2022 University of California Open Enrollment - PowerPoint Presentation

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2022 University of California Open Enrollment

October 28 – November 19, 2021

Introducing our New Logo

WE’RE STILL EVERYTHING YOU CAN DEPEND ON – AND MORE!

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Confidential and Proprietary Information

Why Health Net?

CHOOSE UC BLUE & GOLD FOR 2022!

Affordable premium, $0 deductible and fixed or $0 copayments

Broad choice of providers - including all UC medical centers and medical groups

Dedicated Health Benefit Navigators – personalized navigation for high-touch service

24/7 available Babylon telehealth services at $0 copayment

Proven track record – over 120,000 UC employees, retirees and their dependents already have UC Blue & Gold HMO!

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What’s Changing

Change to Generic Substitutions

Adult Immunizations are now available at most Health Net contracted pharmacies with $0 copayment

New Specialty Medication Split Fill Program

UC BLUE & GOLD BENEFITS

What’s New for 2022?

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2022 Coverage Overview

Preventive Care (screenings and immunizations)

$0

Doctor

and Specialist Office Visits

(see below for behavioral health office visits)

$20 copay

Hospitalization

(medical and behavioral health)

$250 copay per admission

Outpatient Behavioral

Health/Substance Abuse Visits

Visits 1-3: $0

Visits

4+: $20 copay

24/7 Virtual Care

– Telehealth visits through Babylon (including behavioral health)

$0

Urgent Care

$20 copay

Emergency

care (medical and behavioral health)

$125 copay (waived if admitted)

X-ray and Lab Procedures$0MinuteClinic$20 copay (if preventive: $0)

Chiropractic/Acupuncture

$20 copay (24 visits combined max per calendar year)

Covered ServiceYou Pay5

2022 Coverage Overview (cont.)

Maternity

Care

$0 for all services except hospital

stays for which the hospital copay applies

Outpatient Surgery

$100 copay

Ambulance

Emergency Transport (medical and behavioral health)

$0

Prescription

Drugs*

• Retail (30-day

supply)

• Mail order or walk-up services available at UC Medical Centers and CVS Pharmacies

(90-day supply)

• Specialty drugs (up to a 30-day supply)

$5

generic;

$25 brand formulary when a generic in not available;

$40 non-formulary

$10

generic;$50 brand formulary; $80 non-formulary$20Other Behavioral Health Outpatient Services• Psychological testing, outpatient electroconvulsive therapy, extended-length therapy sessions, biofeedback, Applied Behavior Analysis (ABA), methadone maintenance

• Structured/intensive outpatient program treatment• Partial hospitalized/day treatment$0; authorization requiredCovered ServiceYou Pay* Without prior authorization from Health Net, there is no coverage for brand name drugs when a generic equivalent is available. If it is medically necessary for a member to take a brand name medication when a generic equivalent is available, the copay will be covered at Tier 3 ($40 for a 30 day supply, $80 for a 90 day supply).6

Health Net & Managed Health Network (MHN)

MHN provides behavioral health (i.e., mental health and substance use disorder) benefits to UC Blue & Gold members

Behavioral health benefits are integrated with medical benefits

For standard outpatient care (i.e., therapy or medication management) no referral is needed

For certain services (e.g., psychological testing, residential treatment, intensive outpatient, Applied Behavior Analysis, etc.), authorization is required

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Confidential and Proprietary Information

Find a Behavioral Health Provider

Call MHN Customer Service

800-663-9355

Customer Service Representative will ask if you’d like help finding a provider with availability

A coordinator will make calls to providers and will contact you directly once an available provider is found

Please note: access to care standards (regulatory requirement):

MD (i.e., Psychiatrist) appointment = 15 business days

Non-MD (i.e., Therapist) appointment = 10 business days

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Confidential and Proprietary Information

Dedicated Health Benefit Navigators

PERSONALIZED NAVIGATION FOR HIGH-TOUCH SERVICE

Member

HBN

Local Knowledge

Dedicated teams based in So Cal & Nor Cal

Experience

Expertise in UC benefits, ensure a high level of support

Education & Empowerment

Motivating members to engage with their health outcomes

Holistic View of Member

Integration of medical, behavioral health and pharmacy

Member Advocate

Provides end-to-end support and service

Personalized Support

Addresses next best actions

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2022 New Wellness Services

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Real Age Test (Health Assessment)

Lifestyle Management (Health Coaching)

Coach-Directed Lessons

Smoking Cessation Program

Health Challenges

Green Day Tracker

Digital Health Content

And more!

THROUGH SHARECARE

Babylon: Next Generation Telehealth

Inform

High quality info on coronavirus

and what to do about it

Consult

Virtual consultations with licensed clinicians when patients need it

Monitor

Digital in-app monitoring with

a care plan for each individual

Refer

Swift transfer to face-to-face and emergency care when it’s needed.

Decide

Support the decision to self isolate with our AI Symptom Checker –

24/7 Live Chat support with coronavirus-trained professionals.

Remote consultations with doctors and health care professionals

A fundamentally different solution, provides a full range of care and follow-up

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Chiropractic and Acupuncture Program

QUALITY, AFFORDABLE COVERAGE WITHOUT NEEDING A REFERRAL

Initial examination, subsequent office visits, re-examination

Acupuncture Care

$20 per visit, up to 24* visits per calendar year

Pain, including low back pain, post-operative pain

Musculoskeletal and related conditions

Carpal tunnel syndrome, headaches, tennis elbow

$50 annual chiro appliance allowance

$20 per visit, up to 24* visits per calendar year

Musculoskeletal and related conditions

Sprain/strain injuries to the spine and extremities

Inflammatory disorders, low pain syndromes

Chiropractic

Care

Musculoskeletal and related conditions

Inflammatory disorders, low pain syndromes

* visit maximums are combined for acupuncture and chiropractic services

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MinuteClinic

GET CARE ON YOUR SCHEDULE

Located inside CVS pharmacies

Walk-in or schedule appointment online

Staffed by nurse practitioners and physician assistants

More than 1,100 locations in 34 states

No authorization/PCP referral needed

Present Health Net ID card at the time of service

Convenient healthcare services

Wellness and preventive care, minor illnesses/injuries, vaccinations

Low or no copayment

Preventive care $0, all other services $20

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Diabetes and Heart Disease Prevention

OMADA: BREAKTHROUGH ONLINE PROGRAM THAT INSPIRES HEALTHY HABITS

Reduces risk

of type 2 diabetes

and heart disease

16-week

online program

(Foundation), 17+ Weeks (Graduates)

Weekly

lessons, weigh-ins,

food/activity trackers

Dedicated

health coach

for support

and motivation

Best-in-class

and clinically supported

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Active&Fit Direct

FITNESS CLUB DISCOUNTS TO HELP YOU STAY HEALTHY AND STRONG

Allow you to choose from 11,000+ participating fitness centers

$25 a month (plus a $25 enrollment fee and applicable taxes)

Gym membership is flexible

You are able to move to different fitness centers

3-month commitment required

Then membership goes month-to-month

Online directory maps and locator for fitness centers

www.activeandfitdirect.com/fitness/healthnet

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Beyond Benefits

Decision power

®

healthy Discounts

Chiropractic, Acupuncture & more

Receive 25% discount on the usual and customary fees from contracted acupuncturists, chiropractors and massage therapists

Weight Management

Lose weight, feel great and save by using our discounted weight management program

Eye Care

Receive discounts on eye exams, frames and lenses at more than 20,000 locations

Hearing Aids

Receive free/low cost on hearing screening/evaluation (depending on vendors). You can get hearing aids and batteries at a discounted price

Health & Wellness Product

Through the ChooseHealthy store, you can buy health and wellness products at a discount price. Members receive free

standard shipping

For complete details, please see “Healthy Discounts” flyer on our website uc.healthnetcalifornia.com/health-wellness/wellness.html

Healthy Discounts Partners

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Contact Page

OUR FOCUS IS YOUR HEALTH

Health Benefit Navigators:1-800-539-4072, Monday through Friday

8:00 a.m. to 8:00 p.m. PTMHN Customer Service team:1-800-663-9355, Monday through Friday8:00 a.m. to 8:00 p.m. PT

Email:

askblue&gold@healthnet.com for a response within 24-48 hours, Mon-Fri

Facebook:

facebook@HealthNetForUCA website just for UC Blue & Gold members!www.healthnet.com/uc

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Thank You