Eligibility



Read about the eligibility for Medicare Carveout »



Enrollment



Once you are retired from the university and are eligible for Medicare (which is typically at age 65), you must enroll in Medicare Parts A and B through Social Security and enroll in the Medicare Carveout Classic plan through the university. Read more useful information on Medicare in general »



Once enrolled in Part B, Medicare will issue you an ID card with your Part A and Part B effective date.  An ID card will be issued by Anthem for the Medicare Carveout Classic plan as well, when you submit an enrollment form.  It is important to provide all your providers with the updated insurance information to ensure claims are processed appropriately.



Retirees SHOULD NOT enroll in Medicare Part D unless they qualify for the “Extra Help” Program through Social Security. The Extra Help program is for low income retirees and provides prescription coverage to eligible seniors for low monthly premiums and low copays. If you have been qualified through the Social Security Administration for Extra Help, please submit documentation to the UK Employee Benefits Office. In this case, you will be able to drop the UK prescription coverage and participate in the UK medical benefit only. To learn more, contact the Extra Help program at (800) 772-1213.



Summary of Benefits



For more details, view the UK Benefits booklet or view full plan details of Medicare Carveout (PDF) »














2017-2018

UK Medicare Carevout Major Plan Benefits

Benefits for Covered Services Provided at Participating Providers

Lifetime Maximum Benefit

Unlimited

Unlimited

Out-of-Pocket Amount

Annual deductible

$183/member; $366/family

Medical out-of-pocket maximum

$3,000/member; $6,000/family

Prescription out-of-pocket maximum

$3,850/member; $7,700/family

Preventive Care

Routine mammogram and Pap smears, PSA, screning colonoscopy and sigmoidoscopy*

Routine child care and immunization (through age 18)

Routine adult physical exam (19 years and above, 

80% after deductible

Physician Services

Routine outpatient laboratory tests and X-rays

Office visits (excludes certain diagnostic lab tests and X-rays)

Lab tests and X-rays

Allergy injections

Inpatient services

Outpatient surgery and diagnostic tests

80% after deductible

Hospital Services

Inpatient care (semi-private room and board, nursing care, ICU)

Physician visits to emergency room

Outpatient surgery, outpatient nonsurgical care

Outpatient tests, lab and X-ray

Ancillary services

Organ transplants

80% after deductible

Other Medical Services

Emergency room

80% after $100 co-payment (waived if admitted)

Urgent treatment center

Skilled nursing facility (up to 100 days per plan year)

Home health care (up to 100 visits/plan year)

Ambulance services

Hospice services

Durable medical equipment

Physical, speech, hydrotherapy, occupational and acupuncture therapy (limited to 45 visits per plan year, combined)

80% after deductible

Mental Health and Substance Abuse

Inpatient mental health or substance abuse

Outpatient mental health or substance abuse

80% after deductible


Rates









Coverage Level

Monthly cost*

UK credit

Employee pays

Retireee only (eligible for credit)

$317

$285

$32

Retiree + spouse (eligible for credit)

$634

$285

$349

Retiree spouse (not eligible for credit)

$317

$0

$317

Surviving spouse (eligible for credit)

$317

$143

$174

Retiree + spouse (not eligible for credit)

$634

$0

$634