MEDICAL
The name of the medical Network that will replace the Cigna PPO Network
What is “UnitedHealthcare Choice Plus Network.”
The name of the new dental network
The full name of the new dental network is the “Dental Benefit Providers – National Options PPO 30”.
There is a Drug Pricing Tool available
True, OptumRx Drug Pricing Tool is available on the USHEALTHGroup.com website at https://www.ushealthgroup.com/member-services/
Members need to tell their existing Providers there will be a change
No. Members do not need to make any special notification to their existing providers, other than to show them their new ID Cards when they go in for treatment.
Current total Vanilla Soft Result Codes
38
The network transition is applicable in all states
No. NC, SC, CO, and PA will remain on the existing Cigna PPO Network until further notice. This applies to both new business and current in-force business. All other states will have access to the new networks
Members with the DenteMax or Careington dental network will be converted to the Dental Benefit Providers - National Options PPO 30 dental network
No. All members that originally selected the DenteMax or Careington dental networks will not be converted to the Dental Benefit Providers - National Options PPO 30 dental network. Those Members will continue to have access to their existing DenteMax or Careington network.
The OptumRx be available on all plans
In approved states, the OptumRx network will be available on all plans with Rx benefits. Except NC, SC, CO, and PA
The name of the new Vision PPO Network
The name of the new UnitedHealthcare Vision PPO network is the “Spectera Eyecare Network”.
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The UnitedHealthcare Choice Plus Network is available on all plans
The UnitedHealthcare Choice Plus Network is available for PremierChoice, SecureAdvantage, PremierMed and legacy major medical plans. HealthAccess and SecureAccess will remain on the PHCS Limited Benefit Plan network
The Members need to make a special notification to their existing Providers
False. Your Members do not need to make any special notification to their existing providers other than to show them their new ID Cards when they go in for treatment.
The network transition is applicable in all states
False, NC, SC, CO, and PA will remain on the CVS / Caremark Rx network until further notice. This applies to both new business and current in-force business. All other states will have access to the new network.
Members need to send in a claim, they send that information to the same address
No. Claims for the Spectera Eyecare Network will be sent to a different address. Members should always send claims to the address on the back of their ID card.
Vision: Members will have access to LASIK discounts
Yes. As part of the Spectera Eyecare Network, Members will have access to save up to 35% off the national average price of laser vision correction at more than 1,000 QualSight LASIK locations nationwide.
The Member’s premium increases because of the move to the UnitedHealthcare Choice Plus Network
No. Your Member’s premium will not change as a result of changing to the UnitedHealthcare Choice Plus Network.
The solution for new applicants when there are not many Providers in the Dental Benefit Providers - National Options PPO 30 dental network in the area.
When entering an application, EZ-App will show you the dental networks available in your area.
Members will receive at the transition from the CVS / Caremark Network to the OptumRx Network
Approximately one week before the 10/1/2020 transition date for Members in approved states, we will send a follow-up letter that includes the Members new ID Cards and Frequently Asked Questions. The new ID Cards will have OptumRx information.
Their more Providers on the Spectera Eyecare Network compared to the EyeMed Insight Network
The Spectera Eyecare Network is considered one of the larger provider networks in the country. There may be some regional differences, but overall, your Members should expect similar Provider options.
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The repriced claims discounts are better on the UnitedHealthcare Choice Plus Network
The UnitedHealthcare Choice Plus Network is considered one of the most well-managed networks in the country. Overall, we expect to see similar or better network discounts, but individual provider discounts may vary
A Member does not want to move to the Dental Benefit Providers - National Options PPO 30 dental network after the 10/1/2020 transition date. Can they remain on the Cigna Dental Network?
No. On 10/1/2020, all existing Members in approved states accessing the Cigna Dental Network will be transitioned to the Dental Benefit Providers - National Options PPO 30 dental network. For those Members, there will not be an option to remain on the Cigna Dental Network. All Members in NC, SC, CO and PA will remain on the existing networks.
The name of the new Prescription Drug Network
“OptumRx”
The Vision Brochure remains the same as a result of offering the new Spectera Eyecare Network
False. The vision brochure has specific language that applies to the vision network. Since we are changing our vision products from the EyeMed Insight Network to the Spectera Eyecare Network, the brochure will have some changes.
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