2020-2021 Premier Plan Changes & Introducing Voluntary Dental Insurance
Out of Pocket Expense Reduced, Effective August 15
Students’ Out of Pocket (OOP) Maximum for In-network Premier Plan benefits has been decreased from $5000 to $3000 per member not to exceed $6,000 per family. In addition, the OOP for out-of-network benefits has been decreased from $12,500 per member to $8,000 per member.
Cost of Adding Multiple Dependents Reduced, Effective August 15
The cost for a student plus more than on child has decreased from the “Student rate X 3” to the “Student rate X 2“. In addition, the cost for a student plus family has decreased from the “Student rate X 4” to the “Student rate X 3”.
Medical and Behavioral Telehealth Service Consolidated, Effective August 15
Healthiestyou behaviorial telehealth services will replace Betterhelp, thus allowing the telehealth services for medical and mental health to be consolidated under one company. There will be no out-of-pocket cost when Premier Plan members access Healthiestyou services. Effective August 15, go to Telehealth4students.com to register with Healthiestyou. (Note: Telehealth4students.com will be included on your new ID card.)
You will need to find a new provider if your Betterhelp provider isn’t also a Healthiestyou provider, so check with your provider. Students currently using Betterhelp will have a 45 day extension of service to find a new Healthiestyou provider. After September 29, Betterhelp will charge $200/month for services. Also, if you are insured under the 19-20 Premier Plan, expect to receive an email from United Healthcare StudentResources about transitioning to Healthiestyou.
Payment of Out-of-Network Claims Expedited
If you have paid for out-of-network care, Premier Plan insurance reimbursement can be expedited by submitting claims through the new United Healthcare StudentResources (UHCSR) claims portal. Details are on our Claims Process web page.
Prior Authorization for Specific Prescriptions Introduced, Effective August 15
Prior-authorization for purchasing specific medications has become an industry standard and is required under the Premier Plan, effective August 15. Students insured under the 19-20 Premier Plan, who are currently taking medications that require prior-authorization…approximately 11% of all prescribed medications, will be sent an email from United Healthcare StudentResources. If you receive correspondence about Prior Authorization, you will need to consult your doctor to determine if other medication would be appropriate. Otherwise, Prior Authorization must be obtained to continue taking that specific medication. Prescribers have access to United’s Prior Authorization tools to ensure that the right medication, dose, and duration is dispensed for each member.
Your doctor may submit information for a Prior Authorization by visiting:
- www.uhcprovider.com and clicking on the Prior Authorization…purple tile
- www.uhcprovder.com and accessing the provider’s LINK account, or
- https://professionals.optumrx.com/rior-authorization.html as an out-of-network provider
Members may access the RX Drug List on UHCSR’s website to identify what medications require Prior Authorization (PA).
New Voluntary Delta Dental Insurance Plan Offering, Effective October 1
A new national Delta Dental Student Insurance Plan is being offered to students and the Basix discount network will be sunset. This voluntary Delta Dental Student Insurance Plan is independent from the Premier Plan. Coverage begins October 1, 2020 through September 30, 2021. The premium the annual plan will be added to your student account.
If you miss the Open Enrollment period for the dental plan in the Fall, you will have an opportunity to enroll again during the Spring for coverage beginning February 1, 2021 through September 30, 2021. To enroll, complete the Fall application for annual coverage by August 31. Emails will be sent to students this summer about this offering.