum Rx is a pharmacy expert specializing in the delivery, clinical management and affordability of prescription medications and is the largest Medicare pharmacy provider in the U.S.
Q: When does this change take effect?
This change takes effect on Jan. 1, 2017.
Q: Will this change affect my current behavioral health and/or pharmacy benefits or costs? Will it affect my benefits or costs for 2017?
This change will not affect any benefits or costs for 2016. Details for 2017 UC plans--including any changes in benefits and costs--are still being finalized. Medications covered under your current plan will continue to be covered by Optum Rx. Some prescription copays may increase or decrease depending on the medication. Members will be able to confirm their prescription copays during Open Enrollment.
Q: What happens if my medical or behavioral health provider is not in Anthem’s network?
Your PPO plan will continue to offer out-of-network coverage if you choose a medical or behavioral health provider not contracted with Anthem, but using an in-network provider does greatly reduce your costs. Anthem’s medical provider network has considerable overlap with the current Blue Shield Preferred network, and Anthem is actively working to expand overlap with Optum’s behavioral health network to avoid disruptions for UC employees.
If necessary, transition of care may be offered for a limited time during your transition to a provider in Anthem’s network. More information about Anthem’s provider networks and about transition of care and continuity of care will be available during Open Enrollment.
Q: Will this change affect the provider network I use out of state, or when I travel outside the U.S.?
No. Anthem provides access to the same Blue Card network currently available to Blue Shield members outside of California and outside the U.S.
Q: Will there be any changes to my Health Savings Account?
No. Your Health Savings Account will not be affected by this change. Your account will remain with HealthEquity, with the same account and login information and debit card.
Q: Does Anthem offer a telemedicine option like Teladoc?
Anthem has a telemedicine program similar to Teladoc called LiveHealth Online. Details about the program will be available during Open Enrollment.
Q: Will this change affect my UC-sponsored Medicare plan?
For Medicare retirees, who must use Medicare providers, the medical and behavioral health networks are expected to be fairly similar, although some providers may not be in both networks.
