PERS: Medicare eligible

PERS Health Insurance Program Members – Medicare Eligible

Plan benefits and cost

Benefits UnitedHealthcare® Group Medicare Advantage (PPO)

Annual medical deductible

$0

Annual out-of-pocket maximum

$2,500

Office and clinic visits

$15 copay for primary care

$20 copay for specialist visit

Hospital services (inpatient)

$100 copay per day for days 1-3

$0 copay for days 4 and beyond

Hospital services (outpatient)

$125 copay

Hearing aid $2,400 hearing aid allowance per calender year*
Calendar year pharmacy out-of-pocket maximum $7,050 per individual

Prescription drug coverage

Retail up to a 31 day supply

Tier 1 – Preferred Generic: $8 copay
Tier 2 – Generic: $15 copay
Tier 3 – Preferred Brand: 40% coinsurance to $250 max per script
Tier 4 – Non-Preferred Drug: 40% coinsurance to $250 max per script
Tier 5 – Specialty: 40% coinsurance to $250 max per script

  *Hearing aids ordered through providers other than UnitedHealthcare Hearing are not covered.

How do I find a provider?

UnitedHealthcare® Group Medicare Advantage Retiree Plans are Preferred Provider Organization (PPO) plans. As a member of a PPO plan, you have lots of flexibility in choosing a provider.  You can choose from a national network of contracted doctors and hospitals or you can use any doctor or hospital outside the network as long as they participate in Medicare and accept the plan.  And remember, in-network or out-of-network, you pay the same!

Do I have prescription drug coverage?

See if your plan offers prescription drug coverage and learn about your options.

Frequently asked questions

Obtain answers to commonly asked questions related to Medicare, your plan, and UnitedHealthcare® by clicking here.

Who do I contact with additional questions?

For general benefit questions prior to enrollment, call 1-844-884-1850, 6 a.m. – 8 p.m. PT, Monday - Friday. TTY users, call 711.