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Unicare Medicare Plans

UniCare is a subsidiary of WellPoint, one of the nation's largest health benefits company. In past years, UniCare offered Private Fee for Service (PFFS) Medicare Advantage plans. While PFFS programs offered the most flexibility within Medicare Advantage plans, since the selection of doctors is wider and the benefits covered are quite extensive, in 2009/2010, many providers stopped offering these plans. Unicare will continue to offer a very limited market of PFFS policies under the name of Smart Value in limited counties in the following states:

• Colorado
• Connecticut
• Indiana
• Kentucky
• Maine
• Missouri
• Nevada
• New Hampshire
• Virginia
• Wisconsin

Currently, Unicare, under the name of Anthem, provides Medicare Advantage policies as a Preferred Provider Organization (PPO), within the following states:

• Indiana
• Kentucky
• Missouri
• Nevada
• Ohio
• Virginia
• Wisconsin

Plan Benefits

The Anthem PPO Medicare Advantage plan benefits include:

• Using any doctor within the Anthem network.
• For an additional fee, doctors outside of the Anthem network may be used.
• As with any PPO, the health providers in the network can change at any time.
• Anthem Medicare Preferred Standard (PPO) and Anthem Medicare Preferred Select (PPO) do cover both Medicare Part B prescription drugs and Medicare Part D prescription drugs.*
• Dental services have been provided in the past, but it is unknown if this benefit will continue to be provided after 2011.
• No referrals are required for in-network providers

Plan Details

The Anthem PPO Plans, like other Medicare Advantage Plans, allow for all the basics of traditional Medicare coverage and then some. 'Extras' include:

• No prior hospital stay required for stays within a Skilled Nursing Facility, Plan covers up to 100 days each benefit period

• Coverage for podiatry and chiropractic services which are not covered by traditional Medicare.
• Limited routine care coverage for vision and hearing, not normally covered by traditional Medicare.

Plan Costs

The monthly premium is $19. 30 - $28 in addition to the normal Medicare monthly premium.

• The co-pays required for nursing homes are:Days 1 - 20: $0 co-pay per day; Days 21 - 100: $115 co-pay per day

• Copayments of $10 - $100 for in-network services;
• Prescription Drug Coverage Premium of $38
• An average annual estimated cost of $3,950, compared to $3,150 for traditional Medicare, which does not include prescription drug coverage.