Medicare-eligible individuals have multiple opportunities to enroll in the most appropriate plan to meet their needs.
We’ve prepared a Provider Bulletin to help explain the following enrollment periods:
In this edition, read about changes for PCA and HCN services billed to members under age 65, new product names, 2019 Opioid Edits, enhanced prior authorization DME/Supply form, and documentation improvement for MI.
This bulletin provides a summary of the UCare pharmacy formulary changes taking effect Jan. 1, 2019. Plan names have changed for 2019 for Medicare plans and Individual & Family plans.
UCare's 2019 authorization and notification requirements are now available on our website at ucare.org/providers, under the Eligibility & Authorization section: State and Public programs, UCare Medicare Pans, EssentiaCare, Behavioral Health and Pharmacy.
During 2019, UCare will temporarily suspend the requirement for prior authorizations for services delivered to members with UCare Choices and Fairview UCare Choices (renamed as UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview in 2019).
Effective January 1, 2019, UCare will make changes that affect claims submission for only UCare Choices and Fairview UCare Choices plans (to be renamed UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview on January 1, 2019).
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