Choose any dentist. Integrated pharmacy benefit management, and tools to reduce the high cost of specialty drugs. Network Solutions Flexible provider networks for member access to quality care at the best value. Highest customer reviews on one of the most highly-trusted product review platforms. Are you eligible for Medicare? You can use pre-tax dollars to cover important medical and dental needs. You will find information on topics including billing, the Funds relationship with Medicare, Funds provider networks, medical management and patient support in the home. See Vision fee schedule for reimbursement amounts. To pre-certify, the facility should call our Precertification Department at 1-800-292-2288. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Identity Personal Dental Plan covers preventive care (annual cleanings, X-rays and evaluations) The following plan tiers Personal Dental Plan Basic and Personal Dental Plus add more coverage for minor and major restorative services such as extractions, fillings, denture repairs and oral surgery. UMWA H&R Funds Vision Care Program for the 1993 Benefit Plan A. If routine exams are all you need, the cost of insurance might not be worth it. These are EOB codes, revised for NewMMIS, that may appear on your PDF remittance advice. Triangle, VA 22172, 2023 United Mine Workers of America. . Dental insurance premiums ranged from less than $10 per month to more than $80 per month in our review of quotes across the largest dental insurance companies. Be a part of our Union Veterans Leadership Council! hospitals, skilled nursing facilities, home health agencies, etc). Privacy Policy, 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, Generally does not cover over-the-counter medications. 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. Dental insurance makes dental care more affordable! When you go to a physician or other non-hospital type of provider (i.e. If you choose a Fashion or Designer frame from our Davis Vision Exclusive Collection it will be covered in full. Durable Medical Equipment (DME) and Supplies. YES. Requires approval by the Funds Precertification Department at 1-800-292-2288. Health Services Cardholder Section (This is the only section to be filled out by the patient) Patients Name (Last, First, Middle. Must be a Medicare approved Skilled Nursing Facility and must have a qualifying hospital stay prior to admission. Pay: $18.00 per . 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. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. Take a look at the cost for one year of vision insurance compared with the cost of an eye exam. endobj The Funds will also periodically ask you to submit updated information about your other insurance coverage. %PDF-1.4 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 Save when you stay in-network. Attorney, Terms of Click here to learn more! Funds' Call Center: (800) 291-1425. West Virginia Public Employees Insurance Agency Benefitting People Who Serve Members Active Members Non-Medicare Retiree Medicare Retiree Health Plans PPB Plans A, B & D PPB Plan C The Health Plan Medicare Advantage Plan Partners Benefit Coordinators Health Care Providers UMR Express Scripts Mountaineer Flexible Benefits MetLife Humana iSelectMD Union Plus Retiree Health Insurance - UMWA. 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. <>stream Meals and lodging may be covered for beneficiary and escort, if prior approved, for out-of-area transports. 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. Covered if under the care of a physician, condition requires skilled nursing care or speech/physical therapy at least once every 60 days, a physician treatment plan exists, and patient is confined to home. The Funds also has a network of Durable Medical Equipment (DME) and Hearing Aid providers that must be used for obtaining those services. Covered when prescribed by a physician and is medically necessary. No, the Funds is your Medicare Part B payer for non-facility providers. Yes. 18354 Quantico Gateway Drive Suite 200 Triangle, VA 22172 703.291.2400. info@umwa.org 2023 United Mine Workers of America. Call 1-800-292-2288 and press option 4 to seek approval. Finally, if you work until age 65, you can retiree with medical benefits after working as few as 5 years . UMR offers flexible, third-party administration of multiple, complex plan designs and integrated in-house services. Take a look at the cost for one year of vision insurance compared with the cost of an eye exam. In many ways they are: healthy people can go without a dentist or optomologist for a few years. Secondary Claims. American Medical Association (AMA) guidelines are utilized for covered visits. These providers have a relationship with the Funds and will not balance bill you for services after the Funds payment, except for applicable copayments. Your doctor can contact our Provider Services department at (888) 865-5290, if they have any questions. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. Incontinence supplies, such as adult diapers and chux are covered, limited to 3 boxes per month. 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. The Funds will pay the Part A coinsurance during that time. Eligibility: Group Health, Life, and Dental: Regular non-instructional employees who work a minimum of 30 hours per week are eligible for enrollment in these insurance plans; instructional staff members hired to teach the equivalent of 12 undergraduate hours or 9 graduate hours a semester for the full academic year are also eligible for insurance enrollment. Guarantees that a business meets BBB accreditation standards in the US and Canada. Please note that the address for the Funds Medical Management office has been changed. USLegal received the following as compared to 9 other form sites. With a dental plan, you have easy access to the care you need to keep your mouth healthy. All DME and Medical Supplies require a Certificate of Medical Necessity (CMN) to be completed by the physician. Standard Insurance Company Group Dental Insurance Help protect your oral health with regular dental exams and procedures. If you need personalized help over the phone, you can call a licensed insurance agent at 888-680-4770 (TTY users 711) Monday through Friday, 8 am 8 pm Eastern Time. Wisdom teeth are the third set of human molars that typically emerge during the college years, between the ages of 17 to 25. You will need to present your Funds health card to your doctor the next time you go to his office. Dentists can detect signs of disease just from looking at your teeth and gums. Ambulette, Van, Taxi, shuttle, or bus) will be approved only if assisted transportation is medically necessary and beneficiary would otherwise require ambulance transportation. Warning: usage of this Web site requires acceptance of our Site Usage Agreement. To determine whether any other party or insurance carrier may have responsibility to pay for medical treatment, . Medicare beneficiaries have a chiropractic benefit through Medicare. The revised estimates include the most recent MSHA data available as of the release date of the table. Institutional/UB Claims. 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. <>stream Did you know? Select Continue to remain logged in. Dental Preferred Provider Organization (PPO) Plan? United Mine Workers of America. Original Medicare usually doesn't cover dental care such as cleanings, fillings, tooth extractions, or dentures. Choose the template you want in the collection of legal form samples. 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. Handbook, DUI Medical Claims Processing, Insurance Claims. At present, the Funds provides benefits to over 86,000 beneficiaries. Double-check the entire document to make certain you have completed all the information and no changes are needed. Learn More Mission driven to improve lives through healthcare quality and clinical expertise Help mitigate common problems: Gum disease (68%) and dry mouth (30%) are widespread among Americans 65 and older. I was very impressed by her professionalism and dental skills. Providers will find it beneficial to become a Cooperating Funds Provider. We work closely with brokers and clients to deliver custom benefits solutions. 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. . 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. If you have any changes, please email vivaproviderservices@uabmc.edu or call Viva Health Customer Service at (205) 558-7474 or 800-294-7780. Technical Assistance If you have technical questions with regards to the functioning of this website or our Employee, Customer, Provider websites, you may address them via email at support.Information@healthsmart.com. Care management Integrated clinical solutions designed to fit your populations and reduce healthcare costs. 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