Benefit changes coming in 2023 for UAW Retiree Medical Benefits Trust members

Starting Jan. 1, 2023, there will be several changes to the UAW Retiree Medical Benefits Trust members’ health plan benefits. A summary of those changes is included below.

For BCN HMO and BCN Advantage℠:

Benefit changes

• Members will be allowed unlimited, in-network skilled nursing facility, or SNF, days.

For Enhanced Care Plan (ECP) and Traditional Care Network (TCN) plans:

Cost share changes

• The in-network deductible is reduced to $325 for individuals and $600 for families.
• The in-network out-of-pocket maximum is reduced to $650 for individuals and $1,325 for families.

Note: This change excludes Ford Protected members as the current in-network deductible and out-of-pocket maximum is $0.

Benefit changes

• Skilled nursing facility, or SNF, benefit
• Members will be allowed unlimited SNF days.
• Inpatient hospital admissions and home health care
• Members will be allowed unlimited days for inpatient hospital admissions, and
• Unlimited visits for home health care
• Hospice day maximum will now follow Medicare’s guidelines. Members are allowed two 90-day benefit periods followed by unlimited 60-day benefit periods.
• Cardiac rehabilitation, pulmonary rehabilitation and respiratory rehabilitation are covered at 100% of the in-network allowed amount.
• All in-network and out-of-network outpatient behavioral health visits are covered at 100% of the allowed amount. Services rendered by nonparticipating providers aren’t covered.

For Medicare Plus Blue PPO:

Cost share changes

• The in-network deductible is reduced to $150.
• The in-network out-of-pocket maximum is reduced to $500.

Note: This change excludes Protected plans as the current in-network deductible and out-of-pocket maximum is $0.

Benefit changes

(Protected plans are not subject to cost share. Therefore, they’re excluded from the following cost share changes. All other benefit changes apply unless otherwise stated.)

• This plan is now a Medicare Advantage Prescription Drug Plan, effective Jan. 1, 2023. Members will have prescription drug coverage through Blue Cross Blue Shield of Michigan (Optum Rx).
• In-network medical drugs (Part B)
• Outpatient — Subject to 10% coinsurance after deductible
• Office — Subject to $10 primary care provider copay and $20 specialist copay
• Home — Covered at 100% of the allowed amount and follows the home health care benefit
• Skilled nursing facility, or SNF, benefit
• Members will be allowed unlimited SNF days.
• Days 1-20 are subject to in-network deductible, then services are covered at 100% of the allowed amount. Days 21 and over are subject to 10% coinsurance.
• Members will be allowed unlimited days for partial hospitalization.
• Allergy testing and treatment
• Allergy testing, therapy and administration services are covered in-network at 100% of the allowed amount.
• Additional professional services provided during the visit are subject to in-network office visit and outpatient care cost share.
• In-network virtual/telehealth visits rendered by a specialist are subject to a $10 copay.
• Blood, blood storage and administration services are covered in-network at 100% of the allowed amount.
• Foot care — podiatry services
• Allows six visits in-network, subject to a $20 copay for General Members and $0 copay for Protected members. These visits are in addition to podiatry services that are covered under the standard Medicare benefit.
• Services related to wigs are covered without diagnosis restrictions.

As always, be sure to check online for benefits and eligibility.