Find answers to questions regarding:

• Medicare Advantage Comparison
• Medicare Advantage Implementation
• Network
• Plan Design

Medicare Advantage Comparison

How does the university's Medicare Advantage plan compare to the Medicare supplemental plans that were previously offered by the university?

View the Medicare Advantage Plans Comparison Chart to compare what is covered under the university's 2023 supplemental plan to what will be covered under the university's new 2024 Medicare Advantage plans. We worked with our vendors to maintain the network of providers and the same level of benefits you are used to with your current supplemental plan. For better comparison, the chart also includes two publicly offered Medicare Advantage plans that are not offered by the university.

Medicare Advantage Implementation

I received two sets of ID cards from Blue Care Network (BCN), which one should I use?

We are aware some individuals may have received two different card mailings from BCN. If you and/or a covered dependent are enrolled in Medicare you should use the card with the Premier Care Advantage logo in the top right-hand corner. The group ID will begin with XYK. See an example card below.

If you have an individual covered on your health plan that is not Medicare eligible, they will receive a different card. This card should have the Premier Care logo in the top right-hand corner. Your dependent should use this card If you have questions regarding your ID cards, reach out to the BCN customer service number at 800-658-8878.

I have a covered dependent that has not received their Medicare Advantage ID card from Blue Care Network (BCN), what actions should I take?

Each Medicare Advantage member will receive their own Medicare Advantage ID card. The cards will be mailed in separate mailings. It is possible for members of the household to receive their packets on different days.  If your dependent needs health care services before you receive your cards, the provider can confirm enrollment through their provider portal. You can also download the BCBSM/BCN mobile app to view your ID card and show your provider. More information about the virtual ID card is available at bcbsm.com/download-mobile-app/index/

What are the residency requirements for each vendor's Medicare Advantage plan?

Blue Cross Blue Shield of Michigan's (BCBSM) Medicare Advantage PPO plan requires that you live within the United States.

Blue Care Network's U-M Premier Care Advantage plan requires that you live within the state of Michigan.

Physician Health Plan's Michigan Care Advantage plan requires that you live in lower mid-Michigan specifically in the following counties: Bay, Calhoun, Clinton, Eaton, Gratiot, Huron, Ingham, Ionia, Jackson, Kalamazoo, Livingston, Montcalm, Saginaw, Sanilac, Shiawassee, Tuscola, Washtenaw.

Do I need to make any changes if I am happy with my current health plan?

If you are happy with your current health plan vendor (e.g. BCBSM, BCN, PHP) and you reside within the plans residency requirements for at least 6 months, you will transition into the Medicare Advantage plan offered through the University of Michigan for the vendor. The Medicare supplement plan will not be available after Dec. 31, 2023.

Do I need to continue to pay for both the Medicare Part B premium and the university premium?

Yes. There will continue to be two monthly premiums: one for Medicare and one for the university Medicare Advantage plan. You must remain enrolled in Medicare parts A and B to be eligible for university health coverage.

I received a notice that I need to update my current address on file with the University due to utilizing a P.O. box, why?

The Centers for Medicare and Medicaid Services (CMS) validates enrollment for individuals moving into a Medicare Advantage plan. The validation process requires that we have the physical residency for each participant. As a result, we need to have your current address on file so we can complete your enrollment in the Medicare Advantage plan.

I have additional questions regarding this change, where can I find more information?

The University has made a number of resources available to assist with this change. These resources include: Medicare Advantage Plans webpage (includes videos, webinars and charts), Open Enrollment book.

Why is the University switching from the current Medicare supplemental plan to Medicare Advantage plans?

The change to Medicare Advantage plans is driven by three factors:

Member feedback. Since the implementation of Medicare Advantage plans, a segment of our Medicare-eligible population has asked about them.

Medicare Advantage plans offer care management programs and other programs (e.g., Silver Sneakers) that are not available with our previous supplemental plans.

Cost. With the implementation of the Medicare Advantage plans, we can decrease the premiums our Medicare-eligible retirees/survivors will pay in 2024, compared to 2023.

Is my prescription drug coverage changing?

There is no change to the prescription drug coverage. This will continue to be administered through Magellan Rx. For more information about the prescription drug plan, visit hr.umich.edu/prescription-drug-plan.

Will I get a new ID card?

Yes, you will receive a new ID card for the Medicare Advantage plan in late December. 

If I already have a Primary Care Physician (PCP), do I need to take action if I am enrolled in Michigan Care Advantage or U-M Premier Care Advantage?

No. Your PCP will follow you to the Medicare Advantage plan. The health plan will attempt to reach out for a welcome call. During this call, you can confirm the correct PCP assignment or you can reach out to the customer service number on the back of your new Medicare Advantage identification card.

I am not enrolled in Medicare Part B, and will be retiring. How do I enroll in Medicare Part B?

If you or a covered dependent is eligible for Medicare when you retire, you would be eligible to enroll during the Special Enrollment Period (SEP). Sixty days before the month you retire, call the Shared Services Center at (734) 615-2000 and request a retirement packet. There will be a Request for Employment Information form in your retirement packet. Take that form to your local Social Security Administration office the month before retirement to apply for Medicare Part A and Part B.

Once you receive confirmation of your Medicare Part A and Part B effective dates with your Medicare Beneficiary Identification Number (MBI), complete the eForm or contact the Shared Services Center for instructions for providing the Medicare information.

Network

I received a Medicare Advantage provider directory from Blue Cross Blue Shield of Michigan (BCBSM) or Blue Care Network (BCN) but my provider isn’t listed? 

The university’s transition to Medicare Advantage plans maintained a robust provider network and all Michigan Medicine providers participate in the Medicare Advantage plans.. The printed provider network is only a partial list of providers that participate in the plan. The Premier Care Advantage network has providers across the state and the BCBSM Medicare Advantage PPO has providers across the country. A full list of participating providers is available using the online directories that can be found under the Medicare Enrolled heading hr.umich.edu/medicare-advantage. If you do not see your provider in the book or have questions regarding specific providers, reach out to your health plan customer service number located on the back of your ID card. If you are enrolled in the UM Premier Care Advantage plan, you will retain your current PCP. There is no need to make a new selection.

Will I need to select a Primary Care Physician (PCP)?

If you are enrolled in either the Michigan Care Advantage or U-M Premier Care Advantage plan you will need to select a PCP that will coordinate your care with specialists. If you were previously enrolled in either Michigan Care or U-M Premier Care, your PCP selection will continue.

Will I need to change my providers?

Most likely, your current providers accept Medicare and will participate in the new Medicare Advantage plans. You should not need to change providers. To be certain, however, check the provider directory to ensure it includes a doctor and hospital of your choice before you enroll in a new health plan. The providers will vary by health plan participation and network. Doctors and hospitals that accept the Medicare Advantage plans are always subject to change. And remember: You cannot change health plans mid-year if a doctor, provider or hospital no longer participates with your plan. If you are seeing a provider that does not currently accept Medicare, you might be responsible for out-of-pocket charges for treatment. Contact your health plan for more information.

Will I be able to get care if I am traveling within the United States or internationally?

Urgent and emergency services are covered when traveling across the U.S. and internationally. Not all providers are able to bill your health plan, in those instances you may need to pay at the point of care and request reimbursement from the health plan. Contact customer service on the back of your ID card for more information.

Do all Michigan Medicine doctors participate in the new Medicare Advantage plans?

Yes.

Plan Design

Will I be covered when I travel out of Michigan?

Yes, you are covered when you are out of Michigan. You may locate participating providers outside of Michigan by calling the customer service number on the back of your ID card. You are always covered for emergency and urgent care in the U.S. and when you travel out of the country.

Will I have to change my Durable Medical Equipment (DME) provider?

No, you do not need to change your DME provider.

Do I have a deductible with these plans?

No, you do not have a deductible with any of the Medicare Advantage plans.

Do I have an out-of-pocket maximum with these plans?

Out-of-pocket maximum for all plans is $3,000. Fixed copays on select services are stated in the benefit summaries. Copays are tracked; when $3,000 in copays is reached, you will not pay further copays for the rest of the year. This out-of-pocket maximum has been in place since 2014.

Do I need to get preauthorization to use the plan benefits?

Certain services may require a preauthorization by your provider. There is no action you must take as a member to get preauthorization. Your benefit summary has a note on the service types that may require preauthorization, such as home care. This helps you understand what services your provider may need to have preauthorization for to schedule the service.

Do I have an option to opt-out of the University’s Medicare Advantage plans and purchase an individual Medigap policy?

If you plan to enroll in Original Medicare with a Medigap policy (also known as Medicare supplement insurance), you may have a special temporary right, referred to as a Guarantee Issue Right, to buy a plan even if you have pre-existing health problems. Federal law requires the protections described above. Your state of residence may have laws that provide more Medigap protections.

It is the University’s understanding that Michigan residents have 63 days from the date you disenroll from the University’s group Medicare Advantage plan to enroll in a Medigap policy. For example, a member disenrolling from U-M’s group Medicare Advantage plan on June 30, 2024 will have until September 1, 2024 to be covered by a Medigap policy.

This information regarding the State of Michigan regulations is based on the University’s current understanding of highly complex federal and State of Michigan requirements and is specific to group Medicare Advantage plan disenrollment. It is provided for general informational purposes only. It is the responsibility of the plan participant to contact Medicare, the State Health Insurance Program, and/or the insurance carrier you wish to purchase a Medigap policy with to confirm their requirements.

Previously, I disenrolled from the University's health plan to enroll in a Medicare Advantage plan offered to individuals. Will I be allowed to re-enroll in the University's health plan now?

For retirees and covered dependents enrolled in Medicare, may return if you have maintained continuous Medigap and prescription drug coverage from the time of disenrollment to the time of return. The opportunity to re-enroll in our Medicare Advantage plan will be during the next Open Enrollment period with a January 1 effective date.

I would like to disenroll from the University’s Medicare Advantage health plans to return to Original Medicare and purchase my own Medigap policy. Will I be allowed to re-enroll in the University’s health plan later?

For retirees and covered dependents enrolled in Medicare, may return if you have maintained continuous Medigap and prescription drug coverage from the time of disenrollment to the time of return. The opportunity to re-enroll in our Medicare Advantage plan will be during the next Open Enrollment period with a January 1 effective date.