CU Health Plan — Medicare, provided by Anthem Blue Cross Blue Shield, is available to Medicare-eligible participants and their spouses/dependentsDependentAn employee’s spouse, common-law spouse, civil union partner, domestic partner, children under the age of 27, and qualifying disabled children over age 27 of the employee or of the spouse/partner who are biological, legally adopted or for whom there are parental responsibility documents issued by a court. who are enrolled in Medicare Parts A and B.
You cannot participate in this plan if you are not enrolled in Medicare Parts A and B. This is not a Medicare supplement or MediGap plan.
- Medicare Parts A and B is your primary coverage for any claim.
- CU Health Plan — Medicare pays secondary for services covered by Medicare.
- The plan will not cover services that Medicare does not pay.
- CU Medicare will pay up to the allowable amount set by Medicare Parts A and B for that specific service.
- Most medical services or supplies not covered under Medicare are not covered benefits under this plan.
Over/Under Option
- The Over/Under option for situations when at least one member is eligible for Medicare and at least one other member is not.
- The member(s) eligible for Medicare must enroll in the CU Medicare (must be enrolled in Medicare Part A and Part B) and the member(s) not Medicare-eligible must enroll in the High Deductible Plan.
- Although the CU Medicare and High Deductible are two different plans, the premiumsPremiumThe monthly cost to participate in the plan. Typically, it is shared between the employee and the employer. Premiums are deducted from your monthly paycheck. are bundled. See your rate sheet for pricing details.
- Over/Under plans have different enrollment periods and plan years:
- October enrollment for Medicare with the plan year running from Jan. 1 to Dec. 31.
- April/May enrollment for High Deductible with the plan year running from July 1 to June 30.
- You cannot contribute to a Health Savings Account (HSA)HSA (Health Savings Account)A tax-savings account that must be paired with a High-Deductible Health Plan, which can be used to pay for qualified health care expenses now or in the future. An HSA is a savings account that you own. The funds in an HSA carry forward year after year, even if you change employers or retire. once enrolled in Medicare.
- If you are a considering this option, please review details of the both Medicare and High Deductible Plans.
Plan details
- CU Health Plan - Medicare Benefits Coverage Summary (8 pages)
- CU Health Plan - Medicare Benefits Booklet (71 pages)
- SilverScript Pharmacy Benefits Booklet (126 pages)
- Anthem Preventative Care Guidelines
Covered providers and medications
- Find a doctor or urgent care
- Call 1-800-735-6072
- Access the CVS Formulary
- For pharmacy questions, call 1-888-964-0121
- Find an in-network pharmacy
Prescription Benefits
Plan coverage is determined by medication type, supply amount and pharmacy services:
| Drug Tier | Coverage |
|---|---|
| Tier 1 (Generic drugs) | CVS Retail or CVS Mail Order Pharmacy:
|
| Tier 2 (Preferred brand drugs) | CVS Retail or CVS Mail Order Pharmacy:
|
| Tier 3 (non-preferred brand drugs) | CVS Retail or CVS Mail Order Pharmacy:
|
| Tier 4 (Specialty Orals and Injectable drugs) | CVS Retail, CVS Mail Order or Caremark Retail Network Pharmacies:
|