Beginning Jan. 1, 2017, UC’s preferred provider organization (PPO) medical plans for employees (Core, UC Care and UC Health Savings Plan) and for retirees (UC High Option Supplement to Medicare, UC Medicare PPO and UC Medicare PPO without Prescription Drugs) will have new administrators for medical, behavioral health and prescription drug benefits. UC has worked to minimize disruptions for members, but there will be some changes to medical and behavioral health provider networks and to pharmacy costs. The steps below can help you prepare for this change:
- Confirm your current doctors and other providers (including behavioral health) are in-network. Call Anthem Health Guide or search for your provider on anthem.com/ca/uc.
- Check OptumRx formulary and prescription drug costs. OptumRx uses a different formulary than Blue Shield. Your current covered medications will continue to be covered, but the cost of the medications may change. View the OptumRx formulary on optumrx.com/UOCALIF or optumrx.com/UOCALIF2 (for Medicare plans) and use the Optum Price and Save tool to help you identify cost options for your medications. You may want to talk to your doctor about an alternative formulary drug to help you manage your costs. For questions, call OptumRx Member Services.
- Request transition assistance. If you are currently receiving medical or behavioral health care from a provider that will not be in-network in 2017, transition assistance may be available for:
- An acute (short-term) or serious chronic (long-term) medical or behavioral health condition
- Pregnancy and newborn care
- A planned surgery or other procedure
- A terminal illness
Call Anthem Health Guide to request transition assistance.
- Request prior authorization. If you received a prior authorization for a medical or behavioral health service from Blue Shield or Optum, but the procedure or treatment is scheduled after Jan. 1, 2017, you will need to get another prior authorization from Anthem Blue Cross. Call Anthem Health Guide for assistance.
- For continuing online access to your Blue Shield claims information from 2016 and previous years, register for an account at blueshieldca.com/uc by Dec. 31, 2016. After this date, you will not be able to register for an account and will need to call Shield Concierge (855-339-9973) for claims information. If you are registered for an account by Dec. 31, 2016, you will have access to your claims and other member information until December 31, 2017.
- If you need information about Optum behavioral health claims from 2016 and previous years, call Optum for assistance at 888-440-8225. Optum will continue to provide information and assistance to past UC members when needed, even after Dec. 31, 2016.