The United Mine Workers of America (UMW or UMWA) is a North American labor union best known for representing coal miners. Attorney, Terms of Institutional/UB Claims. Medicare Advantage plans often have dental benefits. Medicare supplement insurance coverage can include: Medicare Prescription Drug coverage (Part D) may cover: 18354 Quantico Gateway Drive If you decide to terminate your other coverage you will need to mail the Funds a copy of the termination letter from your other insurance plan to: Funds Health Call Center Benefits are provided for immunizations, allergy desensitization injections, pap smears, screening for hypertension and diabetes, and examinations for cancer, blindness and deafness and other screening and diagnostic procedures when medically necessary. 1. Take a look at the cost for one year of vision insurance compared with the cost of an eye exam. The Funds also has a network of Durable Medical Equipment (DME) and Hearing Aid providers that must be used for obtaining those services. Although its main focus has always been on workers and their rights, the UMW of today also advocates for better roads, schools . Dental benefits may not be available from UMR through your employer. Beneficiaries are referred to Cooperating Providers and the provider is permitted to inform the general public and Funds beneficiaries that they are a Cooperating Funds Provider in marketing materials approved by the Funds. If you have services from these providers you will incur a higher co-payment responsibility. All Rights Reserved. The dentist search is provided for informational purposes only. endobj Dont delay. Providers should email [emailprotected]for more information. Covered for rental or, where appropriate, purchase when determined to be medically necessary by a physician. Rent-to-cap period of 15 months applies to all rentals. Integrated pharmacy benefit management, and tools to reduce the high cost of specialty drugs. For Americans who purchase their own stand-alone dental coverage, premiums are most commonly in the range of $20 to $50 per month. 1 / 5. Please confirm your provider is in the network once you enroll. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Identity Dental Preferred Provider Organization (PPO) Plan? You may receive a copy of your 2020 Form 1095-B upon request by mailing such request to: UMWA Health & Retirement Funds 2121 K Street, NW Suite 350 Washington DC 20037 You may contact the Funds at (800) 291-1425 with any questions. & Estates, Corporate - Guide, Incorporation **Note the 1993 Benefit Plan and the Prefunded Benefit Plan do not cover preventive care office visits for non-Medicare beneficiaries between the ages of 6 and 55.**. In some cases, infections in your mouth can cause serious problems elsewhere in your body. Select Continue to remain logged in. Expansive network of dental providers. For more efficient service, please have your member ID number handy - you can find it on the front of your card. endobj If the warranty has expired, the Funds will direct you to a network vendor for the repairs. . You will find information on topics including billing, the Funds relationship with Medicare, Funds provider networks, medical management and patient support in the home. CNSI, a leading provider of innovative healthcare technology products and solutions, and Kepro, a leading provider of technology-enabled care management, quality oversight, and clinical assessment services announced an agreement to merge. Union Plus Retiree Health Insurance - UMWA. This helps reduce out-of-pocket costs, so you pay less for the dental care you need. Benefits are available if the medical care is not available near the beneficiarys home and the beneficiary must be taken out of area, or if the beneficiary requires frequent transportation, such as for radiation or physical therapy. In many ways they are: healthy people can go without a dentist or optomologist for a few years. 18354 Quantico Gateway Drive Suite 200 Triangle, VA 22172 703.291.2400. info@umwa.org 2023 United Mine Workers of America. If you have any questions, please contact 1-800-292-2288 Thank you. We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs. Electronic Services Available (EDI) Professional/1500 Claims. bathing, housework, day care). All Rights Reserved. The 15 month Rent-to-Cap period applies to all oxygen equipment rentals. United Concordia is offering members dental plans for the individual; two-party; or family. Trustmark Voluntary Benefits offers Life, Accident, Critical Illness, Disability, and Hospital insurance solutions that help policyholders achieve greater financial security and well-being. Medicare supplement insurance coverage can include: Deductibles Coinsurance Foreign travel Medicare Advantage Plans Medicare Advantage may cover: Most Medicare Part A (hospital coverage) covered services (Hospice will remain covered through Medicare) Medicare Part B (medical insurance coverage) covered services 5 0 obj A UMR Dental plan provides you and your family with coverage for most common dental services, from cleanings to major services such as crowns and bridges. Personal Dental Plan covers preventive care (annual cleanings, X-rays and evaluations) The following plan tiers Personal Dental Plan Basic and Personal Dental Plus add more coverage for minor and major restorative services such as extractions, fillings, denture repairs and oral surgery. For the fortunate ones, wisdom teeth erupt upright, perfectly aligning . Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. For Non-Medicare beneficiaries this is not a covered benefit. Database and Application Analyst. A UMR Dental plan provides you and your family with coverage for most common dental services, from cleanings to major services such as crowns and bridges. Once enrolled, you'll be able to start using your VSP benefits within five days. Some Medicare Advantage plans . Covered if admitted by a licensed physician to a licensed skilled nursing care facility and is medically necessary. Why We Chose It: VSP Vision is our top pick because there are multiple plans with flexible coverage and costs, and because it is the largest provider of vision insurance to the most people. <>stream Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. Step 2: Complete Your Eye Exam. You may contact the Funds at (800) 291-1425 with any questions. endobj After the first 100 Medicare days are exhausted, the Funds will become the primary payer if the level of care is skilled. This is how they make money. If so, and you haven't started receiving your benefits, please contact the Funds' Call Center right away. 3 0 obj EOE. YES. With our platform submitting Umwa Vision Benefits usually takes a couple of minutes. With Davis Vision, you are free to choose any frames available at any participating private practice or retail location. <>stream Nashville, TN 37229, This address change applies to Claim Appeals, Pharmacy Appeals, Precertification and Case Management. Forms, Real Estate Click here to learn more! Please fax address, phone number, and other changes, along with a copy of the W-9 to 214-574-3599. Enhanced coverage for pregnant womenduring their pregnancy and three months following delivery. Your session is about to expire. 4 0 obj LLC, Internet Our veterans are some of the most dedicated and hard working union members and we thank you for your service and commitment! Plus, you save money on gasoline because your medications are delivered directly to your home. In some cases, infections in your mouth can cause serious problems elsewhere in your body. The Funds can cover services in excess of 100 days if the Funds pre-certifies the services as skilled care. The Funds maintains a database of Cooperating Providers that have agreed to not balance bill you. May God Bless each and every one of you and may he bless the United Mine Workers of America. Help mitigate common problems: Gum disease (68%) and dry mouth (30%) are widespread among Americans 65 and older. The United Mine Workers of America Health and Retirement Funds (the Funds) is a group of multi-employer plans that provide health and pension benefits to retired coal miners and their eligible dependents. If you need personalized help over the phone, you can call a licensed insurance agent at 888-680-4770 (TTY users 711) Monday through Friday, 8 am 8 pm Eastern Time. Theft, Personal Meals and lodging may be covered for beneficiary and escort, if prior approved, for out-of-area transports. Handbook, DUI You may go to providers outside the Funds Cooperating Provider Network, but those providers may attempt to balance bill you for amounts in excess of the Funds payments. They handled all the insurance billing and I was very happy with my experience. Its important to keep your provider information up to date. Your doctor can contact our Provider Services department at (888) 865-5290, if they have any questions. When comparing dental plans, be sure to compare not only price but the benefits you're receiving too. Medicare beneficiaries have a chiropractic benefit through Medicare. Dental benefits may not be available from UMR through your employer. Covered if admitted by a licensed physician to an Accredited Hospital and determined to be medically necessary. All Rights Reserved. Many union members and retirees with original Medicare (Part A and Part B) coverage are looking for additional insurance to help limit out-of-pocket costs. Execute Umwa Vision Benefits in just a couple of moments following the recommendations listed below: Choose the template you want in the collection of legal form samples. Dont allow American workers to face any https://t.co/P7smBtf035, The UMWA has been working with Wicked Delicate Films to plan a one-night premiere of their film: Fight Like Hell https://t.co/4UmqKOfV2o. PO Box 2320 Yes. Members Contact: (888) 982-4748 Claims Questions: (877) 813-6366 Registration and Technical Issues: (800) 638-0968 Electronic Claims Submission: EDI Payor ID 31172 Paper Claims Submission: WTC Claims Administration, PO Box 11064, Charleston, WV 25339 Self Service Tools Provider Registration I need my username Password not working Unlock my account All DME and Medical Supplies require a Certificate of Medical Necessity (CMN) to be completed by the physician. Choose your field to get started: Medical, Dental or Behavioral. Dental network customer service. Access the most extensive library of templates available. login.cignaResources.newsTitle . If you go to a hospital, a skilled nursing facility, or have home health care, these providers must bill Medicare Part A for all services and then bill the Funds plan as the secondary payer. When you have vision care insurance, you send the vision insurer a check for your premium for individual plans or have the premium deducted from your paycheck for employer-sponsored plans. The Funds will pay the Part A coinsurance during that time. Take a look at the cost for one year of vision insurance compared with the cost of an eye exam. West Virginia Public Employees Insurance Agency Benefitting People Who Serve Members Active Members Non-Medicare Retiree Medicare Retiree Health Plans PPB Plans A, B & D PPB Plan C The Health Plan Medicare Advantage Plan Partners Benefit Coordinators Health Care Providers UMR Express Scripts Mountaineer Flexible Benefits MetLife Humana iSelectMD Guarantees that a business meets BBB accreditation standards in the US and Canada. More savings when you stay in-network 1. United Mine Workers of America. Learn about our Cash Deferred Savings Plans and the Funds. Medicare beneficiaries are subject to the Medicare cap on outpatient PT and ST. Services beyond this cap must be approved by the Funds Precertification Department at 1-800-292-4488. Main Administration Number: (202) 521-2201. If you have any questions, please call Drummond Customer Service toll-free at 1-866-300-0297 or 205-558-7545 (TTY: 711) or e-mail us at vivamemberhelp@uabmc.edu. Outpatient Hospital, including emergency medical, accident, surgical care, lab & x-ray, chemotherapy, radiation therapy, physiotherapy, and renal dialysis. Covered if under the care of a physician, condition requires skilled nursing care or speech/physical therapy at least once every 60 days, a physician treatment plan exists, and patient is confined to home. The Funds will also periodically ask you to submit updated information about your other insurance coverage. you should present only your Funds ID card to those providers because the Funds is your Medicare Part B payer. It has now been removed from the provider manuals . Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. This is the official Facebook Fan page of the United Mine Workers of America International Union. Qualifying for COBRA 1-866-876-2791. 1 0 obj Business. The Funds plan is your Medicare Part B plan and will pay your doctors bills and other non-hospital charges. Lenses will not be covered unless the new prescription differs from the most recent one by an axis change of 20 degrees or .50 diopter sphere or cylinder change and the lenses must improve visual acuity by at least one line on the standard chart. Hearing aids must, however, be ordered through one of the Funds Network Hearing Aid vendors and must be approved by the Funds Prior Authorization Department (800-292-2288). Medical Claims Processing, Insurance Claims. Your location, age deductible . 3)e "8RCB@
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Ln$`2Q0 Secondary Claims. I'm not familiar with UMWA health insurance, but most private carriers expect providers to bill Medicare first. Using the pharmacy mail service program saves your Funds' money too. are not covered. UMWA 1993 Benefit Plan; Prefunded Benefit Plan; The Cash Deferred Savings Plan of 1988; Combined Benefit Fund; UMWA 1992 Benefit Plan; Contact Us; Billing & Claims. Alternate forms of transportation for scheduled trips (i.e. endstream
And, you'll have 60% coverage for orthodontic services, up to a lifetime maximum of $1,500. Click here to learn more! If you are planning to have elective surgery, the following should be pre-certified: Organ transplants, intestinal or gastric bypass for obesity, cerebellar and dorsal stimulator implants, insertion of a prosthesis for cleft palate, plastic surgery including mammoplasty, and reduction mammoplasty. Viva Health is a Member of the UAB Health System. )/Keywords(fY\)\b+"kYyph[%\)eWK)/SourceModified(fY\)\b+"k#x">^ E`:L)/Subject(fY\)\b+"kYyph[%\)eWK)/Title(fY\)\b+"kB%}?v [py\t\r'?jBeX5.6-_g`cp\f+%i)>> To determine whether any other party or insurance carrier may have responsibility to pay for medical treatment, . See your benefit plan documents for all of the coverage details. For Medicare covered beneficiaries, Medicare is the primary payer and Medicare Part A must approve these services. When this happens, the Funds will protect you from paying these amounts, but keep in mind that the providers may indicate an unpaid balance on your credit report. Get access to thousands of forms. Are you eligible for Medicare? Eligibility: Group Health, Life, and Dental: Regular non-instructional employees who work a minimum of 30 hours per week are eligible for enrollment in these insurance plans; instructional staff members hired to teach the equivalent of 12 undergraduate hours or 9 graduate hours a semester for the full academic year are also eligible for insurance enrollment. USLegal received the following as compared to 9 other form sites. Did you know? Navy Federal is the largest natural member (or retail) credit union in the United States, both in asset size and in membership. Medicare does not cover spinal manipulation. All Rights Reserved. Must be a Medicare approved Skilled Nursing Facility and must have a qualifying hospital stay prior to admission. <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page/Parent 22 0 R>> See Vision fee schedule for reimbursement amounts. Dental Insurance Plans | Humana Individual and family dental insurance plans From budget-friendly monthly premiums to low office-visit copays, Humana has a dental plan that is sure to fit your needs. You will receive a $130 allowance toward the cost of the frame. We work closely with brokers and clients to deliver custom benefits solutions. There are several factors that need to be considered to make that determination. You enjoy extra savings when you see a network provider. Click here for weekly coal production updates. Home health visits to assist with activities of daily living (bathing, feeding, and house cleaning, etc.) Complete all of the requested boxes (they are yellowish). 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