Close this box to continue working. Preventive care services are covered at little or no cost to you. 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. For complex cases in high-cost areas, the cost can rise to approximately $2,500 to $3,000. And while most people recognize that medical coverage is necessary, dental and vision plans might seem less essential. Since we started in 1995, Viva Health has grown to be one of the largest health plans in the State of Alabama. LLC, Internet 5 0 obj Medicare supplement insurance coverage can include: Deductibles Coinsurance Foreign travel Medicare Advantage Plans Medicare Advantage may cover: Most Medicare Part A (hospital coverage) covered services (Hospice will remain covered through Medicare) Medicare Part B (medical insurance coverage) covered services Although its main focus has always been on workers and their rights, the UMW of today also advocates for better roads, schools . 2. All Rights Reserved. If you do need corrective lenses in addition to preventive care, you're probably better off with the insurance. All Rights Reserved. Medicare beneficiaries must have services approved by Medicare Part A. Medicare Part A is the primary payer for the first 100 days. You will receive a $130 allowance toward the cost of the frame. 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. Please fax address, phone number, and other changes, along with a copy of the W-9 to 214-574-3599. United Concordia is offering members dental plans for the individual; two-party; or family. Click here for weekly coal production updates. Experience a faster way to fill out and sign forms on the web. Complete all of the requested boxes (they are yellowish). Current estimates contain both current EIA original estimates and revised estimates. Pharmacy: (800) 294-4741. If routine exams are all you need, the cost of insurance might not be worth it. USLegal received the following as compared to 9 other form sites. Get answers to you vaccination and testing questions. Triangle, VA 22172, 2023 United Mine Workers of America. Read our current newsletters for Medical, Dental or Behavioral providers. Dental benefits may not be available from UMR through your employer. Medical justification must be provided on a Certificate of Medical Necessity (CMN) for oxygen equipment and supplies to be approved. More savings when you stay in-network 1. Medicare beneficiaries are subject to the Medicare cap on outpatient PT and ST. Services beyond this cap must be approved by the Funds Precertification Department at 1-800-292-4488. If you have any questions, please contact 1-800-292-2288 Thank you. The Funds was created in the White House in 1946 in a contract between the United Mine Workers of America (UMWA) and the Federal Government. Yes, if you need to schedule a medical appointment but do not have transportation, you may be eligible for non-emergency transportation benefits. Get information about eligibility for benefits. For Americans who purchase their own stand-alone dental coverage, premiums are most commonly in the range of $20 to $50 per month. 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. Copyright 2023 UMHA H & R Funds. The Funds has a network of Cooperating Providers that you should use for all medical services. Professional Institutional Dental: 52180: UMWA Health & Retirement Funds: Participating Plus Payor: Professional Institutional Dental: 80314: UNICARE: Participating Payor: . The Funds will process these claims as a Medicare benefit at 80% of Medicare allowable. endobj In some states, a PPO plan might be your only coverage option. Beneficiaries who live in southwest Pennsylvania, northern West Virginia and Birmingham, Alabama, may elect to enroll with a PCP. With a dental plan, you have easy access to the care you need to keep your mouth healthy. 3. But if you're paying a lower percentage of the costs, you may have a high-dollar copay. 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. The new address is: UMWA Health and Retirement Funds My Account, Forms in Guide, Incorporation Professional Institutional Dental: WMI004: Western Mutual Insurance/TPA_Beech: Direct Payor: Professional Institutional Dental: 37247: Western Mutual Insurance/WMI-TPA . Our office hours are . The dentist search is provided for informational purposes only. Plan Highlights. All Rights Reserved. Patients purchase Marchon products because they are covered by the VSP plan via the in-network doctor. Its important to keep your provider information up to date. hospitals, skilled nursing facilities, home health agencies, etc). Learn how good dental health contributes to better overall health (PDF). <>stream Precertification is required through the Funds Transportation Precertification Department at 1-800-292-2288. 3 0 obj 2121 K Street, NW
And, you'll have 60% coverage for orthodontic services, up to a lifetime maximum of $1,500. endobj Please visit the Mercer Marketplace to learn more about the plans and benefits that your employer is making available to you. 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. Learn about our Cash Deferred Savings Plans and the Funds. Be a part of our Union Veterans Leadership Council! 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. 2016 United HealthCare Services, Inc. A UMR Dental plan provides you and your family with coverage for most common dental services, from cleanings to major services such as crowns and bridges. 3. Effective Date: 01/01/2021 Any deductibles, copays, and coinsurance percentages shown are amounts for which you're responsible. It has now been removed from the provider manuals . With Davis Vision, you are free to choose any frames available at any participating private practice or retail location. endobj PO Box 292167 Did you know? 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. Durable Medical Equipment (DME) and Supplies. Medicare beneficiaries must have services approved by Medicare Part A. Medicare Part A is the primary payer. The Funds will pay the Part A coinsurance during that time. Our Help Desk can be reached at 1-800-638-0968 between the hours of 8:00 am and 5:00 pm Eastern Time, Monday - Friday. Suite 200 Medicare supplement insurance coverage can include: Deductibles Coinsurance Foreign travel Medicare Advantage Plans Medicare Advantage may cover: Most Medicare Part A (hospital coverage) covered services (Hospice will remain covered through Medicare) Medicare Part B (medical insurance coverage) covered services You can use pre-tax dollars to cover important medical and dental needs. Network dentists agree to discount their services for our members up to 35% on average. Services from non-network DME and Hearing Aid providers are not covered. For Medicare covered beneficiaries, Medicare Part A covers the first 100 days of skilled care. Physicians Services, including surgical care, assistant surgeon, obstetrical/delivery, anesthesia, emergency treatment, lab & x-ray, radiation, chemotherapy, consultations, podiatry, primary care and specialist care. Dental network customer service. 1 0 obj Institutional/UB Claims. The 15 month Rent-to-Cap period applies to all oxygen equipment rentals. Electronic Services Available (EDI) Professional/1500 Claims. 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. Precertification is required for days in excess of the 100 day maximum. 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). Dont delay. Triangle, VA 22172, 2023 United Mine Workers of America. Otherwise,you will be redirected to the home page in 60 seconds. We make that possible through giving you access to our full-fledged editor effective at altering/correcting a document?s initial text, inserting unique fields, and putting your signature on. Viva Health is a Member of the UAB Health System. This plan covers all or most of your dental exams and cleanings and provides coverage for fillings. Oxygen requires precertification and must be recertified annually. Call 1-800-292-2288 and press option 4 to seek approval. When comparing dental plans, be sure to compare not only price but the benefits you're receiving too. The UMWA provides comprehensive health benefit coverage. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Identity UMWA Health and Retirement Funds Washington, DC 4 months ago 188 applicants 188 applicants These are EOB codes, revised for NewMMIS, that may appear on your PDF remittance advice. 1. Nashville, TN 37229, This address change applies to Claim Appeals, Pharmacy Appeals, Precertification and Case Management. YES. Finally, if you work until age 65, you can retiree with medical benefits after working as few as 5 years . The plan also provides these extra benefits at no cost: Note: The dentist search is provided for informational purposes only. For more than 100 years, we've been building a different kind of benefits company, and going beyond the needs of our customers. May God Bless each and every one of you and may he bless the United Mine Workers of America. Network Solutions Flexible provider networks for member access to quality care at the best value. & Estates, Corporate - 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. Suite 200 Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. Some Medicare Advantage plans . Our Mission is to strengthen our communities by improving the health of all our neighbors. We work closely with brokers and clients to deliver custom benefits solutions. At present, the Funds provides benefits to over 86,000 beneficiaries. &Sm`V=%~ With our platform submitting Umwa Vision Benefits usually takes a couple of minutes. Subject to prior approval, coverage is provided for medically necessary skilled nursing care in a skilled nursing care facility. Technology, Power of Inpatient Hospital, including semi-private room, intensive or coronary care unit, renal dialysis, mental illness, alcohol/chemical dependency and maternity. endstream 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. Medical Claims Processing, Insurance Claims. 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. Job Type: Full-time. The Funds will also periodically ask you to submit updated information about your other insurance coverage.
