WHAT’S NEW FOR 2023
What You Need to Know
See below for important information about changes effective Jan. 1, 2023.
Introducing Accolade — Your Personal Health Care Advocate
Accolade doesn’t change your medical benefits; it makes them work better for you.
What could be more personal than your health and your experience when you need health care? Yet the health care system can be anything but personal. From finding a doctor or therapist to resolving claims issues, we’re oftentimes left on our own to deal with a complex and confusing system.
That’s why, beginning on Jan. 1, 2023, UC is partnering with Accolade to provide an exceptional level of support to every UC Care, Health Savings Plan and CORE PPO plan member. Accolade doesn’t change your medical benefits; it makes them work better for you.
Accolade is offered exclusively to UC Care, Health Savings Plan and CORE PPO plan members.
You’ll continue to have access to the same Anthem provider network and Anthem will continue to process claims for care. What’s changing is that starting Jan. 1, 2023, Accolade will replace Anthem Health Guide as your first point of contact for help with health benefits questions, big or small. Your experience with Accolade is completely confidential and takes the hassle out of benefits for you and your covered family members. You can ask your Health Assistant or nurse questions like:
- Is this procedure covered by my health insurance? How much will I pay if I get the procedure?
- Where can I find an in-network pharmacy near me? What prescriptions are covered? What will I pay? Can I get this drug through mail order? Can you help me find discount coupons?
- Can you help me find a doctor based on my needs and preferences?
- Where is the nearest urgent care facility?
- Can you help me schedule and prepare for my next doctor’s visit?
- Can I get a second opinion on a diagnosis, possible surgery or treatment plan?
- Can you help me understand the information on my claim or Explanation of Benefits (EOB) from my last doctor visit?
Starting Nov. 1, you can speak directly with Accolade to learn more about the company and how it will support PPO plan members beginning Jan. 1, 2023. You can reach Accolade at (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT).
Accolade’s full services — Health Assistants, Accolade (virtual) Care, and expert medical second opinion services — do not begin until Jan. 1.
Note: Accolade will send a welcome email to your UC email address around Jan. 11. You can change your preferred email address at that time by logging into the Accolade member portal at member.accolade.com. You can also opt-out of Accolade receiving communication at any time by selecting the “unsubscribe” link at the bottom of every email.
Just Ask Accolade
With Accolade, you get a single resource for all your health benefits needs — a care team that takes the hassle out of benefits for you and your covered family members. Accolade’s services are included in your PPO plan benefit at no cost to you. Your Accolade care team:
- Takes the time to listen to your specific needs
- Connects you to benefits that will be most valuable for you
- Makes health care easier with both in-person and virtual care options
- Understands your health plan coverage and can help you avoid unexpected costs
Watch the What Is Accolade video to learn more about services beginning January 2023.
BENEFITS GUIDANCE FROM ACCOLADE HEALTH ASSISTANTS
Accolade helps you get the most out of your PPO plan by connecting you to providers and valuable health programs that make it easier to manage your health care. Health Assistants can answer your questions about finding quality care, understanding health plan coverage and costs, making sense of medical bills and more. Call or message a nurse to discuss symptoms, learn about a condition and explore treatment options.* Getting support from an Accolade Health Assistant or nurse is provided at no cost to you.
VIRTUAL CARE FROM ACCOLADE CARE
With Accolade Care, you can speak with a board-certified doctor or mental health therapist from your phone, tablet or computer — day or night. They can help with urgent medical issues, ongoing and chronic conditions, mental health, preventive care, prescriptions and more. Accolade Care doctors can also be assigned as your primary care physician so that you see the same doctor for each virtual visit — making it easier to manage ongoing conditions and creating a trusting relationship with a doctor and care team who are easy to reach.
EXPERT MEDICAL OPINION FROM 2ND.MD
2nd.MD is Accolade’s expert medical opinion service. Get a second opinion from a leading specialist at no cost so that you feel confident about a new diagnosis, surgery, treatment plan or medication.
Outreach from Accolade
To help ensure a smooth journey through the care experience, Accolade may proactively contact UC PPO plan members to ensure you are doing well and accessing the care you need.
* Accolade and its affiliates (“Accolade”) are not an emergency medical service. Accolade provides a personalized health care information service to support you to better understand and utilize your benefits, receive information from expert medical resources, and facilitate your access to medical care from various health care professionals, including virtual medical care services. Virtual medical care services offered by Accolade are provided through independent professional medical practices, including under the Accolade Care brand, to which Accolade provides various platform and related services.
New ID Cards
To reflect the integration of Accolade into the employee PPO plans, all UC Care, Health Savings Plan, and CORE members will receive a new ID card from Anthem in late December (Anthem will still process claims and produce ID cards). The new ID card will display the Accolade member services number, which will replace the Anthem Health Guide member services number. Accolade will become your first point of contact for all member services and health care questions. Members should be sure to use the new ID card beginning Jan. 1, 2023.
New Infertility Benefits
Get help starting or growing your family. Beginning in 2023, infertility coverage through the UC PPO plans (UC Care, Health Savings Plan and CORE) will be expanded to include IVF, GIFT and ZIFT coverage at 50%, up to a combined two-cycle lifetime maximum limit. Expenses incurred for infertility treatments do not count toward the plans’ out-of-pocket maximum.
The benefit also includes Artificial/Intrauterine Insemination (IUI) Cycles, Assisted Reproductive Technologies (ART), and related services as well as infertility specialty medications. It does not cover expenses for Surrogacy, fees associated with surrogacy, and expenses for procuring donated Oocytes or Sperm.
All infertility services are subject to medical necessity and prior authorization by WINfertility.
Health Savings Plan Updates
Each year, the IRS sets a minimum deductible for Health Savings Account (HSA)-compatible high-deductible plans. As a result, the deductible is increasing:
- The in-network deductible (the amount you pay before the plan pays benefits) is increasing from $1,400 for self-only coverage and $2,800 for family coverage to $1,500 for self-only coverage and $3,000 for family coverage.
- The in-network out-of-pocket maximum (the most you pay in a year for covered services) will remain $4,000 for self-only coverage and $6,400 for family coverage.
Save More in Your Health Savings Account (HSA)
The Health Savings Account — available only to Health Savings Plan members — is a personal savings account that lets you pay for your qualified medical, behavioral health, dental, vision and other health care-related expenses with tax-free dollars.
The amount you can save in the Health Savings Account will increase from $3,650 to $3,850 for self-only coverage — and from $7,300 to $7,750 for family coverage. Health Savings Plan members age 55 and older can contribute an additional $1,000 a year to their HSA.
UC Health to Retain Original Health Plan Branding
Recently, you may have seen communication from University of California (UC) Health introducing UC Vita Health Plans as the new umbrella name for UC Care, UC Health Savings Plan, Core, and UC Blue & Gold HMO.
After further consideration, UC Health has decided to retain its original health plan names and branding. We will continue our increased focus and efforts on improving existing health plans and adding new and valuable tools and resources for plan members and their families. This includes the new partnership with Accolade for the employee and non-Medicare retiree PPO plans administered by Anthem Blue Cross.