Double-check the entire document to make certain you have completed all the information and no changes are needed. Please confirm your provider is in the network once you enroll. Get access to thousands of forms. She recently took over the dental practice from Dr. Florendo. It is truly an honor to serve you, and we will continue to work to keep your trust and pursue the goals of the UMWA. Preventive care services are covered at little or no cost to you. However, if you already have hearing aids from a non-network vendor and need repairs and the warranty is still in effect, that provider should perform any repairs. In fact, Original Medicare generally only pays for dental services for certain emergencies or complicated dental procedures. Your information is securely protected, because we keep to the most up-to-date security standards. Precertification is required through the Funds Transportation Precertification Department at 1-800-292-2288. Dentists can detect signs of disease just from looking at your teeth and gums. Read our current newsletters for Medical, Dental or Behavioral providers. It may provide coverage for other services, such as crowns. Incontinence supplies, such as adult diapers and chux are covered, limited to 3 boxes per month. Enjoy smart fillable fields and interactivity. 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). Copyright 2023 UMHA H & R Funds. O4 Text Component. Are you eligible for Medicare? Learn about our Cash Deferred Savings Plans and the Funds. When you get your maintenance drugs through the Funds pharmacy mail service you will pay a lower co-payment than at retail pharmacies and receive a 90-day supply of your medications. Some Medicare Advantage plans . Subrogation support. Get information about eligibility for benefits. My Account, Forms in <>stream No paperwork; in- or out-of-network dentists who submit your claims. login.cignaResources.findCareTitle . If you are eligible for Medicare and have elected the Funds as your Medicare Part B payer, the Funds will pay any chiropractic services that are covered by Medicare Part B. bNM;8_l}X+O5|:kDx#JPG{%1hx. Get your online template and fill it in using progressive features. All beneficiaries are required to use one of the seven Funds Network DME vendors. The beneficiary will be responsible for any copayments or coinsurance due after the Medicare Part B payment is made. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. We want to thank all of the members of supporters who got on the buses, attended the rallies, and walked the halls of Congress when called upon. Your insurance company might pay anywhere from 60 to 80% of the cost for these services, with you covering the rest of the cost. For Non-Medicare beneficiaries this is not a covered benefit. Main Administration Number: (202) 521-2201. United Concordia is offering members dental plans for the individual; two-party; or family. Service, Contact For Medicare covered beneficiaries, Medicare Part A covers the first 100 days of skilled care. Covered when ordered by attending physician, patient is referred to a designated pulmonary consultant for testing and the consultants report is submitted to the Plan administrator with the order for oxygen. Ambulette, Van, Taxi, shuttle, or bus) will be approved only if assisted transportation is medically necessary and beneficiary would otherwise require ambulance transportation. At present, the Funds provides benefits to over 86,000 beneficiaries. 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. Yes, with a doctors order, skilled nursing care, physical therapy, and speech therapy may be provided by licensed personnel from a certified home health agency. No, the Funds does not recommend that you enroll in a Medicare Advantage plan. Integrated pharmacy benefit management, and tools to reduce the high cost of specialty drugs. And while most people recognize that medical coverage is necessary, dental and vision plans might seem less essential. Current estimates contain both current EIA original estimates and revised estimates. Yes. With a dental plan, you have easy access to the care you need to keep your mouth healthy. 3 0 obj Help mitigate common problems: Gum disease (68%) and dry mouth (30%) are widespread among Americans 65 and older. You should have received a letter from us with the information we have on record for you. <>stream Please visit the Mercer Marketplace to learn more about the plans and benefits that your employer is making available to you. login.cignaResources.newsTitle . UMWA Retiree Health Plans The three multiemployer retiree health plans for UMWA members are (1) the Combined Benefit Fund (CBF), (2) the UMWA 1992 Health Benefit Plan (1992 Plan), and (3) the UMWA 1993 Health Benefit Plan (1993 Plan). You can use pre-tax dollars to cover important medical and dental needs. Medicare beneficiaries Medicare Part A is the primary payer. Original Medicare usually doesn't cover dental care such as cleanings, fillings, tooth extractions, or dentures. You enjoy extra savings when you see a network provider. Click here for weekly coal production updates. Please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. The Funds maintains a database of Cooperating Providers that have agreed to not balance bill you. 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). Alternate forms of transportation for scheduled trips (i.e. Care management Integrated clinical solutions designed to fit your populations and reduce healthcare costs. A healthcare FSA or Flexible Spending Account is a pre-tax account that covers certain medical, dental and vision care expenses that aren't covered by your healthcare plan. For the fortunate ones, wisdom teeth erupt upright, perfectly aligning . 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. Durable Medical Equipment (DME) and Supplies. Dental benefits may not be available from UMR through your employer. % Many union members and retirees with original Medicare (Part A and Part B) coverage are looking for additional insurance to help limit out-of-pocket costs. 1993/Pre-Funded Plans Age limit does not apply to Medicare eligible beneficiaries. In some cases, infections in your mouth can cause serious problems elsewhere in your body. All Rights Reserved. Follow the simple instructions below: Feel all the key benefits of submitting and completing forms on the internet. c.111M and 956 CMR 5.00. Pharmacy: (800) 294-4741. Step 2: Complete Your Eye Exam. The Funds plan is your Medicare Part B plan and will pay your doctors bills and other non-hospital charges. Dental benefits may not be available from UMR through your employer. Best Dental Insurance Companies of 2023 Best Overall: Cigna Runner-Up, Best Overall: Renaissance Dental Best for No Waiting Periods: Spirit Dental Best Value: Humana Dental Insurance Best. The United Mine Workers of America had a thriving and successful 2022, but it was also filled with a lot of struggle and hard work. NOTE: This is only a summary; for detailed information on coverage, please consult your certificate . Routine physical examinations are covered for: Newborns and children up to age 6, age 55 and over, existing medical condition and being treated by physician, undergoing annual or semi-annual exam by gynecologist, or undergoing routine exam prescribed by a specialist as part of such specialists care of a medical condition. Main Administration Number: (202) 521-2201. Select Continue to remain logged in. If routine exams are all you need, the cost of insurance might not be worth it. If you do need corrective lenses in addition to preventive care, you're probably better off with the insurance. Job Type: Full-time. Ensures that a website is free of malware attacks. Dont allow American workers to face any https://t.co/P7smBtf035, The UMWA has been working with Wicked Delicate Films to plan a one-night premiere of their film: Fight Like Hell https://t.co/4UmqKOfV2o. endobj Please contact our Customer Service Department at 1-800-687-0500 for more information. Warning: usage of this Web site requires acceptance of our Site Usage Agreement. Professional Institutional Dental: WMI004: Western Mutual Insurance/TPA_Beech: Direct Payor: Professional Institutional Dental: 37247: Western Mutual Insurance/WMI-TPA . 18354 Quantico Gateway Drive Suite 200 Triangle, VA 22172 703.291.2400. info@umwa.org 2023 United Mine Workers of America. When comparing dental plans, be sure to compare not only price but the benefits you're receiving too. For more detailed information, you may contact Delta Dental of Iowa at number 800-544-0718 (TTY: 888-287-7312), Monday through Friday from 7:30 a.m. to 5:00 p.m. (central time). Hearing aids must, however, be ordered through one of the Funds Network Hearing Aid vendors and must be approved by the Funds Prior Authorization Department (800-292-2288). are not covered. Complete all of the requested boxes (they are yellowish). eHealth can provide information about many different insurance companies and Medicare plans at no additional cost to you with no obligation to enroll. PPO plans provide benefits for a broad range of covered services/procedures, giving you the flexibility to choose any licensed dentist, in or out of network. Navy Federal is the largest natural member (or retail) credit union in the United States, both in asset size and in membership. We are committed to providing the best care for our members and the best provider services, including expedited claims turnaround times. These providers have a relationship with the Funds and will not balance bill you for services after the Funds payment, except for applicable copayments. 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. PO Box 2320 Choose any dentist. Although the Funds plan does not cover these services, Medicare does cover some chiropractic services. 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. Start today at: 1-866-443-9160 to have your prescription drugs transferred. 3. You'd have to pay out-of-pocket. Benefits are available if the medical care is not available near the beneficiarys home and the beneficiary must be taken out of area, or if the beneficiary requires frequent transportation, such as for radiation or physical therapy. UMWA, Medical Assistance, Medicare, etc.) 3 reviews of Maria Saguin, DDS - Topanga Dental "I recently had a visit to get a teeth cleaning with Dr saguin. This plan does not meet the minimum creditable coverage requirements under M.G.L. All Rights Reserved. This is the official Facebook Fan page of the United Mine Workers of America International Union. 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. Close this box to continue working. Annual Premiums: Individual - $762; Two-Party - $1,410; Family - $2,139. Pay: $18.00 per . Trustmark Voluntary Benefits offers Life, Accident, Critical Illness, Disability, and Hospital insurance solutions that help policyholders achieve greater financial security and well-being. PO Box 292167 Until it is confirmed that you are in the Funds Medicare Part B plan, your doctors should continue to bill Medicare Part B for all services. Custodial/non-skilled care is not covered (i.e. Benefits for necessary repairs and maintenance, except the replacement of batteries, will be provided after the expiration of the warranty period. See your benefit plan documents for all of the coverage details. Call 1-800-292-2288 and press option 4 to seek approval. Triangle, VA 22172, 2023 United Mine Workers of America. Attorney, Terms of If so, and you haven't started receiving your benefits, please contact the Funds' Call Center right away. 1-866-876-2791. Provider must obtain precertification for any DME items over $300. Guide, Incorporation LLC, Internet 1-877-816-3596. Medicare Prescription Drugcoverage (Part D) may cover: Generally does not cover over-the-counter medications, 18354 Quantico Gateway Drive Copyright 2023 UMHA H & R Funds. You will find information on topics including billing, the Funds relationship with Medicare, Funds provider networks, medical management and patient support in the home. 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