What’s New for 2019
As a State of Wisconsin Group Health Insurance Program participant , you may be eligible to enroll in the It’s Your Choice (IYC) Medicare Advantage plan provided by UnitedHealthcare®. The IYC Medicare Advantage plan is a UnitedHealthcare® Group Medicare Advantage (PPO) plan, which means you have lots of flexibility in choosing a provider. You can see any provider outside of the network, as long as they accept Medicare and are willing to bill UnitedHealthcare. If you need specialty care, no referral is required.
The IYC Medicare Advantage plan offers comprehensive coverage for hospital and medical services (Uniform Benefits ), pharmacy benefits (by Navitus Health Solutions), as well as additional programs and services. Examples are:
- SilverSneakers® Fitness Program
Designed for all fitness levels and abilities, includes access to exercise equipment, classes and more at 14,000+ fitness locations.
With this program, you may get an annual in home clinical visit from one of our nurse practitioners at no extra cost. The visit is voluntary and designed to support but not take the place of your regular doctor’s care. HouseCalls may not be available in all areas.
- Special Programs
To help members who are living with chronic disease, like diabetes or heart disease.
- Solutions for Caregivers
At no additional cost, Solutions for Caregivers supports you, your family and those you care for by providing information, education, resources and care planning.
- Virtual Doctor Visits
See and speak to specific doctors for non-acute issues using your computer or a mobile device, like a tablet or smartphone, at no additional cost.
- Online Access
Look up your latest claim information, review benefit information, learn more about health and wellness topics and sign up for healthy challenges based on your interests and goals.
Go to UHCRetiree.com/ETF to access a Provider Directory. 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, call 1-844-876-6175, TTY 711, 7 a.m. – 6 p.m. CT, Monday – Friday.
Referrals, Authorizations, Out-of-Network
Members have access to our national network of providers and the flexibility to see any provider (in or out-of-network ) at the same cost share, as long as they accept the plan and have not opted out of Medicare . If you need specialty care, no referral is required.
Emergency and Urgent Care
If you require emergency or urgent care, seek care at the nearest medical facility.
You can also receive emergency or urgently needed services from a provider outside the United States. If you receive emergency or urgently-needed services outside of the United States, the provider may require that you pay for the cost of the services in full. Ask for a written, detailed bill or receipt showing the specific services provided to you. Send a copy of the itemized bill or an itemized receipt to us to pay you back. You should be prepared to assist us in obtaining all of the information necessary to properly process your request for reimbursement, including medical records.
Mental, Behavioral Health and Substance Abuse
Behavioral Health: 1-800-453-8440 TTY 711
NurseLine: 1-877-365-7949, TTY 711
Major Health Systems
You have access to any provider who accepts Medicare assignment.