The Best Health Plan for the Best You 2018 Plan Information
New for 2018 No monthly premium contribution for Medicare Advantage plan members Join HAP by calling Retiree Health Care Connect at (866) 637-7555 (TTY: 711).
Dear Trust member: HAP and the United Automobile Workers have a shared history. More than 50 years ago, UAW President Walter Reuther sought an option to traditional health insurance for UAW members. The plan he established became HAP. We carry out his vision by providing high-quality and affordable plans to UAW Trust members. Retirees and their families have chosen HAP for comprehensive health care benefits with affordable out-of-pocket costs. We re proud to be a UAWrepresented nonprofit health plan. Our employees, represented by UAW Local 600 and 1811, are a dedicated team of experts serving fellow union members and their families. Please explore the benefits of HAP membership by reading this brochure. We hope you ll see HAP is the clear choice for UAW Trust retirees. We strive to be the best health plan provider in Michigan. We want you to have the best coverage, the best doctors and hospitals and the best customer service all so you can enjoy the best health possible. Ready to enroll? Join HAP by calling Retiree Health Care Connect at (866) 637-7555 (TTY: 711). If you have questions about HAP, contact HAP Customer Service at one of the following numbers: HAP HMO (non-medicare): (800) 422-4641 (TTY: 711) April 1 through Sept. 30: Monday through Friday from 8 a.m. to 7 p.m. Oct. 1 through March 31: Monday through Friday from 8 a.m. to 7 p.m. and Saturday from 8 a.m. to noon. HAP Senior Plus HMO (Medicare Advantage): (800) 801-1770 (TTY: 711) April 1 through Sept. 30: Monday through Friday from 8 a.m. to 8 p.m. Oct. 1 through Feb. 14: Seven days a week, 8 a.m. to 8 p.m. Feb. 15 through March 31: Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to noon. In solidarity, HAP Trust Team 1
The HAP Difference
Why HAP is the best health plan for the best you No monthly premium contribution for Medicare Advantage plan members No coinsurance so you always know your out-of-pocket costs Unlimited office visits and coverage for routine and specialty care Low deductible and copays Large service area and vast network of leading doctors, specialists and health systems Identity theft protection Emergency travel assistance Care coordination for support when you re dealing with multiple health issues Customer service representatives in Detroit and Flint HAP UAW Trust member service area Iosco Arenac Huron Bay Tuscola Sanilac Saginaw Shiawassee Genesee Lapeer St. Clair Livingston Oakland Macomb Washtenaw Wayne Monroe 3
Compare HAP to the Traditional Trust plan Deductible 1 HAP HMO $400 per person $675 per family Traditional care network (in network) $400 per person $675 per family Coinsurance 2 None 10% Unlimited office visits 3 Unlimited specialist office visits 3 Preventive services 3 Eye and hearing exams 3 Weight Watchers Reduced rate Emergency and urgent care coverage Identity theft protection Assist America global emergency travel assistance Personal service coordinator 1 Deductibles don t apply to protected UAW Trust members. 2 Coinsurance is the amount you pay after you meet your deductible. 3 Minimal copay may apply. See your Summary of Benefits & Coverage. 4
More choice and flexibility HAP is affiliated with leading hospitals in southeast and east central Michigan. With thousands of participating doctors in our network, chances are yours is a HAP doctor. Your doctor. Your choice. You can choose your doctor from thousands of our highly qualified primary care physicians. If you select a PCP in the Henry Ford or Genesys networks, you ll receive specialty care from doctors within that network. This allows all doctors who support your care to work together so you receive the care you need when you need it. If you choose a PCP in our other networks, you can see a specialist in any HAP network. As a HAP Senior Plus (HMO)* member, you ll also choose a PCP. Your PCP may recommend specialty services from a certain specialist or facility, but you can choose to receive the care you need from any HAP Senior Plus contracted specialist. Visit hap.org/doctors to see if your doctor is with HAP. You can see a list of doctors and compare them based on what s important to you. * HAP Senior Plus (HMO) is a health plan with a Medicare contract. Enrollment in the plan depends on contract renewal. 5
Hospital affiliations by county* Bay McLaren Bay Region, Bay City Genesee Genesys Regional Medical Center, Grand Blanc Hurley Medical Center, Flint McLaren Flint, Flint Jackson Henry Ford Allegiance Health, Jackson Lapeer McLaren Lapeer Region, Lapeer Livingston St. Joseph Mercy Livingston Hospital, Howell Macomb Henry Ford Macomb Hospital, Clinton Township McLaren Macomb, Mt. Clemens St. John Macomb-Oakland Hospital, Warren Campus, Warren Monroe ProMedica Monroe Regional Hospital, Monroe Oakland Beaumont Hospital, Farmington Hills Beaumont Hospital, Royal Oak Beaumont Hospital, Troy Crittenton Hospital Medical Center, Rochester DMC Huron Valley-Sinai Hospital, Commerce Township Henry Ford West Bloomfield Hospital, West Bloomfield McLaren Oakland, Pontiac Pontiac General Hospital, Pontiac Providence-Providence Park Hospital, Novi Campus, Novi Providence-Providence Park Hospital, Southfield Campus, Southfield St. John Macomb-Oakland Hospital, Madison Heights Campus, Madison Heights St. Joseph Mercy Oakland, Pontiac Straith Hospital for Special Surgery, Southfield Saginaw Aleda E. Lutz VA Medical Center, Saginaw** Covenant HealthCare, Saginaw St. Mary s of Michigan, Saginaw *For a current list of HAP-affiliated hospitals, call HAP Customer Service at one of the numbers listed in the back of this brochure. 6 **Not available for Medicare Advantage members.
St. Clair Lake Huron Medical Center, Port Huron McLaren Port Huron, Port Huron St. John River District Hospital, East China Township Washtenaw St. Joseph Mercy Ann Arbor Hospital, Ann Arbor St. Joseph Mercy Chelsea Hospital, Chelsea University of Michigan Health System, Ann Arbor VA Ann Arbor Healthcare System** Wayne Beaumont Hospital, Dearborn Beaumont Hospital, Grosse Pointe Beaumont Hospital, Taylor Beaumont Hospital, Trenton Beaumont Hospital, Wayne DMC Children s Hospital of Michigan, Detroit DMC Detroit Receiving Hospital, Detroit DMC Harper University Hospital, Detroit DMC Hutzel Women s Hospital, Detroit DMC Rehabilitation Institute of Michigan, Detroit DMC Sinai-Grace Hospital, Detroit Garden City Hospital, Garden City Henry Ford Hospital, Detroit Henry Ford Wyandotte Hospital, Wyandotte John D. Dingell VA Medical Center, Detroit** Karmanos Cancer Institute, Detroit St. John Hospital and Medical Center, Detroit St. Mary Mercy Livonia, Livonia Other Battle Creek VA Medical Center, Battle Creek** Caro Community Hospital, Caro Deckerville Community Hospital, Deckerville Harbor Beach Community Hospital, Harbor Beach Hills & Dales General Hospital, Cass City Hillsdale Community Health Center, Hillsdale Huron Medical Center, Bad Axe Marlette Regional Hospital, Marlette McKenzie Memorial Hospital, Sandusky Memorial Healthcare, Owosso Mercy Health Children s Hospital, Toledo, Ohio Mercy Health Defiance Hospital, Toledo, Ohio Mercy Health St. Anne Hospital, Toledo, Ohio Mercy Health St. Charles Hospital, Oregon, Ohio Mercy Health St. Vincent Medical Center, Toledo, Ohio MidMichigan Medical Center, Clare MidMichigan Medical Center, Gladwin MidMichigan Medical Center, Midland ProMedica Flower Hospital, Ohio** ProMedica Toledo Children s Hospital, Toledo, Ohio** ProMedica Toledo Hospital, Toledo, Ohio** Scheurer Hospital, Pigeon St. Joseph Health System-Tawas, Tawas City St. Mary s of Michigan-Standish Hospital, Standish West Branch Regional Medical Center, West Branch *For a current list of HAP-affiliated hospitals, call HAP Customer Service at one of the numbers listed in the back of this brochure. **Not available for Medicare Advantage members. 7
We re not your ordinary HMO HAP is different. We ve always promoted prevention and wellness. We offer free and lowcost programs to bring you the best, most experienced HMO plan in Michigan. With HAP, you ll find an easy-to-use health plan with highly qualified doctors and hospitals. HAP s Trust Medicare Advantage HMO Plan Almost 65? As a UAW Trust participant and HAP member, you re automatically eligible to receive coverage through our Senior Plus (HMO) Medicare Advantage plan. To receive your health benefits through HAP s Senior Plus plan, you must enroll in Original Medicare and Parts A (hospital insurance) and B (medical insurance) before the month you turn 65. You ll then automatically be enrolled in our Senior Plus plan. There are no enrollment forms to complete. Hassle-free, paperless referrals With HAP, you can see your HAP dermatologist or allergist without referrals. In fact, with contracted providers, these and many other specialty and ancillary office visits don t require referrals. Here are some of those specialties: Dermatology Cardiology Podiatry Standard X-ray OB-GYN Routine labs Allergy When you need a referral to see a specialist or ancillary provider such as for an MRI or for nonroutine lab tests, we offer a paperless referral process. Your PCP does all the work while you just show up at your appointment. Your referral will already be there. 8
Prior authorization For some procedures, your doctor will need approval from HAP before they ll be covered. This is called prior authorization. It helps ensure a procedure is medically necessary. If a service requires prior authorization, your doctor will take care of it for you. New to Medicare? You re eligible for an introductory Welcome to Medicare preventive visit within the first 12 months you have Part B medical insurance. This includes a review of your medical and social history. It also includes education and counseling about preventive services, including certain screenings, shots and referrals for other care. You pay nothing for the Welcome to Medicare preventive visit. If your doctor or health care provider performs tests or services during the same visit not covered, you may have to pay a copay and deductible. Personalized service Our dedicated Customer Service team will support you every step of the way. If you have questions or need information, you can call Customer Service or you can send secure messages by logging in at hap.org. Your personal service coordinator To make sure our relationship gets off to a healthy start, you ll have your very own personal service coordinator for the first two years of membership. Your coordinator will help answer your health plan and benefit questions, find solutions and guide you. Your coordinator will contact you during your first 45 days as a member to make sure you understand your benefits.
Global emergency travel assistance You can travel worry-free. You ll be able to call Assist America for emergency travel assistance whenever you re more than 100 miles away from home or in another country for no more than 90 days in a row. Assist America will arrange and pay for all the assistance it provides without limits on the covered cost. This is in addition to HAP s worldwide emergency medical coverage. Here are some of the ways Assist America can help: Hospital admission guarantee Emergency trauma counseling Emergency medical evacuation Lost prescription, eyeglasses or luggage help Document translation help and much more Assist America s call center is staffed 24/7. Android and iphone users can download Assist America s mobile app from their app store for a one-touch connection to the call center. Identity theft Our partnership with Assist America also includes free identity theft protection. You get: 24/7 identity fraud support to help you recover your personal information and lost or stolen credit cards and documents Monitoring of credit and debit card usage when you register your cards Emergency care When an emergency arises, you shouldn t have to worry about whether your hospital admission is covered. With HAP, you have 24/7 emergency coverage.* If you think a condition requires emergency care, go to the nearest hospital s emergency room for medical attention or call 911. If you re admitted to a hospital not affiliated with HAP, notify us within 48 hours. Once your condition is stable, you may be transferred to an affiliated hospital. 10 * The emergency and urgent care benefit information provided is a brief summary, not a complete description of benefits. For more information, contact HAP. Benefits, covered prescription medications, pharmacy network, premiums, copays or coinsurance may change on January 1 of each year. Limitations, copays and restrictions may apply.
Urgent care If you have a health condition that doesn t require an emergency room visit, but may require prompt attention such as a sprained ankle, fever or wound that requires stitches you can get care from urgent care facilities in Michigan within HAP s network. If you are outside of HAP s service area, we ll still cover you for urgent or emergency care.* To find an urgent care center near you, visit hap.org or call Customer Service at one of the numbers in the back of this brochure. HAP member discounts HAP members get discounts and extras on health and wellness activities, services, shopping and events. It s one more way HAP helps stretch your health care dollars. You ll find a complete list of discounts at hap.org/member-discounts. Keep your health on track You can enjoy a variety of programs and tools that focus on healthy living, such as eating plans and exercise. When you join HAP, take advantage of programs that include: Each HAP member has access to istrive for Better Health, our digital wellness manager powered by WebMD Health Services. It helps you identify your health status, set goals and track your progress using interactive tools. Weight Watchers Weight Watchers teaches effective methods for losing weight and keeping it off. More than 63,000 HAP members have lost more than 226 tons. istrive for Better Health Get a personalized digital wellness manager and free wellness tools and programs, powered by WebMD Health Services. * The emergency and urgent care benefit information provided is a brief summary, not a complete description of benefits. For more information, contact HAP. Benefits, covered prescription medications, pharmacy network, premiums, copays or coinsurance may change on January 1 of each year. Limitations, copays and restrictions may apply. 11
Health screenings HAP offers periodic screenings that look for diseases before you have symptoms. Screenings can find diseases early, when they re easier to treat, such as colon cancer, breast cancer and bone mineral density. HAP s Restore CareTrack disease management program If you have a chronic condition such as asthma, coronary artery disease or diabetes, HAP offers options to help you manage your condition, including: Working with a nurse health coach over the phone In-home telemedicine monitoring program to help monitor your medications and condition through daily sessions Behavioral health specialists who ll help identify emotional triggers and behavioral conditions that can affect your physical well-being and your ability to follow your treatment plan Medication review to ensure the right medication and dosage is taken at the right time Diabetes prevention To help you manage your diabetes, HAP hosts an annual diabetes health fair. The fair includes a retinal eye screening, blood pressure screening and consultations with health care professionals.
HAP s Restore Case Management program Our Restore Case Management program is free to HAP members. With this program, a registered nurse will work closely with you and your doctor to make sure you receive the care you need when you need it. The nurse will help you: Schedule appointments with specialists and treatment facilities Provide a full understanding of each condition Learn how to manage medications Coordinate home visits with doctors, registered nurses and therapists when needed Make sure you get the medical equipment you need Connect you with community resources that assist with basic everyday needs For more information about HAP s Restore programs or to refer yourself, call us at (313) 664-8324 for Restore Case Management or (800) 288-2908 for Restore CareTrack. For information on benefits for UAW Trust members, visit hap.org/uawrmbt. Or call HAP: HAP Senior Plus (HMO): (800) 801-1770* (TTY: 711) HAP HMO: (800) 422-4641 (TTY: 711) If you re a retiring UAW Chrysler, GM or Ford employee or current UAW Trust member, join HAP by calling Retiree Health Care Connect at (866) 637-7555 (TTY: 711). * Outside of these business hours, you can use our automated system at the same number and leave your name and phone number. A HAP Medicare Customer Service representative will return your phone call the next business day. 13
Health Plans for Everyone Individual Group Medicare Medicaid hap.org hap.org/blog Subsidiaries Alliance Health and Life Insurance Company ASR Health Benefits HAP Midwest Health Plan HAP Preferred Inc. HAP and its subsidiaries do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations. 2017 HAP a nonprofit company 1.5M 1/18 18-019 1150