This is a hypothetical look at a year's worth of preventive care only, assuming your insurance pays 100% for vision exams, as many do. And, you'll have 60% coverage for orthodontic services, up to a lifetime maximum of $1,500. The Funds plan is your Medicare Part B plan and will pay your doctors bills and other non-hospital charges. Although its main focus has always been on workers and their rights, the UMW of today also advocates for better roads, schools . Contact the Funds Call Center (800-291-1425) to inquire about a PCP in your area. For seniors over 65, Medicare insurance doesn't cover dental services, but you can buy a private Medicare Advantage plan with a supplemental plan for dental coverage. The 15 month Rent-to-Cap period applies to all oxygen equipment rentals. 296 talking about this. If you have any changes, please email vivaproviderservices@uabmc.edu or call Viva Health Customer Service at (205) 558-7474 or 800-294-7780. This summary of benefits and coverage shows how you and The Standard would share the cost for covered dental care services. Spanish, Localized login.cignaResources.newsTitle . The Funds maintains a database of Cooperating Providers that have agreed to not balance bill you. Provider Services Claims: (888) 865-5290. But if you're paying a lower percentage of the costs, you may have a high-dollar copay. Incontinence supplies, such as adult diapers and chux are covered, limited to 3 boxes per month. Medicare supplement insurance coverage can include: Most Medicare Part A (hospital coverage) covered services (Hospice will remain covered through Medicare), Medicare Part B (medical insurance coverage) covered services, Medicare Part D Prescription drug coverage. All Rights Reserved. Also included with no waiting period: Periodontal maintenance (limit 2 per year) and periodontal scaling and root planing (limit 1 per quadrant every 3 years). If the warranty has expired, the Funds will direct you to a network vendor for the repairs. More savings when you stay in-network 1. Rent-to-cap period of 15 months applies to all rentals. 3 0 obj Electronic Services Available (EDI) Professional/1500 Claims. 1 0 obj Services must be provided by an approved hearing aid vendor who has signed a Hearing Aid Vendor agreement and is on the approved list of 29 providers. Non emergency ambulance transportation for scheduled trips to receive medical care is provided only for patients that are bed confined or can only be moved by a stretcher to the ambulance. Providers should email [emailprotected]for more information. <>stream Services from non-network DME and Hearing Aid providers are not covered. Learn More Mission driven to improve lives through healthcare quality and clinical expertise Take a look at the cost for one year of vision insurance compared with the cost of an eye exam. Non-Medicare beneficiaries must have services approved by the Funds' Precertification Department at 1-800-292-2288. Today, the Union also represents health care workers, truck drivers, manufacturing workers and public employees in the United States and Canada. Oxygen requires precertification and must be recertified annually. . Main Administration Number: (202) 521-2201. Medicare supplement insurance coverage can include: Medicare Prescription Drug coverage (Part D) may cover: 18354 Quantico Gateway Drive YES. UMR is a UnitedHealthcare company. You don't need a referral to see a specialist. Qualifying for COBRA The Funds also has a network of Durable Medical Equipment (DME) and Hearing Aid providers that must be used for obtaining those services. VSP makes money off of those sales. O4 Text Component. Trustmark Voluntary Benefits offers Life, Accident, Critical Illness, Disability, and Hospital insurance solutions that help policyholders achieve greater financial security and well-being. Step 2: Complete Your Eye Exam. Dental Insurance 101 FAQs Contact us Give us a call at (866) 569-9900 Mon-Fri 9am-9pm ET Send us an email at direct_support@glic.com Important product disclosure She has a very sweet personality and her staff is very nice too! Are you eligible for Medicare? to process the proper billing information in a timely . Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. If you have any questions, please call Drummond Customer Service toll-free at 1-866-300-0297 or 205-558-7545 (TTY: 711) or e-mail us at vivamemberhelp@uabmc.edu. Covered when prescribed by a physician to restore functions lost or reduced by illness or injury. Professional Institutional Dental: 52180: UMWA Health & Retirement Funds: Participating Plus Payor: Professional Institutional Dental: 80314: UNICARE: Participating Payor: . LLC, Internet If you have any questions, please contact 1-800-292-2288, Main Administration Number: (202) 521-2201. Your information is securely protected, because we keep to the most up-to-date security standards. <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page/Parent 22 0 R>> Enhanced coverage for pregnant womenduring their pregnancy and three months following delivery. Yes. We will then update your information on our website. For Medicare covered beneficiaries, Medicare Part A covers the first 100 days of skilled care. Care management Integrated clinical solutions designed to fit your populations and reduce healthcare costs. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Dental Insurance Plans | Humana Individual and family dental insurance plans From budget-friendly monthly premiums to low office-visit copays, Humana has a dental plan that is sure to fit your needs. UMR offers flexible, third-party administration of multiple, complex plan designs and integrated in-house services. Hearing aids over $600 require precertification through the Funds Hearing Aid Precertification Department at 1-800-292-2288. Please fax address, phone number, and other changes, along with a copy of the W-9 to 214-574-3599. When comparing dental plans, be sure to compare not only price but the benefits you're receiving too. The United Mine Workers of America (UMW or UMWA) is a North American labor union best known for representing coal miners. Yes. Custodial/non-skilled care is not covered (i.e. UMWA Health and Retirement Funds Washington, DC 2 weeks ago Be among the first 25 applicants Be among the first 25 applicants Save when you stay in-network. are not covered. Navy Federal Credit Union (or Navy Federal) is a US credit union headquartered in Vienna, Virginia, chartered and regulated under the authority of the National Credit Union Administration (NCUA). Since that year, the UMWA and Bituminous Coal Operators Association, Inc. (BCOA) have negotiated periodically over employee benefits for coal miners, retirees, and their dependents. You may contact the Funds at (800) 291-1425 with any questions. Triangle, VA 22172, 2023 United Mine Workers of America. endstream 2. See your benefit plan documents for all of the coverage details. 1 / 5. UMWA Associate Membership The Associate Membership is a way for a surviving spouse, family member or general supporter of the United Mine Workers to become part of the movement to restore fairness, justice and dignity for working families. UMWA H&R Funds Vision Care Program for the 1993 Benefit Plan A. Coverage is provided for immunizations, screenings for high blood pressure, diabetes, and other conditions, and for medically necessary tests to detect cancer, blindness, and deafness. You should have received a letter from us with the information we have on record for you. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Identity Providers will find it beneficial to become a Cooperating Funds Provider. In addition, people over 65 are more susceptible to oral cancer. If you are planning to have elective surgery, the following should be pre-certified: Organ transplants, intestinal or gastric bypass for obesity, cerebellar and dorsal stimulator implants, insertion of a prosthesis for cleft palate, plastic surgery including mammoplasty, and reduction mammoplasty. Welcome to Funds information for health care providers. Washington DC 20037 Medicare Prescription Drugcoverage (Part D) may cover: Generally does not cover over-the-counter medications, 18354 Quantico Gateway Drive Choose your field to get started: Medical, Dental or Behavioral. Covered with prior approval from the Plan Administrator if for ambulance transportation to or from a hospital, clinic, medical center, physicians office or skilled nursing care facility, when considered medically necessary by a physician. Basic dental care includes office visits, extractions, fillings, periodontal treatment (gum disease), and root canals. you should present only your Funds ID card to those providers because the Funds is your Medicare Part B payer. Network dentists agree to discount their services for our members up to 35% on average. Step 4: Get an Eye Exam Annually. Please note that the address for the Funds Medical Management office has been changed. "I urge Congress to take the necessary steps to quickly pass the PRO Act. Medical Biller REMOTE. You'd have to pay out-of-pocket. Nashville, TN 37229, This address change applies to Claim Appeals, Pharmacy Appeals, Precertification and Case Management. We work closely with brokers and clients to deliver custom benefits solutions. NOTE: This is only a summary; for detailed information on coverage, please consult your certificate . If you go to a hospital, a skilled nursing facility, or have home health care, these providers must bill Medicare Part A for all services and then bill the Funds plan as the secondary payer. No, the Funds does not recommend that you enroll in a Medicare Advantage plan. This list was formerly published as Part 6 of the administrative and billing instructions in Subchapter 5 of your MassHealth provider manual. In many ways they are: healthy people can go without a dentist or optomologist for a few years. If so, and you haven't started receiving your benefits, please contact the Funds' Call Center right away. Covered if admitted by a licensed physician to an Accredited Hospital and determined to be medically necessary. 3. Job specializations: Insurance. Handbook, DUI She recently took over the dental practice from Dr. Florendo. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. Your doctor can contact our Provider Services department at (888) 865-5290, if they have any questions. If you decide to terminate your other coverage you will need to mail the Funds a copy of the termination letter from your other insurance plan to: Funds Health Call Center Our office hours are . Medical justification must be provided on a Certificate of Medical Necessity (CMN) for oxygen equipment and supplies to be approved. The United Mine Workers of America Health and Retirement Funds Funds' Call Center: (800) 291-1425. endobj Your session is about to expire. *Note If you are in the Funds 1993 Benefit Plan, there is a small listing of Non-PPL providers. Plan Highlights. eHealth can provide information about many different insurance companies and Medicare plans at no additional cost to you with no obligation to enroll. 100% paid medical insurance; Paid Vacation, Personal and Sick Days; Life Insurance; Pension Plan after 18 months; Member of the UMWA; 11 Paid Holidays; Must pass Child Abuse, FBI and Criminal Background Clearances. United Concordia is offering members dental plans for the individual; two-party; or family. Dental insurance premiums. EOE. There are plans as low as $10/month, but to have any real coverage for major services, such as crowns and bridges, you should expect to pay at least $35/month. Select a directory, and find network participating health care professionals . That is your decision to make. Click here for weekly coal production updates. Dental network customer service. bNM;8_l}X+O5|:kDx#JPG{%1hx. 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