UC Davis Health Care Facilitator Program

UC Davis Health parts ways with WHA; Advantage Referrals to expire

UC Davis Health, which includes the UC Davis Medical Center and UC Davis Medical Group, is withdrawing as a corporate member of the insurance company Western Health Advantage.

As of April 2017, WHA stopped allowing new members to choose UC Davis Medical Group for primary care unless those new members were UC employees or retirees. Then, in June, the UC Regents approved the request of UC Davis Health to dissolve the partnership with WHA. Even so, UC employees/retirees who have WHA continue to be able to choose UC Davis Medical Group for primary care. For more information about the withdrawal, please see the FAQs posted by UC Davis Health.

UCOP announced on 8/22 that UC will continue to offer WHA as a health plan option for employees/retirees in 2018.

Subsequently, UCOP reported on 9/1 that WHA's Advantage Referral Program will expire at the end of the year. As a result, UC WHA members will be limited to specialists within their primary medical groups next year, unless their primary medical group authorizes an outside referral. Members who currently use Advantage Referrals to self-refer to specialty care outside their primary medical group may want to contact WHA to apply for Continuity of Care (temporary authorization) in order to continue to see those specialists into the new year. For more information about the loss of Advantage Referrals, see the FAQs posted by WHA under "UC Employees."

Updated 9/7/2017.

Anthem to replace OptumRx for PPO pharmacy benefits in 2018

Effective Jan. 1, 2018, Anthem Blue Cross will administer pharmacy benefits for all of UC’s preferred provider organization (PPO) medical plans. This change will affect faculty, staff and retirees enrolled in the following PPO plans:

  • Core
  • UC Care
  • UC Health Savings Plan
  • UC High Option Supplement to Medicare
  • UC Medicare PPO with Rx

For more information, see the UCnet article.

See also:  PPO administrator transition:  Making things right for UC’s faculty, staff and retirees to find out more about what UC Human Resources has been doing to improve our PPO members' experiences.

Understanding UC's 2017 medical plans

Although Open Enrollment for 2017 closed on 11/22/2016, here are some resources for you to use and peruse to understand more about UC's 2017 health plans:

  • For an at-a-glance snapshot of local provider availability by plan, see More on UC Medical Plans 2017.
  • Note for Medicare retirees in Davis:  Sutter primary care physicians in Davis are not currently accepting new Medicare patients. This means that UC High Option and UC Medicare PPO members who have not seen Sutter doctors before, and who want Sutter for primary care, may need to choose a Sutter doctor in another town. Alternately, members of those plans could choose a non-Sutter doctor in Davis for primary care, but still access Sutter specialists in Davis. (Some Sutter primary care doctors in Davis are still taking new Health Net Seniority Plus patients.)
  • The UC Medical Plan Chooser for 2017 lets employees and retirees price and compare medical plans; the Chooser also reports medical plan availability by zip code.
  • The 2017 Retiree Premium Estimator is an Excel spreadsheet that calculates UC retiree medical and dental plan premiums for those who get less than 100% of the UC contribution. Don't have Microsoft Excel? Download a free viewer here.
  • For detailed information on the UC health plans, see UCnethttp://ucnet.universityofcalifornia.edu/oe
  • For video shorts (<10 minutes each) on health plan topics specific to UC:  http://uc.a.guidespark.com
  • For a more in-depth comparison of plans, view HCF Program presentations (see Presentations for Employees/Retirees in the site menu)

UC simplifies retiree health benefits rules

To simplify administration and respond to the concerns of newer employees hired before 7/1/2013, UC changed the eligibility rules for retiree health benefits.

Click here for more information on the change.

Click here for the Retiree Health Eligibility Factsheet [PDF format]

Did You Know?

Most of the medical plans that the University offers to employees and retirees cover 30-day supplies of prescription drugs for a flat copayment. However, if you take medications on an ongoing basis, you can save money by using University of California pharmacies. At UC pharmacies, you can get 90-day supplies of your drugs for two copayments; you pay 1/3 less!

If you are enrolled in some of the Anthem Blue Cross plans (UC Care, UC High Option, UC Medicare PPO); Health Net Blue & Gold HMO or Western Health Advantage HMO:

Click here for a list of UC Davis outpatient pharmacies (in Davis and Sacramento).

Don't live near a UC pharmacy?  You can get the same two copayment deal for 90-day supplies through some plans at certain local retail pharmacies and/or through your plan's mail order pharmacy.

  • Health Net Blue & Gold HMO: Local CVS pharmacies
  • UC Care: Local Costco, Safeway/Vons, and Walgreens pharmacies
  • UC High Option: Local Costco, CVS, Safeway/Vons, and Walgreens pharmacies
  • UC Medicare PPO: Local Costco, CVS, Safeway/Vons, and Walgreens pharmacies
  • WHA: Local Bel Air, Costco, CVS, Rite Aid, Raley's, Save Mart, Safeway, Target, Wal-Mart, and Walgreens pharmacies

Click here for medical plan contact information. Log on to your plan's website as a member to access links to their mail order pharmacy programs.

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