No, the Funds is your Medicare Part B payer for non-facility providers. This is the official Facebook Fan page of the United Mine Workers of America International Union. Be a part of our Union Veterans Leadership Council! UMWA Health & Retirement Funds "I urge Congress to take the necessary steps to quickly pass the PRO Act. In some cases, infections in your mouth can cause serious problems elsewhere in your body. MassHealth List of EOB Codes Appearing on the Remittance Advice. endobj endstream Jan 1, 2002 Title: Jim Walter Resources, Inc. and United Mine Workers of America 3.1 Formation of Unions; 3.2 United Mine Workers of America; 3.3 Massey Attack Black United Mine Workers of America (hereinafter referred to as the Union) on behalf of Use professional pre-built templates to fill in and sign documents online faster. Theft, Personal 1-877-816-3596. 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. Incontinence supplies, such as adult diapers and chux are covered, limited to 3 boxes per month. . The United Mine Workers of America Health and Retirement Funds Our office hours are . 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 Subrogation support. UMWA Health & Retirement Funds 2121 K Street, NW, Suite 350 Washington, DC 20037 Attn: Hiring Manager/Employee Benefits Attorney EEO/M/F/D/V Job Type: Full-time Benefits: 401 (k) 401 (k) matching Dental insurance Employee assistance program Flexible schedule Flexible spending account Health insurance Life insurance Paid time off Parental leave Dont delay. Main Administration Number: (202) 521-2201. Find a health care professional in your patients' network. Call us for support with your dental benefits. Take a look at the cost for one year of vision insurance compared with the cost of an eye exam. Choose your field to get started: Medical, Dental or Behavioral. Privacy Policy. Yes, the Funds covers routine eye exams, eyeglasses, and contact lenses once every 24 months with payment limitations. Navy Federal Credit Union (or Navy Federal) is a US credit union headquartered in Vienna, Virginia, chartered and regulated under the authority of the National Credit Union Administration (NCUA). Technical Assistance If you have technical questions with regards to the functioning of this website or our Employee, Customer, Provider websites, you may address them via email at support.Information@healthsmart.com. The Funds will pay the Part A coinsurance during that time. The Funds will process these claims as a Medicare benefit at 80% of Medicare allowable. 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. After the first 100 Medicare days are exhausted, the Funds will become the primary payer if the level of care is skilled. UMR is a UnitedHealthcare company. Yes, with a doctors order, skilled nursing care, physical therapy, and speech therapy may be provided by licensed personnel from a certified home health agency. You can use pre-tax dollars to cover important medical and dental needs. Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. Sunglasses, designer frames, scratch-resistant lenses, and tinting are not covered. bNM;8_l}X+O5|:kDx#JPG{%1hx. Triangle, VA 22172, 2023 United Mine Workers of America. You may receive a copy of your 2020 Form 1095-B upon request by mailing such request to: Nursing home stays for custodial care (personal care, feeding, toileting, etc.) Suite 200 The beneficiary will be responsible for any copayments or coinsurance due after the Medicare Part B payment is made. 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. Please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. It has now been removed from the provider manuals . 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. 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. Plus 50% coverage for major restorative dental care, up to a yearly maximum of $500. If you are eligible for Medicare and have elected the Funds as your Medicare Part B payer, the Funds will pay any chiropractic services that are covered by Medicare Part B. Some Medicare Advantage plans . No paperwork; in- or out-of-network dentists who submit your claims. Table 1 summarizes information about the health plans in the 2017 plan year (the most recent information . 3 0 obj Providers should email [emailprotected]for more information. Optional dental coverage of 80% for preventive dental care costs , up to a yearly maximum of $750. Get your online template and fill it in using progressive features. If routine exams are all you need, the cost of insurance might not be worth it. ERA Enrollment Required. 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. 3)e "8RCB@ \ }#6* p]{ wF:]!Y{P>jq Kio!~iA4",Is[p;j&ys XBO>-p{^-Oy7JA&Eol-p6*u0UOBBP:rRHRJRb|IBL?W5wWg.2L'k.ny1$4W-ax%5 Ln$`2Q0 This is a hypothetical look at a year's worth of preventive care only, assuming your insurance pays 100% for vision exams, as many do. hospitals, skilled nursing facilities, home health agencies, etc). You will be redirected to the home page in 60 seconds. Best Dental Insurance of 2023 Best Overall: Renaissance Best For Low Fees: Cigna Best for Immediate Coverage: Spirit Dental and Vision Best for Families: UnitedHealthcare Best for Seniors: Smart Health Dental Best for Singles: Physicians Mutual Best for Orthodontics: Delta Dental Best Value: Guardian Direct Best Overall : Renaissance Get a Quote 100% paid medical insurance; Paid Vacation, Personal and Sick Days; Life Insurance; Pension Plan after 18 months; Member of the UMWA; 11 Paid Holidays; Must pass Child Abuse, FBI and Criminal Background Clearances. Complete all of the requested boxes (they are yellowish). Cigna Dental Insurance. login.cignaResources.findCareTitle . Medicare does not cover spinal manipulation. PO Box 292167 We will then update your information on our website. Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. This is how they make money. They handled all the insurance billing and I was very happy with my experience. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Identity Covered when ordered by attending physician, patient is referred to a designated pulmonary consultant for testing and the consultants report is submitted to the Plan administrator with the order for oxygen. 3. 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. And while most people recognize that medical coverage is necessary, dental and vision plans might seem less essential. For Medicare covered beneficiaries, Medicare is the primary payer and Medicare Part A must approve these services. When comparing dental plans, be sure to compare not only price but the benefits you're receiving too. Copyright 2023 UMHA H & R Funds. Start today at: 1-866-443-9160 to have your prescription drugs transferred. 1. Highest customer reviews on one of the most highly-trusted product review platforms. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. In some cases, infections in your mouth can cause serious problems elsewhere in your body. The Funds will also periodically ask you to submit updated information about your other insurance coverage. The 15 month Rent-to-Cap period applies to all oxygen equipment rentals. Cigna Dental is another major provider that has a long-standing positive reputation for its dental insurance plans. Your location, age deductible . Pay: $18.00 per . Please contact our Customer Service Department at 1-800-687-0500 for more information. Waiting periods may be waived on major services if the member had prior coverage for 12 continuous months. My Account, Forms in If so, and you haven't started receiving your benefits, please contact the Funds' Call Center right away. 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. &Sm`V=%~ Get answers to you vaccination and testing questions. If you are currently using items being supplied by a DME company not in the Funds DME Network you will need to switch to one of our 7 DME Network vendors. Services must be provided by an approved hearing aid vendor who has signed a Hearing Aid Vendor agreement and is on the approved list of 29 providers. document.write(new Date().getFullYear()) United HealthCare Services, Inc. When the beneficiary has reached his or her restoration potential, the services are no longer covered. are not covered. endobj 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. It may provide coverage for other services, such as crowns. VSP strong arms the eye doctors to purchase the above brands from them by promising to drive patients to those "in network" eye doctors. 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). 2. Integrated pharmacy benefit management, and tools to reduce the high cost of specialty drugs. Mountain Community Health (MCH) is a Federally Qualified Health Center, providing a full spectrum of preventative and primary medical and dental care to people of all ages, regardless of insurance or the ability to pay. Services from non-network DME and Hearing Aid providers are not covered. With a focus on prevention, dental insurance typically covers professional services like routine check-ups, cleanings and exams at 100%. Warning: usage of this Web site requires acceptance of our Site Usage Agreement. Medicare beneficiaries have a chiropractic benefit through Medicare. The Funds plan is your Medicare Part B plan and will pay your doctors bills and other non-hospital charges. A specified number of trips at a negotiated rate will be authorized for payment. These providers have a relationship with the Funds and will not balance bill you for services after the Funds payment, except for applicable copayments. Online provider access to member health benefits and claims information With our growing provider base, members have better access to the best care available. The Funds can cover services in excess of 100 days if the Funds pre-certifies the services as skilled care. In addition, people over 65 are more susceptible to oral cancer. You should have received a letter from us with the information we have on record for you. The Associate Membership is a way for a surviving spouse, family member or general supporter of the United Mine Workers to become part of the movement to restore fairness, justice and dignity for working families. I'm not familiar with UMWA health insurance, but most private carriers expect providers to bill Medicare first. If in excess of guidelines, claims will suspend for medical review. Form 1099-R is mailed by the end of January 2021. These are EOB codes, revised for NewMMIS, that may appear on your PDF remittance advice. United Concordia is offering members dental plans for the individual; two-party; or family. All DME and Medical Supplies require a Certificate of Medical Necessity (CMN) to be completed by the physician. Complete all of the requested boxes (they are yellowish). Effective Date: 01/01/2021 Any deductibles, copays, and coinsurance percentages shown are amounts for which you're responsible. TopTenReviews wrote "there is such an extensive range of documents covering so many topics that it is unlikely you would need to look anywhere else". You may contact the Funds at (800) 291-1425 with any questions. See your benefit plan documents for all of the coverage details. login.cignaResources.newsTitle . Learn More Mission driven to improve lives through healthcare quality and clinical expertise For more efficient service, please have your member ID number handy - you can find it on the front of your card. Expansive network of dental providers. Navy Federal is the largest natural member (or retail) credit union in the United States, both in asset size and in membership. Precertification is required through the Funds Transportation Precertification Department at 1-800-292-2288. No, the Funds does not recommend that you enroll in a Medicare Advantage plan. bathing, housework, day care). O4 Text Component. UMWA Associate Membership The Associate Membership is a way for a surviving spouse, family member or general supporter of the United Mine Workers to become part of the movement to restore fairness, justice and dignity for working families. Execute Umwa Vision Benefits in just a couple of moments following the recommendations listed below: Send your new Umwa Vision Benefits in a digital form when you are done with filling it out. 2016 United HealthCare Services, Inc. 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. A healthcare FSA or Flexible Spending Account is a pre-tax account that covers certain medical, dental and vision care expenses that aren't covered by your healthcare plan. Using the pharmacy mail service program saves your Funds' money too. Covered with prior approval from the Plan Administrator if for ambulance transportation to or from a hospital, clinic, medical center, physicians office or skilled nursing care facility, when considered medically necessary by a physician. YES. Ensures that a website is free of malware attacks. 3. Our veterans are some of the most dedicated and hard working union members and we thank you for your service and commitment! 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. All Rights Reserved. Finally, if you work until age 65, you can retiree with medical benefits after working as few as 5 years . Once enrolled, you'll be able to start using your VSP benefits within five days. 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. You don't need a referral to see a specialist. You'd have to pay out-of-pocket. Double-check the entire document to make certain you have completed all the information and no changes are needed. Dental insurance premiums. Precertification is required for days in excess of the 100 day maximum. Electronic Services Available (EDI) Professional/1500 Claims. The Funds maintains a database of Cooperating Providers that have agreed to not balance bill you. You will need to present your Funds health card to your doctor the next time you go to his office. There are plans as low as $10/month, but to have any real coverage for major services, such as crowns and bridges, you should expect to pay at least $35/month. That is your decision to make. Join millions of satisfied users who are already completing legal forms right from their houses. Dental insurance makes dental care more affordable! However, if you already have hearing aids from a non-network vendor and need repairs and the warranty is still in effect, that provider should perform any repairs. Having dental insurance throughout retirement can keep you on the right track with accessibility to routine dental care and procedures to keep your smile healthy. Physicians Services, including surgical care, assistant surgeon, obstetrical/delivery, anesthesia, emergency treatment, lab & x-ray, radiation, chemotherapy, consultations, podiatry, primary care and specialist care. For more than 100 years, we've been building a different kind of benefits company, and going beyond the needs of our customers. Dental benefits may not be available from UMR through your employer. 1993/Pre-Funded Plans Age limit does not apply to Medicare eligible beneficiaries. We work closely with brokers and clients to deliver custom benefits solutions. Beckley, WV 25802. Inpatient Hospital, including semi-private room, intensive or coronary care unit, renal dialysis, mental illness, alcohol/chemical dependency and maternity. Step 3: Use Your Eye Insurance Benefits to Purchase Vision Care Items. Copyright 2023 UMHA H & R Funds. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. If the warranty has expired, the Funds will direct you to a network vendor for the repairs. Electronic Remittance (ERA) YES. Dental benefits may not be available from UMR through your employer. radiologist or laboratory, etc.) For seniors over 65, Medicare insurance doesn't cover dental services, but you can buy a private Medicare Advantage plan with a supplemental plan for dental coverage. Standard Insurance Company Group Dental Insurance Help protect your oral health with regular dental exams and procedures. NOTE: This is only a summary; for detailed information on coverage, please consult your certificate . 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. % 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. More savings when you stay in-network 1. 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 United Mine Workers of America (UMW or UMWA) is a North American labor union best known for representing coal miners. This summary of benefits and coverage shows how you and The Standard would share the cost for covered dental care services. Must be a Medicare approved Skilled Nursing Facility and must have a qualifying hospital stay prior to admission. A popular feature of our online services is our free Online Claim Status service available to providers who are contracted with several of our HealthSmart networks. Funds' Call Center: (800) 291-1425. Please fax address, phone number, and other changes, along with a copy of the W-9 to 214-574-3599. All Rights Reserved. Save when you stay in-network. Original Medicare usually doesn't cover dental care such as cleanings, fillings, tooth extractions, or dentures. 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. Main Administration Number: (202) 521-2201. services, For Small Professional Institutional Dental: 52180: UMWA Health & Retirement Funds: Participating Plus Payor: Professional Institutional Dental: 80314: UNICARE: Participating Payor: . 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. Care management Integrated clinical solutions designed to fit your populations and reduce healthcare costs. Cost of Wisdom Tooth Extraction With Dental Insurance Other Ways To Pay For Wisdom Tooth Removal In areas with typically lower costs, removing four wisdom teeth, including sedation, can range from $1,000 to $1,650. 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. 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. Enhanced coverage for pregnant womenduring their pregnancy and three months following delivery. Triangle, VA 22172, 2023 United Mine Workers of America. Medicare supplement insurance coverage can include: Medicare Prescription Drug coverage (Part D) may cover: 18354 Quantico Gateway Drive Are you eligible for Medicare? Your doctor can contact our Provider Services department at (888) 865-5290, if they have any questions. Medical justification must be provided on a Certificate of Medical Necessity (CMN) for oxygen equipment and supplies to be approved. With Davis Vision, you are free to choose any frames available at any participating private practice or retail location. As John L. Lewis once said, we derive our strength from the membership of the United Mine Workers of America. With a dental plan, you have easy access to the care you need to keep your mouth healthy. 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. Outpatient Hospital, including emergency medical, accident, surgical care, lab & x-ray, chemotherapy, radiation therapy, physiotherapy, and renal dialysis. When you go to a physician or other non-hospital type of provider (i.e. While you are not required to use the providers in this database, these providers have agreed to accept the Funds payment as payment in full, less any applicable copayment you may owe. With a dental plan, you have easy access to the care you need to keep your mouth healthy. The United Mine Workers of America had a thriving and successful 2022, but it was also filled with a lot of struggle and hard work. Get access to thousands of forms. Click here to learn more! Choose the template you want in the collection of legal form samples. Spanish, Localized 2. 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. And, you'll have 60% coverage for orthodontic services, up to a lifetime maximum of $1,500.