You may go to providers outside the Funds Cooperating Provider Network, but those providers may attempt to balance bill you for amounts in excess of the Funds payments. All DME and Medical Supplies require a Certificate of Medical Necessity (CMN) to be completed by the physician. Listing for: US Oncology, Inc. Full Time, Remote/Work from Home position. Electronic Remittance (ERA) YES. If the employer offered dental and medical through separate plans, you can choose to continue both or opt to continue just the medical or dental plan. Contact the Funds Call Center (800-291-1425) to inquire about a PCP in your area. Get access to thousands of forms. Did you know? Guide, Incorporation My Account, Forms in Help mitigate common problems: Gum disease (68%) and dry mouth (30%) are widespread among Americans 65 and older. bNM;8_l}X+O5|:kDx#JPG{%1hx. YES. 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. **Note the 1993 Benefit Plan and the Prefunded Benefit Plan do not cover preventive care office visits for non-Medicare beneficiaries between the ages of 6 and 55.**. 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). Triangle, VA 22172, 2023 United Mine Workers of America. The Funds plan is your Medicare Part B plan and will pay your doctors bills and other non-hospital charges. Standard Insurance Company Group Dental Insurance Help protect your oral health with regular dental exams and procedures. Pharmacy: (800) 294-4741. Main Administration Number: (202) 521-2201. Choose the Get form key to open it and begin editing. Welcome to Funds information for health care providers. With the Dental Preferred Provider Organization (PPO) plan: Search for a dentist in the PPO network, Building a foundation of health, preventive care coverage and more. Calling all veterans! Complete all of the requested boxes (they are yellowish). When you have vision care insurance, you send the vision insurer a check for your premium for individual plans or have the premium deducted from your paycheck for employer-sponsored plans. Cigna Dental Insurance. Since we started in 1995, Viva Health has grown to be one of the largest health plans in the State of Alabama. Network dentists agree to discount their services for our members up to 35% on average. 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. Nashville, TN 37229, This address change applies to Claim Appeals, Pharmacy Appeals, Precertification and Case Management. #1 Internet-trusted security seal.
Please confirm your provider is in the network once you enroll. Privacy Policy, UMWA Urges Swift Action to Pass the Richard L. Trumka Protecting the Right to Organize Act, UMWA Mourns Miner Killed at Central Appalachian Mining, West Virginia HB 3270 is Bad for WV Workers. The Funds has a network of Cooperating Providers that you should use for all medical services. Click here for weekly coal production updates. Are you eligible for Medicare? The new address is: UMWA Health and Retirement Funds The Funds maintains a database of Cooperating Providers that have agreed to not balance bill you. Take a look at the cost for one year of vision insurance compared with the cost of an eye exam. For complex cases in high-cost areas, the cost can rise to approximately $2,500 to $3,000. Subject to prior approval, coverage is provided for medically necessary skilled nursing care in a skilled nursing care facility. When this happens, the Funds will protect you from paying these amounts, but keep in mind that the providers may indicate an unpaid balance on your credit report. Start today at: 1-866-443-9160 to have your prescription drugs transferred. We will then update your information on our website. Medicare beneficiaries Medicare Part A is the primary payer. Professional Institutional Dental: 52180: UMWA Health & Retirement Funds: Participating Plus Payor: Professional Institutional Dental: 80314: UNICARE: Participating Payor: . Forms, Real Estate Ambulette, Van, Taxi, shuttle, or bus) will be approved only if assisted transportation is medically necessary and beneficiary would otherwise require ambulance transportation. Maximum allowable of $150 per month per benefit. 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. The beneficiary will be responsible for any copayments or coinsurance due after the Medicare Part B payment is made. In fact, Original Medicare generally only pays for dental services for certain emergencies or complicated dental procedures. If you keep your other insurance, please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. Patients purchase Marchon products because they are covered by the VSP plan via the in-network doctor. Providers should email [emailprotected]for more information. Annual Premiums: Individual - $762; Two-Party - $1,410; Family - $2,139. Copyright 2023 UMHA H & R Funds. The plan also provides these extra benefits at no cost: Note: The dentist search is provided for informational purposes only. Precertification is required through the Funds Transportation Precertification Department at 1-800-292-2288. Dental benefits may not be available from UMR through your employer. No waiting periods. 1. If you are Medicare eligible, and have signed up to have the Funds as your Medicare Part B payer and Medicare confirms that transition, your doctors will be required to bill the Funds for all Medicare Part B services, except those furnished by non-facility providers (e.g. A hearing aid purchased from a vendor not in the Funds network will not be covered. They handled all the insurance billing and I was very happy with my experience. If you do need corrective lenses in addition to preventive care, you're probably better off with the insurance. Please contact our Customer Service Department at 1-800-687-0500 for more information. endobj endobj 4 0 obj American Medical Association (AMA) guidelines are utilized for covered visits. For more efficient service, please have your member ID number handy - you can find it on the front of your card. When you go to a physician or other non-hospital type of provider (i.e. Viva Health is a Member of the UAB Health System. Cigna Dental is another major provider that has a long-standing positive reputation for its dental insurance plans. Table 1 summarizes information about the health plans in the 2017 plan year (the most recent information . ERA Enrollment Required. endstream The United Mine Workers of America Health and Retirement Funds Union Plus Retiree Health Insurance - UMWA. Alternate forms of transportation for scheduled trips (i.e. With Davis Vision, you are free to choose any frames available at any participating private practice or retail location. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Identity Health & Well Being: Medical/Dental/Vision Insurance Paid Time Off Various Personal and Parental Leave Programs Universal Life Insurance Retirement Programs & Matching Employee Contributions: 401K & RRSP Employee Recognition & Anniversary Programs Training, Development, and Growth Opportunities 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. Enhanced plan. Benefits for necessary repairs and maintenance, except the replacement of batteries, will be provided after the expiration of the warranty period. Durable Medical Equipment (DME) and Supplies. UMWA, Medical Assistance, Medicare, etc.) See your benefit plan documents for all of the coverage details. Click here for more information. If you are currently using items being supplied by a DME company not in the Funds DME Network you will need to switch to one of our 7 DME Network vendors. Best Dental Insurance of 2023 Best Overall: Renaissance Best For Low Fees: Cigna Best for Immediate Coverage: Spirit Dental and Vision Best for Families: UnitedHealthcare Best for Seniors: Smart Health Dental Best for Singles: Physicians Mutual Best for Orthodontics: Delta Dental Best Value: Guardian Direct Best Overall : Renaissance Get a Quote The United Mine Workers of America Health and Retirement Funds (the Funds) is a group of multi-employer plans that provide health and pension benefits to retired coal miners and their eligible dependents. . Read our current newsletters for Medical, Dental or Behavioral providers. If you have any questions, please contact 1-800-292-2288 Thank you. If you are at least age 55 but under age 65 when you last work, you only need 10 years. Save when you stay in-network. Your location, age deductible . You may receive a copy of your 2020 Form 1095-B upon request by mailing such request to:
This plan covers all or most of your dental exams and cleanings and provides coverage for fillings. This plan is not a Qualified Health Plan under the Affordable Care Act. All Rights Reserved. Suite 350
Please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. All Rights Reserved. Select a directory, and find network participating health care professionals . Once enrolled, you'll be able to start using your VSP benefits within five days. Providers will find it beneficial to become a Cooperating Funds Provider. We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs. All Rights Reserved. Subrogation support. VSP strong arms the eye doctors to purchase the above brands from them by promising to drive patients to those "in network" eye doctors. 1 0 obj The Funds requires that you enroll in Medicare Part B, and keep your Part B, to qualify for or to maintain your Funds Health Services Card. All Rights Reserved. With a focus on prevention, dental insurance typically covers professional services like routine check-ups, cleanings and exams at 100%. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. % Our Mission is to strengthen our communities by improving the health of all our neighbors. UMWA 1993 Benefit Plan; Prefunded Benefit Plan; The Cash Deferred Savings Plan of 1988; Combined Benefit Fund; UMWA 1992 Benefit Plan; Contact Us; Billing & Claims. Precertification is required for days in excess of the 100 day maximum. 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. Us, Delete Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. Copyright 2023 UMHA H & R Funds. This list was formerly published as Part 6 of the administrative and billing instructions in Subchapter 5 of your MassHealth provider manual. The United Mine Workers of America (UMW or UMWA) is a North American labor union best known for representing coal miners. May God Bless each and every one of you and may he bless the United Mine Workers of America. If routine exams are all you need, the cost of insurance might not be worth it. . Integrated pharmacy benefit management, and tools to reduce the high cost of specialty drugs. Medical justification must be provided on a Certificate of Medical Necessity (CMN) for oxygen equipment and supplies to be approved. Incontinence supplies, such as adult diapers and chux are covered, limited to 3 boxes per month. 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