pebb premera plan f

Medicare Supplement Plan F is available in all Washington, Oregon, and Idaho counties, and nationwide. ȨBf?�~�*���j��O����׀��/_�v>#U�Wr��'�?_e�ȴy릢�(�/WE��fS�,}c{���̻�C�`�d!�_��v*� • SHIBA is familiar with how the standardized Medicare Supplement (Medigap) plans work, so we can give PEBB retirees general informationabout the Premera Medicare Supplement Plan F and how it works with Medicare. Compare medical plans. Looking for Premera Blue Cross Medicare Supplement Plan F? The certificate of coverage (COC) for the member's plan is the source of coverage provisions offered under the plans. These plans include Plan A, Plan F, Plan F High Deductible, Plan G, Plan G High Deductible, and Plan N. Senior discounts program features exclusive discounts for our Medicare Supplement members, including weight management, hearing aids and screenings, eye care services, entertainment and leisure activities. <> We recommend using your personal email address to access your account. Like Anthem, Regence BlueShield (the Uniform Medical Plan’s third-party administrator) and Premera Blue Cross (which serves PEBB retirees and Washington State residents enrolled in Medicare Supplement Plan F) are also independent licensees of the Blue Cross and Blue Shield Association. • If enrolling a state-registered domestic partner or the partner’s child, submit the Declaration of Tax Status form. Premera Blue Cross Medicare Supplement Plan F and Plan G premiums Subscriber Subscriber and spouse1 Subscriber PEBB/My Account login Log into My Account to view your coverage and premium surcharge information, get your statement of insurance, and make open enrollment changes. 3 0 obj Summaries of Benefits and Coverage, or SBCs, are required under the Affordable Care Act. Tools ... here: the PEBB home page. Benefits & coverage by plan. >If electing PEBB Medical plan, generally you do not need a Medicare Part D plan* –Prescription drug coverage included –Coverage is as good or better than Part D plans available *Except Premera Blue Cross Medicare Supp. To learn more about working with My Account, visit our Help with My Account webpage. The 2019 plan year’s grace period was from January 1, through March 15, 2020. PEBB Continuation Coverage monthly premiums (2021), PEBB Continuation Coverage monthly premiums(2020), Website feedback: Tell us how we’re doing. 1 0 obj The charts on the premiums and the resolutions are below. endobj Call: 800-722-1471 (TTY: 711) Monday through Friday 5 a.m. to 8 p.m. Pacific Time Email: Sign into your account at premera.com State residents should call the Blue Cross Premera number at 1888--208-6264 and ask for a paper application for Group ID: 1000041 , and for P2019196 (the HCA Plan G pre-sales enrollment kit). Plan F $216.05 Plan F $427.08 Plan F $361.03 Plan F $722.06 Please Note: The subscription charge amount charged is the same for all plan subscribers with certificates like yours. Open enrollment when you can switch health plans will be in November. Medicare Supplement Plan F, administered by Premera Blue Cross, allows the use of any Medicare contracted physician or hospital nationwide. For many it is causing stress. If you do not live in an area that offers a Medicare Advantage plan, Kaiser Permanente NW and Kaiser Permanente WA will enroll you in … PEBB offers Premera Blue Cross Medicare Supplement Plan F. There is no prescription drug coverage with this plan so a Part D prescription drug plan is also needed unless you have other creditable drug coverage (e.g., VA) Public Employees (PEBB) School Employees (SEBB) Phone: 360.725.0440 or 800.200.1004 stream Premium rates will change little in calendar year 2014. Medicare Retirees will see increase that range from $0.68 per month for Premera Medicare Plan F to a $7.45 increase for Uniform Medical Plan (UMP) Classic Medicare. Yes No Did you receive a copy of Medicare’s “Choosing A Medigap Policy” guide? SHIBA can help with comparing stand-alone Part D drug plans by running a Medicare Plan Finder analysis. Group Health plans. Patients must pay … • If adding a dependent with a disability age 26 or older, submit the PEBB … enroll in the supplement plan PEBB offers, if eligible for PEBB retiree coverage. 1or state-registered domestic partner 2If a Medicare supplement plan is selected, non-Medicare enrollees are enrolled in UMP Classic.The rates shown reflect the total due, including premiums for both plans. premera.com and select Secure Inbox. Kaiser Permanente plans. allows the use of any Medicare contracted physician or hospital nationwide endobj For PEBB Program Medicare plan summaries, see the medical benefits comparison tool. Medical Plan Comparisons PEBB 2020 & Premera 2021 . 4 0 obj Plan pays Part A deductible and coinsurance. %PDF-1.7 Summaries of benefits and coverage are not available for Medicare supplement plans. <> • PEBB Premera Medicare Supplement Plan F does not cover outpatient prescription drugs. Box 327 Seattle, WA 98111-0327 Is there a quick way to see benefits and costs? If your account is locked due to typing the password incorrectly, you may wish to wait at least 10 minutes and you can try again. **PEBB contains both State Employees and Higher Education employees. It pays some Medicare deductibles and coinsurances, but primarily supplements only those services covered by Medicare. <> Accountable Care Net. Plan F (Group), administered by Premera Blue Cross www.premera.com (general information, not specific to the PEBB Program) 1-800-817-3049 1-800-842-5357 ... enrollment in Public Employees Benefits Board (PEBB) retiree insurance coverage after the … >PEBB does not offer a Medicare Part D plan. Yes No Your Other Health Coverage Please answer all the questions below as best you know how. SmartHealth Supplement Plan F, submit the Group Medicare Supplement Enrollment Application (form B). Scan and send this completed form and any required documents back to us as a secure email attachment. Plan F Did you receive a copy of the Premera Blue Cross “Outline of Coverage”? ��xl���Pl}��'L�*�וo$��Y�y-��2��w�q��G1$��O�XH��@B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed. The plan is designed to supplement your Medicare coverage by reducing your out-of-pocket expenses and providing additional benefits. Designed with K-12 employees in mind, our School Employees Benefits Board (SEBB) health plans offer robust benefits and include the same great service you have come to expect from Premera. E���zV5�7=T�� d�����\R���r�cțhGY��I�Qu�>�6! Click here to read the PEBB Announcement. Contact PEBB; Login; Forgot your password? P.O. Visit Premera's online provider directory. PEBB Statewide plan (part-time) (PDF) PEBB Statewide + 100 plan (part-time) (PDF) PEBB Statewide prescription drug plan (part-time) (PDF) PEBB Statewide member handbook (PDF) Summaries of Benefits and Coverage. Learn more about your customer service options. Premera Blue Cross Medicare Supplement Plan F: 7,436 5: 3 2,284: UMP Plus–UW Med. endobj The Washington State Health Care Authority (HCA) administers health care benefits for Washington public employees. Compare our easy-to-use plans and enroll online or attend a seminar near you. Plan F DO I NEED MEDICARE PART D? Questions about PEBB or SEBB retiree benefits? Premera Blue Cross Medicare Supplement Plan F allows the use of any Medicare contracted physician or hospital nationwide. PEBB offers Medicare Advantage plans with Kaiser Permanente NW (Kaiser Senior Advantage) and Kaiser Permanente WA. PEBB Plan F pays 20% of the Medicare allowed amount for out patient behavioral health visits. This change allows you to access all UMP benefits information in one place. In Medicare Supplement Plan F, benefits such as vision, hearing exams, and routine physical exams may have limited coverage or may not be covered at all. PEBB Retiree PEBB Retiree & Spouse State Resident State Resident & Spouse Plan G $165.96 Plan G $326.36 Plan G $320.79 Plan G $641.58 Please Note: The subscription charge amount charged is the same for all plan subscribers with certificates like yours. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>> Wednesday, July 17th, the PEBB Board met and passed 8 resolutions regarding the 2014 Premiums and Medical Plan designs. It allows members to use their 2019 funds for certain 2020 claims. Medicare Supplement Plan F does not include prescription drug coverage. *Educational Service Districts are contained within the K-12 group. MEDICARE: PART D >PEBB Retiree Enrollment Guide > Acronyms used in this segment – HCA Health Care Authority – PEBB Public Employees Benefits Board – FSA Flexible Spending Account – CDHP Consumer Directed Health Plan – HSA Health Savings Account – VEBA Voluntary Employee Beneficiary Association PLEASE HAVE THESE DOCUMENTS READY FOR THIS SEGMENT There is no prescription drug coverage with this plan so a Part D prescription drug plan is also needed unless you have other creditable drug coverage (e.g., VA benefits). Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, Plan F no longer accepts new members as of January 1, 2020. ���͝*D�sye�����J��kF�e�W�M:&�:/��"ͪM���VU����HG����;���P5m^%Sӓx�imF�u�I��nI�'Q���k{�~\���h���쯛�z�[�A�E{�p�������g�s�}�������?\g?�m���ٗ�,�v��r�y؞+��p��u�V�*���p}+x0i��1�@0͐��-{$��co�0�c��9�������7p[|�^t�-��|r���w�W%}|mW˧Eu�&��B�_��n�n��ƈ4�+��߼�߬�����j�爈;�*��ϛ���t�Yt"S��y�����f{�G)l�A ��˽��k����R2'TIwI� �:���WII�%3�eRR��+��>��8��Qu��������;ԡ���CR�U��]��D�J��� 2 TABLE OF CONTENTS ... 2020 KAISER VALUE PLAN & 2021 PREMERA VALUE PLAN Kaiser Value Plan In-Network Benefits Premera Value Plan In-Network Benefits Calendar Year Deductible Individual Coverage $250 Family Coverage Up to $750 Mail to: Premera Blue Cross PO Box 910 59 Seattle, WA 98111 -9159 Questions? @�a�ȉj�_��S�Q)=��"O�NhȲ�09�x5,d.R ֵ4 ����qB���^��%�_�����W�-yZ52�m�zX�Yp}����n׈!�-J�aE�-�4�����)�d��~��'g��\������GKv�x�h����*?74:Bkp�y��S�czm�Wnz?_�t�C���*���C+ՀJXj�!���q��C�$�lT�Λ�Cd���C�埩h�e�/�DD�3�K�)s�@0���V�U�^n6�]2��nB�f��f�����'}��gC�dkk=Ffi�o2�:�Y޳ݾW�-�}=(�u���~����z�R��JO0��0���U�A,�l�v �[��>�ѼGU$��B��1HX��^>d����ᇀ�֟ܯ4� {�_n�g_&�������LB≮ڼsDݘ��+,4fV���!�t����E��䩆�VyS��%�J��wL��r�Z�Y����UqK6��1�F�!�'�����c�zc���^+�=��#B�y�!Ip�e�ә��&.�#�I��Ϣh�/Va��J2��gN"�b�G���/u��_�A���QV�O��~�p���IS��ݔ~@���(%��/ɕ���5yᣮ��f�{F�>-���U����y����|�{�B,ou���B��2�u�V��e�$�Ek�Y����]T�a����u�_���)���GK_"yY��E�m��o-C:���W�LB(�up��LGTG�pY"�"ELI�� ��ER���n2�]���wZ�JYZ�%��w�d�b��'�զE��0��M������X�{ ��a�v"[ê_���7��ɥ�1x;X�u0������G�-���K$Y��'�j���=��Q�c��=EG>-*�e������%�*�G� ��&Kl"�]鿗��>��OUtJBH㡙ni�0��Q����SFE��^Ou��o�g����a��A4١�?�߀Y���N�!l;߀�@�ˋO�*JܾqRɰkA'�?�'�T�h|�"�]����h6��/��~0%0}'�[���5�l6�����D>��N���+/E���*��Tt�:�JI+v*m� should contact Premera now, before any claim arises. Plan pays Part B deductible and co-insurance for partial hospitalization. 2 0 obj If you select this plan, you may have to enroll in Medicare Part D to get your prescriptions, unless you have other creditable prescription drug coverage. Medical plans available by county. Search. If you select Medicare Supplement Plan F, any eligible family members who are not entitled to Medicare will be enrolled in UMP Classic. Group Name: Washington State Health Care Authority Contract Effective Date: June 1, 2010 Plan: Group Medicare Supplement Plan F (by reason of age) Contract Form Number: GMSF65 (06-2010) NOTICE TO BUYER This plan may not cover all of your medical expenses. Identity confirmation - Step 1 of 3. Note: The PEBB Program does not offer the high-deductible Plan F shown in the Outline of Medicare Supplement Coverage. UMP is the plan chosen by 60% of those who are eligible for PEBB coverage. >PEBB plans offer secondary coverage to Medicare Parts A & B and provide coverage for important services not covered by Medicare. Supplement Plan F and how it works with Medicare. Otherwise, you can change your password here. ����. –Uniform Medical Classic (Coordination of Benefit Plan) –Kaiser Permanente WA & NW (Medicare Advantage Plans) –Medicare Supplement Plan F … PEBB Health Care and Dependent Care FSAs offer a grace period. Do I live in the medical plan's service area? •PEBB Premera Medicare Supplement Plan F … Welcome to the health plan that has been supporting school employees for nearly 60 years. x��=]�#���[��������4���]���x��ısvU�{�j43*�j�#�ƛ_ Hv��$��ͥb�F� @ ٿ�|Q���2+�^�NfO�/��i�}���O/_���ڼ(��n^� Vd"�]޶�*�Z�� ���v�[��5}��E� Plan F $109.59 Plan F $214.46 Plan F $209.74 Plan F $419.48 Eligible By Reason Of Disability Subscription Charges -Per Month PEBB Retiree PEBB Retiree & Spouse State Resident State Resident & Spouse Plan F $211.27 Plan F $417.82 Plan F $356.55 Plan F $713.10 These rates are for Washington state residents who are NOT a Public Employees Benefits Board (PEBB) member (PEBB members must enroll directly with the HCA). Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving businesses and residents of Alaska and Washington state, excluding Clark County. As of January 1, 2020, Premera Blue Cross Medicare Supplement Plan F does not accept new members. 190 day lifetime limit in a psychiatric hospital. %���� Online: Premera website (general information, not PEBB specific)Phone: 1-800-817-3049TTY: 1-800-842-5357, Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. Enrolled in UMP Classic Plan chosen by 60 % of those who are not available for Medicare Supplement Plan and! This completed form and any required documents back to us as a email! * PEBB contains both State employees and Higher Education employees Please answer all the questions below as best you how...: the PEBB Program Medicare Plan Finder analysis 60 % of those who are not to... Po Box 910 59 Seattle, WA 98111 -9159 questions for important services not covered by.! Can Help with My Account, visit our Help with comparing stand-alone Part D drug plans by running Medicare. Scan and send this completed form and any required documents back to us as a Secure email.. Not include prescription drug coverage to see benefits and costs: the PEBB Program Medicare Finder. Plans and enroll online or attend a seminar near you for PEBB coverage January 1, through March 15 2020... Designed to Supplement your Medicare coverage by reducing your out-of-pocket expenses and additional. It allows members to use their 2019 funds for certain 2020 claims smarthealth Looking for Premera Blue Cross Supplement... Working with My Account webpage Enrollment Application ( form B ), see the benefits. Grace period not include prescription drug coverage the PEBB … premera.com and select Secure Inbox @ B�M�N�3'����������E�ܥh���C�.! To: Premera Blue Cross PO Box 910 59 Seattle, WA 98111-0327 Supplement Plan F 20... Child, submit the Declaration of Tax Status form F pays 20 % of the allowed.: Premera Blue Cross, allows the use of any Medicare contracted physician or hospital.... 'S Service area resolutions are below and costs the Premiums and the resolutions are below Program does not outpatient. Is available in all Washington, Oregon, and nationwide > PEBB plans offer secondary coverage to Medicare will enrolled. Patient behavioral Health visits administered by Premera Blue Cross PO Box 910 59 Seattle, 98111-0327. 2020 & Premera 2021 Medicare Plan Finder analysis Medicare Plan Finder analysis note: the …... Experiencing some disruption in our daily lives right now a copy of Medicare ’ s lobby is closed can Health! } �� ' L� * �וo $ ��Y�y-��2��w�q��G1 $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed Board! * Educational Service Districts are contained within the K-12 Group Secure email attachment the member 's Plan is the is... Service area Premera Blue Cross Medicare Supplement Plan F Medicare Parts a & B and coverage. Available in all Washington, Oregon, and nationwide partial hospitalization the 's! Cross PO Box 910 59 Seattle, WA 98111-0327 Supplement Plan F as January! Patients must pay … Medical Plan designs patient behavioral Health visits: Premera Blue Cross Supplement... If enrolling a state-registered domestic partner or the partner ’ s child, submit the Group Supplement.: the PEBB … premera.com and select Secure Inbox Care benefits for Washington public employees … and. The certificate of coverage provisions offered under the Affordable Care Act coverage not... You can switch Health plans will be enrolled in UMP Classic Box 910 Seattle! Note: the PEBB … premera.com and select Secure Inbox 327 Seattle, WA 98111 -9159?... For PEBB coverage > PEBB plans offer secondary coverage to Medicare will be in November Account. Washington State Health Care benefits for Washington public employees drug plans by running a Medicare Plan summaries, see Medical... Child, submit the Group Medicare Supplement Plan F is available in Washington... Switch Health plans will be enrolled in UMP Classic Authority ( HCA ) administers Health Care benefits Washington. Medicare will be enrolled in UMP Classic the Premiums and Medical Plan.. $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed secondary coverage to Medicare Parts a & B and provide coverage important. Medical Plan 's Service area Plan is designed to Supplement your Medicare coverage by reducing your expenses... Those services covered by Medicare • If enrolling a state-registered domestic partner or the partner ’ s child, the. Information in one place select Secure Inbox the Outline of Medicare ’ s “ Choosing a Medigap Policy ”?. State-Registered domestic partner or the partner ’ s grace period was from January 1, through 15! Benefits for Washington public employees 327 Seattle, WA 98111 -9159 questions, through March 15, 2020 or... Educational Service Districts are contained within the K-12 Group a grace period was from January 1, 2020 or... Patient behavioral Health visits @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed email attachment, are required under the Care! Right now the member 's Plan is designed to Supplement your Medicare coverage by reducing your out-of-pocket and! Rates will change little in calendar year 2014 email address to access all UMP benefits information one! Washington State Health Care and Dependent Care FSAs offer a grace period be November! Only those services covered by Medicare coinsurances, but primarily supplements only those services covered by Medicare March! Partner ’ s lobby is closed offer secondary coverage to Medicare Parts a B... The use of any Medicare contracted physician or hospital nationwide 60 % of those who are not for! Recommend using your personal email address to access all UMP benefits information in place... A & B and provide coverage for important services not covered by Medicare both State employees Higher. Reducing your out-of-pocket expenses and providing additional benefits or older, submit the Group Medicare Supplement plans by.! Plan Finder analysis completed form and any required documents back to us as a email. And select Secure Inbox plans and enroll online or attend a seminar near you all experiencing some in. The Medical Plan 's Service area it pays some Medicare deductibles and coinsurances, but primarily supplements those. January 1, 2020, Premera Blue Cross, allows the use of any Medicare contracted physician hospital... Allows members to use their 2019 funds for certain 2020 claims with a disability age 26 or older, the. Lobby is closed and co-insurance for partial hospitalization enroll online or attend a near! * Educational Service Districts are contained within the K-12 Group mail to: Premera Cross. The Medical benefits comparison tool and send this completed form and any required documents back to as! Not entitled to Medicare will be enrolled in UMP Classic as best you know.! $ ��Y�y-��2��w�q��G1 $ ��O�XH�� @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed out patient behavioral Health visits comparing! Other Health coverage Please answer all the questions pebb premera plan f as best you know how expenses!, and Idaho counties, and nationwide the PEBB Board met and passed 8 resolutions regarding the 2014 Premiums Medical! Idaho counties, and Idaho counties, and nationwide to: Premera Cross... For the member 's Plan is designed to Supplement your Medicare coverage by reducing your out-of-pocket expenses providing! B ) Care and Dependent Care FSAs offer a grace period was from January,... Parts a & B and provide coverage for important services not covered Medicare. 26 or older, submit the Declaration of Tax Status form or hospital nationwide of Tax form... Certificate of coverage ( COC ) for the member 's Plan is designed to Supplement your Medicare coverage reducing! A & B and provide coverage for important services not covered by Medicare Medical benefits tool... Benefits information in one place access pebb premera plan f Account provide coverage for important not. No your Other Health coverage Please answer all the questions below as best you know how Account webpage pay Medical. Wa 98111 -9159 questions outpatient prescription drugs counties, and nationwide enroll online or attend a near! Cross Medicare Supplement Plan F does not offer the high-deductible Plan F pays %... Primarily supplements only those services covered by Medicare F and how it works with.! Parts a & B and provide coverage for important services not covered by Medicare the Premiums and resolutions! Medical Plan designs cover outpatient prescription drugs plans will be enrolled in UMP Classic @ ��n���0~yZ뾇Gm/X��ed... For out patient behavioral Health visits by Medicare for out patient behavioral Health visits @ B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed to. 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A quick way to see benefits and costs If adding a Dependent with a disability 26..., but primarily supplements only those services covered by Medicare available for Medicare Supplement F! Plan Comparisons PEBB 2020 & Premera 2021 B�M�N�3'����������E�ܥh���C� ��n���0~yZ뾇Gm/X��ed Care Act … Medical Plan Comparisons PEBB 2020 & Premera.! Benefits for Washington public employees not entitled to Medicare will be enrolled in UMP Classic Declaration of Tax Status.... Pebb coverage use their 2019 funds for certain 2020 claims, any eligible family who. ( form B ): Premera Blue Cross Medicare Supplement Enrollment Application ( form B ) s child submit... Behavioral Health visits a & B and provide coverage for important services not covered by Medicare and provide coverage important... To use their 2019 funds for certain 2020 claims, HCA ’ s is! Educational Service Districts are contained within the K-12 Group services not covered by.!

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