With It's Your Choice Medicare Plus, you are not bound by a network, having the freedom to see any doctor anywhere who accepts Medicare. You can even receive reimbursement worldwide for services typically covered by Medicare. This plan works with Medicare, acting as a supplement for the portion of covered services not paid by Medicare. IYC Medicare Plus will continue to be a Medicare supplement plan for eligible retirees and their dependents who select the IYC Access Plan and the State Maintenance Plan (SMP).
IYC Medicare Plus will pay your Medicare Parts A and B deductibles and coinsurance. This group plan is superior to individual Medicare supplements as it provides protections from fees that exceed usual, customary and reasonable amounts if members use a provider who is not affiliated with Medicare. It also offers coverage during foreign travel. Note, however, in cases where Medicare excludes coverage for a service, this plan will also deny coverage.
The IYC Medicare Plus plan is designed to supplement, not duplicate, the benefits available under Medicare for State and Local Group Health Insurance Program retirees.
See the Comparison of Benefit Options online for more details and the Certificate of Coverage for complete information.
What’s New for 2020
SilverSneakers® fitness program: This popular fitness program will continue to be included in your IYC Medicare Plus plan at no additional cost. SilverSneakers provides unlimited access to more than 16,000 fitness locations around the country—just show your WEA Trust Insurance ID card with the SilverSneakers logo.
Live telehealth visits at no cost: With our always-available telehealth service, you can have a face-to-face conversation with a doctor anywhere you have an internet connection. Don’t worry about finding a parking spot or driving in the snow, a video doctor visit is just moments away—perfect for minor conditions such as seasonal flu, bug bites or strep throat. Our telehealth service also offers scheduled therapy visits with a psychologist or therapist—all from the comfort of your own home.
Low back pain program pilot continues: If you are among the 80% of people who will experience low back pain at some point in your life, our program powered by Kiio™ could help you. The program uses a mobile app to guide you through exercise routines personalized for your specific pain. More information at WEAtrust.com/LowBackPain.
None. This plan provides you with freedom of choice among hospitals and physicians in Wisconsin, nationwide and for travel abroad. When receiving services for non-Medicare benefits covered by this plan, please use providers from the WEA Trust Preferred Network or through our out-of-state network. Each of those networks can be accessed at weatruststatehealthplan.com/providers.
Referrals, Authorizations, Out-of-Network
Referrals and prior authorizations are not necessary under this plan as benefits only supplement approved Medicare benefits.
A list of services requiring preauthorization can be found at weatrust.com/members/preauthorization-information.
Mental, Behavioral Health and Substance Abuse
Medically necessary services are available when performed by licensed mental health professionals practicing within the scope of their license. Inpatient services will be limited to 120 days. No prior authorization is required for outpatient services from a network provider, except for psychiatric and neuropsychiatric testing. Prior authorization is required for in-patient and transitional care. For other services, contact 1-866-485-0630.
WEA Trust contracts with a variety of health care provider systems that offer their own nurselines. A list of those nurselines can be found at weatruststatehealthplan.com/nurseline.
What if health care was as convenient as Amazon Prime? Or as easy as Netflix? With WEA Trust’s telehealth service, powered by Amwell, health care is delivered to you, on your terms.
Use Amwell to have a video visit with a doctor or therapist on your smartphone, tablet, or computer. Providers on Amwell treat, diagnose and even prescribe—helping you feel better faster. You’ll get quality care from your own home, for a more affordable price than in-person visits.
Visit weatrust.com/amwell or call 1-800-SEE-DOCS for more information or to get started.
Care Outside the Service Area
IYC Medicare Plus offers health systems and providers who accept Medicare assignment both statewide and nationwide. It includes a foreign travel rider.
Major Health Systems
You have access to any provider who accepts Medicare assignment.