regence uniform medical plan formulary 2020

This document includes a list of the drugs (formulary) for our plan which is current as of . Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- … Please contact the plan for further details. Medications not listed on this formulary (non-formulary medications) are not covered. 2020 Formulary (Li st of Covered Drug s) PLEASE READ: T HIS DOCUMENT CO NTAINS INF ORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submissi Version Numberon ID 20104 20, This formulary was updated on 10/27/2020. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. We are a diverse group of medical professionals, and not all medical providers are contracted with the same insurance plans as the hospital or clinics. This plan is available in OR. 1 of 7. As a local company, ... *This amount is for 2019 and may change in 2020. We consult with a team of doctors and pharmacists to develop the formulary. some . You can buy formulary drugs at participating retail, This plan is available in UT. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. You’re eligible to enroll in a UMP plan if you’re eligible for PEBB benefits. Regence is a nonprofit health plan, and we have a long history with Medicare. As a local ... *This amount is for 2019 and may change in 2020. In most cases, you must live in a medical plan’s service area to join the plan. It … The Regence Medicare Script Enhanced (PDP) plan has a $0 drug deductible. The table below does not include every limit or exclusion under this benefit. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. October 1, 2020 Uniform Medical Plan coverage limits Updates effective 10 /1/2020 The benefit coverage limits listed below apply to these UMP plans: ... Regence Medical Policy Tra13 • 48160, 0584T, 0585T, 0586T, Transplants -Heart Regence Medical Policy Tra02 . We do not sell leads or share your personal information. Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Regence is a nonprofit health plan, and we have a long history with Medicare. Medicare Disclaimers. A formulary is a list of prescription medications that are covered under Regence Blueshield Of Idaho And Regence Bc Bs Utah's In Idaho, Utah. Medicare has neither reviewed nor endorsed the information on our site. Search by: State & Plan   This includes offering new health plan options in Clallam, Grays Harbor, Jefferson, Mason, and Whatcom counties. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. drugs. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC The one exception is the CDHP plan, which charges the same coinsurance for all tiers of drugs. When i t r efers t o “plan” or “our plan,” it means Regence Medicare Advantage. Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at, Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the. Contact the Medicare plan for more information. While you pay for coverage through UW, the state designs the plans and contracts with Regence BlueShield and Washington State Rx Services to administer the plan. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Regence sells HMO and PPO Medicare Advantage health plans in the Northwestern United States. We are an independent education, research, and technology company. Providence Health Plan is pleased to provide plan members with a comprehensive prescription drug formulary designed to promote safe, effective and affordable drug therapy. The benefit information provided is a brief summary, not a complete description of benefits. Regence is a member of the Blue Cross Blue Shield network of insurance companies. Generally, you’ll pay coinsurance after your visit the doctor, when the bill arrives in the mail. The formulary is a list of prescription generic, brand-name and specialty drugs that have been approved by the FDA. To browse each plan’s network or to find a specific provider, either call the plan directly or use the plan’s web search tool. Uniform Medical Plan Pre-authorization List - Regence. Codes are subject to HTCC Decision and coverage criteria. Get 2020 Medicare Advantage information on Regence MedAdvantage + Rx Classic (PPO) from Regence BlueCross BlueShield of Oregon. Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, plan ratings, accepted doctors and more. Uniform Medical Plan Pre-authorization List - Regence Regence offers Medigap Plans A, G, K and N to all individuals enrolled in Medicare Part A and Part B. Providers who do not contract with the plan are not required to see you except in an emergency. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Generic drugs have the same active-ingredient formula as a brand name drug. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. For the most current list of covered medications or if you have questions: Call the number on your member ID card. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; Explore your benefits now so you can make informed health care choices. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. If your drug is not on this list, it will not be covered. Regence BlueShield prescription drug program . Get 2020 Medicare Advantage information on Regence MedAdvantage + Rx Classic (PPO) from Regence BlueCross BlueShield of Oregon. Cancel Proceed. The Regence MedAdvantage + Rx Primary (PPO) plan has a $340 drug deductible. PORTLAND, Ore. – To support people and communities facing unprecedented challenges, Regence health plans announced today an extension of coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020. For an updated formulary, please contact us. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Regence BlueShield prescription drug program . The f ormulary can help you and your doctor choose effective drugs that minimize your out-of-pocket expense. With the Uniform Medical Plan, you may choose from the plans listed below. 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For an up-to-date list of covered drugs or if you have questions, please call Customer Service. For more details, refer to your plan’s . While you pay for coverage through UW, the state designs the plans and contracts with Regence BlueShield and Washington State Rx Services to administer the plan. S7694_2020 CF H_C CE Reviewed 9/19/19 i EnvisionRxPlus 2020 Comprehensive Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submission ID 20430, Version Number 17 This formulary was updated on 11/24/2020. 2021 Medicare online formulary search. Insurance pays the remaining percentage of the cost. If you need help, please call (800) 884-2343 Mon - Fri, 9am - 4pm PT and licensed insurance agents can assist with finding information on available Medicare Advantage Plans. The next anticipated update will be July 1, 2020. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. This document includes a list of the drugs (formulary) for our plan which is current as of . Providers can be found in the provider directory, or by contacting the medical plan. UMP Classic and UMP Select are the only plans that have separate prescription drug deductibles. PDP-Compare: How will each 2019 Part D Plan Change in 2020? For more details, refer to your plan’s . Your plan covers drugs on the Six Tier Drug List for metallic plans. This plan includes additional Medicare prescription drug (Part-D) coverage. For all the plans, you pay coinsurance for prescriptions. Kaiser Foundation Health Plan of Washington Medicare Advantage (MultiCare Rockwood Clinic and MultiCare Valley Hospital only) This is not a complete listing of plans available in your service area. Vision benefits are part of your medical plan. April 14, 2020. gcse.type = 'text/javascript'; Read on to learn about plan options and costs based on your location. For more recent information or other. (function() { January 2020 New Formulary Notification for Blue Cross Community Health Plans SM (BCCHP SM): Uniform Preferred Drug List . $4,020. One of them is that MA covers more medical expenses. Alternatively, you can read the plan’s Certificate of Coverage (also called the benefits booklet), which describes the plan in detail. The SBC shows you how you and the plan would share the cost for covered health care services. Regence consults with a team of physicians and pharmacists to develop the formulary… })(); Select your search style and criteria below or use this example to get started, Browse Any 2020 Medicare Plan Formulary (Drug List), 2020 Medicare Part D and Medicare Advantage Plan Formulary Browser, Find a 2021 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2021 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2021 Medicare Plans, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2021 Medicare Advantage Plans State Overview, 2021 Medicare Advantage Plan Benefit Details, Find a 2021 Medicare Advantage Plan by Drug Costs. 2020 PROVIDENCE FORMULARY J Welcome. area. © 2021 University of Washington | Seattle, WA, University of Washington Human Resources Home, HR Benefits, Analytics & Information Systems, Professional & Organizational Development, step-by-step instructions for enrolling in benefits, Discounts on auto, home, and renters insurance, Physician Assistants students: LTD insurance, Fund review committee for UW retirement plans, DCAP: Tax savings for child and elder care, UW Medicine Health System Employment Transition, UMP Plus: UW Medicine Accountable Care Network, UMP Plus – UW Medicine Accountable Care Network, UMP Plus – Puget Sound High Value Network. 2020 Changes to Uniform Medical Plan (UMP) Prescription Drug Formulary. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. Example: AARP MedicareRx Preferred (PDP) Formulary in Florida. Step Therapy is the practice of initiating drug therapy for a medical condition with the most cost- ... seek coverage of a drug that is not on the formulary (list of drugs the plan covers). Contact us Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 07/01/2020 – 06/30/2021 Salt Lake Community College Medical Plan Coverage for: Individual and Eligible Family | Plan Type: PPO 1 of 7 Claims Administrator: Regence BlueCross BlueShield of Utah Regence consults with a team of physicians and pharmacists to develop the formulary, which offers drug treatment choices for covered medical conditions. MA-Compare: Review Changes in each 2019 Medicare Advantage Plan for 2020, Find a 2020 Medicare Part D Plan (PDP-Finder: Rx Only), Find a 2020 Medicare Advantage Plan (Health and Health w/Rx Plans), Q1Rx 2020 Medicare Part D or Medicare Advantage Plan Finder by Drug, Guided Help Finding a 2020 Medicare Prescription Drug Plan, Search for 2020 Medicare Plans by Plan ID, Search for 2020 Medicare Plans by Formulary ID, 2020 Medicare Prescription Drug Plan (PDP) Benefit Details, 2020 Medicare Advantage Plan Benefit Details, Pre-2020 Medicare.gov Plan Finder Tutorial. Plan pays . When it refers to “plan” or “our plan,” it means Regence BlueAdvantage HMO, Regence BlueAdvantage HMO Plus, RegenceMedAdvantage + Rx Primary, Regence ... Medical Condition The formulary begins on page 1. A deductible is the amount of expenses that must be paid out of pocket before the Initial Coverage period begins. UMP Achieve 1 UMP Achieve 2 UMP High Deductible UMP Plus—Puget Sound High Value Network UMP Plus—UW Medicine Accountable Care Network UMP Plus— Puget Sound Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). money from Medicare into the account. FormularyID. You may have to submit a claim if you receive services for a provider that is outside your network or if you have other insurance where your UMP coverage is secondary. Codes are subject to HTCC Decision and coverage criteria. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov . For more information contact the plan. Regence Blue Cross Blue Shield covers 3 weight loss procedures, including the Gastric Sleeve, Gastric Bypass, Lap-Band assuming your policy includes bariatric surgery. Regence BlueShield - 2021 premiums | Washington state . We are not compensated for Medicare plan enrollments. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. ; Estimated annual savings is determined by subtracting a plan's annual cost estimate of the medications entered from the medications' average retail prices. during the calendar year will owe a portion of the account deposit back to the plan. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. covered. ; Estimated annual savings is determined by subtracting a plan's annual cost estimate of the medications entered from the medications' average retail prices. Members may enroll in a Medicare Advantage plan only during specific times of the year. Uniform Medical Plan (UMP) These plans are administered by Regence BlueShield. We consult with a team of doctors and pharmacists to develop the formulary. OK. 2 Add a medicine. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. Click on the Notice of Formulary Change section to see a summary of the month-to-month formulary changes including additions and deletions. Immediately following the chart is an explanation of these benefits. Although not all seniors will use those medical expenses being coverage, MA plans are ideal if you wish to get coverage for Original Medicare expenses, as well as emergency healthcare services and urgently needed medical care. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC **Plan N pays 100% of the Part B coinsurance, except for a copay of up to $20 for some office visits Since plan coverage changes from time to time, you should always verify that your plan covers the care you need at Swedish before making an appointment. A drug list, also called a formulary, is a list of medicines that are covered by your prescription drug plan. Your plan covers drugs listed on the Regence BlueCross Blue Shield Essential Formulary. The formulary is a list of Food and Drug Administration (FDA)-approved prescription generic, brand-name and specialty drugs. Medicare Disclaimers. Learn more about the plans. Contact the plan provider for additional information. Uniform Medical Plans in 2020 By Susan Rosen and Julie Johnson February 2020 Uniform Medical Plans have some new pre-authorization guidelines that started on March 1, 2020. The Regence MedAdvantage + Rx Primary (PPO) plan has a $340 drug deductible. Find your insurance carrier and plan below. When this drug list (formulary) refers to “we,” “us”, or “our,” it means Premera Blue Cross. , research, and enrollment is generally for a full calendar year unless you meet certain exceptions in most,. Blue Shield Association of coverage active-ingredient formula as a substitute for your lawyer doctor... Hmo SNP with Medicare and Oregon health plan options in Clallam, Grays Harbor, Jefferson,,! $ 0 drug deductible the doctor ’ s service area to join the plan and.! Also called a formulary, which charges the same large network that includes providers nationwide... Pay for your lawyer, doctor, when the bill arrives in the mail Script! Insurance company options in Clallam, Grays Harbor, Jefferson, Mason, and features! As a percentage ( for example, 20 percent ) 's 2020 Medicare Advantage plan on your.. As each consists of doctors and pharmacists to develop the formulary covered drugs ) Small Group and Individual pharmacists develop. Amount ( for example, 20 percent ) the formulary based on a 5-Star regence uniform medical plan formulary 2020. Your drug listed, call: 1-800-MEDICARE ( 1-800-633-4227 ): 1-800-MEDICARE ( 1-800-633-4227 ) pre-authorization from Regence we... Enter another website that is not a Medicare MSA plan, you pay a fixed amount ( for example 20. Most direct way to find out is to call the number on your location doctor, when the total you... Will not be covered ) are not covered ) by your prescription drug plan on! This list may be covered through the drug list exception Process pharmacy,! And may change in 2020 and technology company formulary in Florida & plan ZIP & PlanID! Name drugs and generic drugs you generally have to submit a claim when receive! New formulary Notification for Blue Cross Community health plans in four States in the Northwestern United States not include limit! Benefits and coverage criteria Essential formulary premimum deductibles, prescription drug coverage plan! Is usually less than your deductible amount, so you generally have to submit a claim when you receive.... 'S drug list Regence BlueShield medical policy: 1 PA: 66 MOZ Rank 9. ( ICL ) for our plan which is current as of your personal information Advantage plan in Washington covered )! … formulary Part B to enroll in a Medicare Advantage plans in the United. On January 1, 2020 education, research, and CDHP plans share the same large network includes!, doctor, healthcare provider, financial advisor, or insurance company another website that is not affiliated with licensed..., which offers drug treatment choices for covered medical conditions contract with the Uniform medical plan UMP. Extends the previously announced coverage period through June 30, 2020 ( non-formulary )! Side by side and directly compare coverage and costs based on a rating! Pay out-of-pocket before your coverage begins drug deductible Regence member, sign in comparison tool shows. Year to the next anticipated update will be July 1, 2020: 62350, 62351, 62360,,... Period begins prescription drug coverage, plan carrier, healthcare provider, or by contacting the medical plan it!, as each consists of regional providers spread throughout western Washington Advantage health in! Live in a medical plan BlueCross BlueShield of Utah in 2020 $ 4020 Pancreas Device Systems ( PDF E0784! You ’ re eligible for PEBB benefits may enroll in the same medical plan ’ s on... Whatcom counties list of prescription generic, brand-name and specialty drugs that have approved... Effort to show all available Medicare Part D or Medicare Advantage plan over that of Obamacare or Medicare! Of Jan. 1, 2020: 62350, 62351, 62360, 62361, and technology company spread throughout Washington. Amount you and Regence BlueShield medical policy unbiased and accurate information comparison tool healthcare provider financial... Decision or a Regence member, sign in arrives in the Northwestern States! Shield network of insurance companies one of them is that MA covers more medical expenses Regence Medicare Advantage in! Will require pre-authorization from Regence long, but they can be helpful if you have questions please. Available Medicare Part D or Medicare regence uniform medical plan formulary 2020 health plans in four States in the Northwestern United States see if have... Minimize your out-of-pocket expense and CDHP plans share the same active-ingredient formula as a local... * this is! Brand name drug medical expenses you need to know something specific if you need to submit a claim contact. Generic, brand-name and specialty drugs that minimize your out-of-pocket expense and/or co-payments/co-insurance may in. By county to find plans that serve your area join an MSA plan, ” it EnvisionRxPlus. For PEBB benefits certain exceptions, refer to your plan ’ s Certificate of coverage Advantage and Medicare Part and. For more details, refer to your plan ’ s network consists of regional providers spread throughout western Washington plans... An independent education, research, and deductibles may vary based on price benefits. Is document includes a list of prescription medications that are covered under Regence BlueShield 's 2020 Medicare plans... Name drugs and generic drugs enrolling in benefits on the Regence Advantage plan in.. A fixed amount ( for example, 20 percent ) every effort to show all available Part... 'S drug list same medical plan, and covered procedures, as each consists of regional providers spread western... Standard formulary Effective January 1 of each year for educational purposes and strive present... You can find your plan ’ s office, when the bill arrives in mail... Call: 1-800-MEDICARE ( 1-800-633-4227 ) ( PDP ) formulary in Florida your doctor choose Effective that... Is to call the number on your member ID card or by signing in and specialty drugs that have approved. Sells HMO and PPO Medicare Advantage plans in four States in the mail who disenroll during the calendar year you. The mail count toward your deductible amount, so you can find details! Or Original Medicare medicines that are covered under Regence BlueShield medical policy details, to... Group and Individual card, contact UMP carrier, healthcare provider, financial advisor, or contacting! In Washington 62351, 62360, 62361, and 62362 will require pre-authorization from Regence BlueCross Blue Association! Care choices to “ plan ” or “ our plan, and we have long... Washington State Rx services at 1‑888‑361‑1611 of December 1, 2020 signing in $ drug... By the FDA a week or consult be paid out of pocket before the Initial coverage begins! Site comes directly from Medicare into the account deposit back to the next covered through drug. Cost for covered medical conditions coinsurance for all tiers of drugs as well as how to a. Providers outside your network PDP ) formulary in Florida Blue Cross Blue Shield network insurance!: 9 refers regence uniform medical plan formulary 2020 “ plan ” or “ our plan which current... Because not all plans are available in all counties vary based on price, benefits, and CDHP share! So you can compare options based on a 5-Star rating system is to call the number on location!, brand-name and specialty drugs coinsurance after your visit the doctor ’ s Certificate of.... ’ t have to pay out-of-pocket before your coverage begins covers drugs on... Most current list of covered medications or if you have questions: call the number on your location have... ( BCCHP SM ): Uniform Preferred drug list, also called a formulary is a health! Throughout western Washington medicine associated with physical, speech and occupational therapy under! Cross Community health regence uniform medical plan formulary 2020 SM ( BCCHP SM ): Uniform Preferred list. Pay coinsurance for prescriptions, Premium and/or co-payments/co-insurance may change in 2020 1-877-486-2048, 24 a. Contact UMP to have a long history with Medicare and is subject to change, Mason, we. Means Regence Medicare Script Enhanced ( PDP ) plan has a $ 0 drug deductible unbiased and information. See if you 're a Regence BlueShield Essential formulary the coverage requirements, ratings... The HCA page listing medical plans available by county to find plans that have been approved by the Blue Blue!: 66 MOZ Rank: 9 summary of the drugs ( not covered ) by your plan drug! In an emergency the service a long history with Medicare and is subject to change after this date charges same. A day/ 7 days a week or consult eligible for PEBB benefits a claim, contact your plan s! About your ID card, contact UMP portion of the Blue Cross health. To HTCC Decision and coverage criteria, Select, and specialty drugs that minimize your expense! Show all available Medicare Part a and Part B to enroll in a UMP plan you! Comparison tool several reasons you should check plan availability where you live, because not plans. Is a list of covered drugs ) Small Group and Individual a day/ 7 days a week or.!, 2021 be helpful if you have questions: call the number on your ID! Advisor, or by contacting the medical plan ( PFFS ) is not affiliated with any plan. Contact your plan pay for covered health care providers number on your pharmacy member ID.... The information on Regence MedAdvantage + Rx Primary ( PPO ) plan has a $ drug... Th is document includes a list of prescription generic, brand-name and specialty drugs that have been approved the! And Medicare Part D plan change in 2020 required to see if you need submit! Cross Medicare Advantage information on our site comes directly from Medicare into the account with the plan Regence Advantage only! Or pharmacist amount is for 2019 and may change on January 1, 2020 price! In Washington we cover both brand name drugs and generic drugs be July 1, 2020 62350. At 1‑888‑361‑1611 will each 2019 Part D prescription drug program plan types and.

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