2. When you get your maintenance drugs through the Funds pharmacy mail service you will pay a lower co-payment than at retail pharmacies and receive a 90-day supply of your medications. Your insurance company might pay anywhere from 60 to 80% of the cost for these services, with you covering the rest of the cost. O4 Text Component. Your doctor can contact our Provider Services department at (888) 865-5290, if they have any questions. 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. Learn how good dental health contributes to better overall health (PDF). Double-check the entire document to make certain you have completed all the information and no changes are needed. If routine exams are all you need, the cost of insurance might not be worth it. Providers will find it beneficial to become a Cooperating Funds Provider. Call us for support with your dental benefits. Alternate forms of transportation for scheduled trips (i.e. Covered when prescribed by a physician and is medically necessary. Close this box to continue working. Basic dental care includes office visits, extractions, fillings, periodontal treatment (gum disease), and root canals. Access the most extensive library of templates available. Preventive care services are covered at little or no cost to you. But if you're paying a lower percentage of the costs, you may have a high-dollar copay. In some cases, infections in your mouth can cause serious problems elsewhere in your body. Call Fast. 296 talking about this. document.write(new Date().getFullYear()) United HealthCare Services, Inc. Enjoy smart fillable fields and interactivity. Save when you stay in-network. Dental insurance premiums ranged from less than $10 per month to more than $80 per month in our review of quotes across the largest dental insurance companies. Our Mission is to strengthen our communities by improving the health of all our neighbors. 222 West Las Colinas Boulevard Suite 500N Irving, Texas 75039 214.574.3546 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. 1 / 5. 1993/Pre-Funded Plans Age limit does not apply to Medicare eligible beneficiaries. The United Mine Workers of America (UMW or UMWA) is a North American labor union best known for representing coal miners. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. Get access to thousands of forms. If you do need corrective lenses in addition to preventive care, you're probably better off with the insurance. **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.**. Subject to prior approval, coverage is provided for medically necessary skilled nursing care in a skilled nursing care facility. It is truly an honor to serve you, and we will continue to work to keep your trust and pursue the goals of the UMWA. LLC, Internet Warning: usage of this Web site requires acceptance of our Site Usage Agreement. k%+fm0HsYr The Funds also has a network of Durable Medical Equipment (DME) and Hearing Aid providers that must be used for obtaining those services. Unauthorized usage or access will be prosecuted to the maximum extent under the law. 18354 Quantico Gateway Drive Technology, Power of All Rights Reserved. Our Help Desk can be reached at 1-800-638-0968 between the hours of 8:00 am and 5:00 pm Eastern Time, Monday - Friday. Dental network customer service. Medicare Advantage plans often have dental benefits. Wisdom teeth are the third set of human molars that typically emerge during the college years, between the ages of 17 to 25. We are committed to providing the best care for our members and the best provider services, including expedited claims turnaround times. United Mine Workers of America. Although the Funds plan does not cover these services, Medicare does cover some chiropractic services. Annual Premiums: Individual - $762; Two-Party - $1,410; Family - $2,139. Online provider access to member health benefits and claims information With our growing provider base, members have better access to the best care available. to process the proper billing information in a timely . Nursing home stays for custodial care (personal care, feeding, toileting, etc.) Using the pharmacy mail service program saves your Funds' money too. They have several individual dental insurance plan options starting at $19 per month per person. Copyright 2023 UMHA H & R Funds. Get answers to you vaccination and testing questions. 18354 Quantico Gateway Drive Suite 200 Triangle, VA 22172 703.291.2400. info@umwa.org 2023 United Mine Workers of America. Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. If in excess of guidelines, claims will suspend for medical review. Health Services Cardholder Section (This is the only section to be filled out by the patient) Patients Name (Last, First, Middle. "I urge Congress to take the necessary steps to quickly pass the PRO Act. Find a health care professional in your patients' network. She has a very sweet personality and her staff is very nice too! Choose the Get form key to open it and begin editing. endstream 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. 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. &Sm`V=%~ Click here to learn more! 1-866-876-2791. Medical Claims Processing, Insurance Claims. 3 0 obj Covered as a limited benefit. Learn More Mission driven to improve lives through healthcare quality and clinical expertise 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. Complete and partial dentures once per 5 years, plus repairs and adjustments. Privacy Policy. UMR is a UnitedHealthcare company. Listed on 2023-02-27. 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 As John L. Lewis once said, we derive our strength from the membership of the United Mine Workers of America. When comparing dental plans, be sure to compare not only price but the benefits you're receiving too. Choose your field to get started: Medical, Dental or Behavioral. 1. Privacy Policy, Most Medicare Part A (hospital coverage) covered services (Hospice will remain covered through Medicare), Medicare Part B (medical insurance coverage) covered services, Medicare Part D Prescription drug coverage, Generally does not cover over-the-counter medications. Although its main focus has always been on workers and their rights, the UMW of today also advocates for better roads, schools . PO Box 2320 3. The beneficiary will be responsible for any copayments or coinsurance due after the Medicare Part B payment is made. Attorney, Terms of We work closely with brokers and clients to deliver custom benefits solutions. Forms, Real Estate 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. UMWA H&R Funds Vision Care Program for the 1993 Benefit Plan A. To pre-certify, the facility should call our Precertification Department at 1-800-292-2288. VSP strong arms the eye doctors to purchase the above brands from them by promising to drive patients to those "in network" eye doctors. Best Dental Insurance Companies of 2023 Best Overall: Cigna Runner-Up, Best Overall: Renaissance Dental Best for No Waiting Periods: Spirit Dental Best Value: Humana Dental Insurance Best. c.111M and 956 CMR 5.00. You will find information on topics including billing, the Funds relationship with Medicare, Funds provider networks, medical management and patient support in the home. Please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. Dental Preferred Provider Organization (PPO) Plan? 2 0 obj 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. YES. Covered if admitted by a licensed physician to a licensed skilled nursing care facility and is medically necessary. That is your decision to make. UMWA Health and Retirement Funds Washington, DC 4 months ago 188 applicants 188 applicants Step 2: Complete Your Eye Exam. Covered if admitted by a licensed physician to an Accredited Hospital and determined to be medically necessary. It has now been removed from the provider manuals . Coverage is provided for immunizations, screenings for high blood pressure, diabetes, and other conditions, and for medically necessary tests to detect cancer, blindness, and deafness. 8 [sfHD%0y <>stream services, For Small All Rights Reserved. Job Type: Full-time. Sunglasses, designer frames, scratch-resistant lenses, and tinting are not covered. Effective Date: 01/01/2021 Any deductibles, copays, and coinsurance percentages shown are amounts for which you're responsible. If dental was included with the medical plan offered by your employer, you must elect to continue the entire plan. Rent-to-cap period of 15 months applies to all rentals. The Funds requires that you enroll in Medicare Part B, and keep your Part B, to qualify for or to maintain your Funds Health Services Card. And, you'll have 60% coverage for orthodontic services, up to a lifetime maximum of $1,500. Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. Business. Trustmark Voluntary Benefits offers Life, Accident, Critical Illness, Disability, and Hospital insurance solutions that help policyholders achieve greater financial security and well-being. Main Administration Number: (202) 521-2201. You may contact the Funds at (800) 291-1425 with any questions. But in the long term, the benefits of a dental or vision plan may pay off. Learn about our Cash Deferred Savings Plans and the Funds. 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. 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. Routine physical examinations are covered for: Newborns and children up to age 6, age 55 and over, existing medical condition and being treated by physician, undergoing annual or semi-annual exam by gynecologist, or undergoing routine exam prescribed by a specialist as part of such specialists care of a medical condition. jq Kio!~iA4",Is[p;j&ys XBO>-p{^-Oy7JA&Eol-p6*u0UOBBP:rRHRJRb|IBL?W5wWg.2L'k.ny1$4W-ax%5 Ln$`2Q0 Network dentists agree to discount their services for our members up to 35% on average. The Funds was created in the White House in 1946 in a contract between the United Mine Workers of America (UMWA) and the Federal Government. endobj Provider Services Claims: (888) 865-5290. Step 4: Get an Eye Exam Annually. If so, and you haven't started receiving your benefits, please contact the Funds' Call Center right away. Please fax address, phone number, and other changes, along with a copy of the W-9 to 214-574-3599. Until it is confirmed that you are in the Funds Medicare Part B plan, your doctors should continue to bill Medicare Part B for all services. 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. 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. Outpatient Hospital, including emergency medical, accident, surgical care, lab & x-ray, chemotherapy, radiation therapy, physiotherapy, and renal dialysis. 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. My Account, Forms in No paperwork; in- or out-of-network dentists who submit your claims. For Non-Medicare beneficiaries this is not a covered benefit. 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. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. The revised estimates include the most recent MSHA data available as of the release date of the table. An escort may also be covered if the attending supplies satisfactory evidence to support the need. Help mitigate common problems: Gum disease (68%) and dry mouth (30%) are widespread among Americans 65 and older. Professional Institutional Dental: WMI004: Western Mutual Insurance/TPA_Beech: Direct Payor: Professional Institutional Dental: 37247: Western Mutual Insurance/WMI-TPA . Health aides EIA original estimates and revised umwa dental insurance become the primary payer only price but the benefits you & x27!: Western Mutual Insurance/TPA_Beech: Direct Payor: professional Institutional dental: 37247: Western Mutual Insurance/WMI-TPA a,. Plans, be sure to compare not only price but the benefits of dental... Ask you to submit updated information about your other insurance coverage ( 888 ) 865-5290 maximum allowable $. 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Best value to prior approval, coverage is provided for medically necessary with payment limitations -! Right away 2023 United Mine Workers of America: usage of this Web site acceptance.