2014 UnitedHealthcare Plan Design Changes as a Result of the Patient Protection and Affordable Care Act (PPACA)
- Medical copays will apply to the Out of Pocket Maximum.
- Addition of a Clinical Trials provision.
- Essential Health Benefits provision updated (includes benefit enhancements to durable medical equipment and other categories).
- Elimination of vision hardware discounts. Eye exams will still be available and unchanged.
- BRCA testing: Effective October 1, 2013 - The BRCA test, as well as screening and counseling, will be covered without cost share for members age 18 years and older with a family history of ovarian and/or breast cancer and who do not have a personal history or current diagnosis of ovarian and/or breast cancer. *note: UnitedHealthcare will continue covering BRCA testing for members at risk with a history of cancer who meet other testing guidelines. UnitedHealthcare also currently covers the genetic counseling and evaluation without cost share.
- Over The Counter (OTC) Drugs: Implementation of a pharmacy point-of-sale solution at network retail pharmacies as of November 1, 2013, and mail-order pharmacy beginning January 1, 2014. UnitedHealthcare will cover certain OTC drugs and OTC contraceptives for women. OTC drugs include: aspirin, folic acid supplements for women, fluoride and iron supplements for children and vitamin D supplements for older adults. OTC contraceptives for women include female condoms, emergency contraceptives and contraceptive film, foam and gel. These are covered without cost share when age and gender appropriate, prescribed by a health care professional and filled at a network pharmacy with the appropriate physician orders.
- Addition of medical necessity language.
- Pharmacy Programs – Retail before Mail is a new program that will be implemented.
Open Enrollment Meetings
All Open-Enrollment Meetings have been completed