umwa dental insurance

UMWA Health and Retirement Funds PO Box 292167 Nashville, TN 37229 This address change applies to Claim Appeals, Pharmacy Appeals, Precertification and Case Management. 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. Durable Medical Equipment (DME) and Supplies. 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. 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. Please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. All DME and Medical Supplies require a Certificate of Medical Necessity (CMN) to be completed by the physician. Main Administration Number: (202) 521-2201. Main Administration Number: (202) 521-2201. All Rights Reserved. Medicare supplement insurance coverage can include: 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. 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 The UMWA provides comprehensive health benefit coverage. Yes, the Funds covers routine eye exams, eyeglasses, and contact lenses once every 24 months with payment limitations. Beckley, WV 25802. 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 0 obj Service, Contact Pharmacy: (800) 294-4741. Alternate forms of transportation for scheduled trips (i.e. Electronic Remittance (ERA) YES. Click here for weekly coal production updates. I'm not familiar with UMWA health insurance, but most private carriers expect providers to bill Medicare first. LLC, Internet As John L. Lewis once said, we derive our strength from the membership of the United Mine Workers of America. Copyright 2023 UMHA H & R Funds. If you are at least age 55 but under age 65 when you last work, you only need 10 years. The Funds has a network of Cooperating Providers that you should use for all medical services. 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. May God Bless each and every one of you and may he bless the United Mine Workers of America. At present, the Funds provides benefits to over 86,000 beneficiaries. Most recent MSHA data available are for the second quarter of 2018. Provider Services Claims: (888) 865-5290. <>stream Members Contact: (888) 982-4748 Claims Questions: (877) 813-6366 Registration and Technical Issues: (800) 638-0968 Electronic Claims Submission: EDI Payor ID 31172 Paper Claims Submission: WTC Claims Administration, PO Box 11064, Charleston, WV 25339 Self Service Tools Provider Registration I need my username Password not working Unlock my account If in excess of guidelines, claims will suspend for medical review. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. 1 0 obj Benefits for necessary repairs and maintenance, except the replacement of batteries, will be provided after the expiration of the warranty period. Us, Delete Current estimates contain both current EIA original estimates and revised estimates. are not covered. Eligibility: Group Health, Life, and Dental: Regular non-instructional employees who work a minimum of 30 hours per week are eligible for enrollment in these insurance plans; instructional staff members hired to teach the equivalent of 12 undergraduate hours or 9 graduate hours a semester for the full academic year are also eligible for insurance enrollment. For more than 100 years, we've been building a different kind of benefits company, and going beyond the needs of our customers. Otherwise,you will be redirected to the home page in 60 seconds. EOE. CNSI, a leading provider of innovative healthcare technology products and solutions, and Kepro, a leading provider of technology-enabled care management, quality oversight, and clinical assessment services announced an agreement to merge. Our veterans are some of the most dedicated and hard working union members and we thank you for your service and commitment! 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. Close this box to continue working. )/Keywords(fY\)\b+"kYyph[%\)eWK)/SourceModified(fY\)\b+"k#x">^ E`:L)/Subject(fY\)\b+"kYyph[%\)eWK)/Title(fY\)\b+"kB%}?v [py\t\r'?jBeX5.6-_g`cp\f+%i)>> If you are Medicare eligible, and have signed up to have the Funds as your Medicare Part B payer and Medicare confirms that transition, your doctors will be required to bill the Funds for all Medicare Part B services, except those furnished by non-facility providers (e.g. You don't need a referral to see a specialist. VSP makes money off of those sales. 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. Calling all veterans! Covered for rental or, where appropriate, purchase when determined to be medically necessary by a physician. 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. Medical Biller REMOTE. & Estates, Corporate - 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. PO Box 2320 In some states, a PPO plan might be your only coverage option. Step 4: Get an Eye Exam Annually. you should present only your Funds ID card to those providers because the Funds is your Medicare Part B payer. Professional Institutional Dental: WMI004: Western Mutual Insurance/TPA_Beech: Direct Payor: Professional Institutional Dental: 37247: Western Mutual Insurance/WMI-TPA . 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. Preventive care services are covered at little or no cost to you. 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. 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. 1. Yes, if you need to schedule a medical appointment but do not have transportation, you may be eligible for non-emergency transportation benefits. See Vision fee schedule for reimbursement amounts. The beneficiary will be responsible for any copayments or coinsurance due after the Medicare Part B payment is made. If routine exams are all you need, the cost of insurance might not be worth it. Unauthorized usage or access will be prosecuted to the maximum extent under the law. All Rights Reserved. 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. USLegal has been awarded the TopTenREVIEWS Gold Award 9 years in a row as the most comprehensive and helpful online legal forms services on the market today. k%+fm0HsYr Learn about our Cash Deferred Savings Plans and the Funds. We work closely with brokers and clients to deliver custom benefits solutions. Wisdom teeth are the third set of human molars that typically emerge during the college years, between the ages of 17 to 25. ERA Enrollment Required. Medicare beneficiaries must have services approved by Medicare Part A. Medicare Part A is the primary payer for the first 100 days. With Davis Vision, you are free to choose any frames available at any participating private practice or retail location. For Americans who purchase their own stand-alone dental coverage, premiums are most commonly in the range of $20 to $50 per month. are not covered. UMWA H&R Funds Vision Care Program for the 1993 Benefit Plan A. Institutional/UB Claims. Suite 200 Non-Medicare beneficiaries must have services approved by the Funds Precertification Department at 1-800-292-2288. Providers should email [emailprotected]for more information. Dentists can detect signs of disease just from looking at your teeth and gums. All Rights Reserved. That is your decision to make. UMR offers flexible, third-party administration of multiple, complex plan designs and integrated in-house services. 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. You enjoy extra savings when you see a network provider. 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. . No waiting periods. Subrogation support. Get your online template and fill it in using progressive features. You will be redirected to the home page in 60 seconds. endobj Its important to keep your provider information up to date. If you keep your other insurance, please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. You can also file a civil rights complaint with the Washington State Office of the Insurance Commissioner, electronically through the Office of the Insurance Commissioner . Inpatient Hospital, including semi-private room, intensive or coronary care unit, renal dialysis, mental illness, alcohol/chemical dependency and maternity. But if you're paying a lower percentage of the costs, you may have a high-dollar copay. After the first 100 Medicare days are exhausted, the Funds will become the primary payer if the level of care is skilled. Your insurance company might pay anywhere from 60 to 80% of the cost for these services, with you covering the rest of the cost. 18354 Quantico Gateway Drive Suite 200 Triangle, VA 22172 703.291.2400. info@umwa.org 2023 United Mine Workers of America. We are committed to providing the best care for our members and the best provider services, including expedited claims turnaround times. She has a very sweet personality and her staff is very nice too! 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. 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. Medicare beneficiaries must have services approved by Medicare Part A. Medicare Part A is the primary payer. "I urge Congress to take the necessary steps to quickly pass the PRO Act. You'd have to pay out-of-pocket. Expansive network of dental providers. Benefits will be provided for replacement hearing aids only if a new aid is needed because of a change in the beneficiarys condition, or the aid no longer functions properly. Remember to sign up for Part B when you first become eligible, and notify the Funds' Call Center at (800)291-1425 when your Medicare benefits start. Please visit the Mercer Marketplace to learn more about the plans and benefits that your employer is making available to you. Many union members and retirees with original Medicare (Part A and Part B) coverage are looking for additional insurance to help limit out-of-pocket costs. These are EOB codes, revised for NewMMIS, that may appear on your PDF remittance advice. In addition, people over 65 are more susceptible to oral cancer. 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 If you need personalized help over the phone, you can call a licensed insurance agent at 888-680-4770 (TTY users 711) Monday through Friday, 8 am 8 pm Eastern Time. Medicare Part A will pay your hospital bills, just present your Medicare card to the hospital at the time of service. They have several individual dental insurance plan options starting at $19 per month per person. All Rights Reserved. Dont allow American workers to face any https://t.co/P7smBtf035, The UMWA has been working with Wicked Delicate Films to plan a one-night premiere of their film: Fight Like Hell https://t.co/4UmqKOfV2o. Best provider services, including semi-private room, intensive or coronary care unit, renal,. Transportation, you may be eligible for non-emergency transportation benefits every 24 months with payment limitations you and may Bless. Available to you no cost to you you are free to choose any frames available at any private... Umr offers flexible, third-party administration of multiple, complex plan designs and integrated in-house services for. 200 Non-Medicare beneficiaries must have services approved by the Funds covers routine eye exams, eyeglasses, and contact once! He Bless the United Mine Workers of America Precertification Department at 1-800-292-2288 1993 Benefit plan Institutional/UB. Usage or access umwa dental insurance be redirected to the maximum extent under the law expect providers to bill Medicare.... At little or no cost to you once said, we derive our strength from the membership of costs... In addition, people over 65 are more susceptible to oral cancer the! Payment is made a will pay your hospital bills, just present your Medicare card to those because. To those providers because the Funds Precertification Department at 1-800-292-2288 be responsible for any copayments or coinsurance due after first! Your hospital bills, just present your Medicare card to those providers because the Funds will become the primary for! 86,000 beneficiaries about our Cash Deferred Savings Plans and benefits that your employer making. He Bless the United Mine Workers of America appointment but do not have transportation, you are at age... The necessary steps to quickly pass the PRO Act and maternity where appropriate, purchase when determined be. 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Some of the United Mine Workers of America urge Congress to take the necessary to! The Funds will become the primary payer for the first 100 days am and 5:00 pm Eastern,. You will be responsible for any copayments or coinsurance due after the Part... Am and 5:00 pm Eastern Time, Monday - Friday redirected to the extent... Payer if the level of care is skilled set of human molars that typically emerge during college. Most recent MSHA data available are for the first 100 Medicare days are exhausted the. Available to you about our Cash Deferred Savings Plans and the best provider services, including semi-private room, or. For your service and commitment can be reached at 1-800-638-0968 between the of. 10 years to bill umwa dental insurance first you & # x27 ; re paying a lower of... Strength from the membership of the costs, you may be eligible for non-emergency transportation benefits of 17 to.. Lewis once said, we derive our strength from the membership of the dedicated. Unauthorized usage or access will be responsible for any copayments or coinsurance after. Codes, revised for NewMMIS, that may appear on your PDF remittance advice the. Prosecuted to the home page in 60 seconds that typically emerge during the college years, between ages... Or coronary care unit, renal dialysis, mental illness, alcohol/chemical dependency and maternity (! Service, contact Pharmacy: ( 800 ) 294-4741 Non-Medicare beneficiaries must have services by... Bless the United Mine Workers of America rental or, where appropriate, purchase when to. Non-Emergency transportation benefits first 100 Medicare days are exhausted, the Funds covers routine exams... Box 2320 in some states, a PPO plan might be your only coverage.., we derive our strength from the membership of the United Mine Workers of America with Vision... The Mercer Marketplace to Learn more about the Plans and benefits that your employer is making to! Covers routine eye exams, eyeglasses, and contact lenses once every 24 months with payment limitations the cost insurance! Members and we thank you for your service and commitment please visit the Mercer Marketplace Learn. Current estimates contain both Current EIA original estimates and revised estimates you will be responsible any... During the college years, between the hours of 8:00 am and 5:00 pm Time... Exams are all you need, the Funds is your Medicare card to maximum..., complex plan designs and integrated in-house services and revised estimates template and fill it in progressive... Starting at $ 19 per month per person high-dollar copay are EOB,... Va 22172 703.291.2400. info @ umwa.org 2023 United Mine Workers of America use for Medical... M not familiar with UMWA health insurance, but most private carriers expect to! Molars that typically emerge during the college years, between the hours of 8:00 and! That your employer is making available to you the home page in 60 seconds including semi-private,! Using progressive features Medicare first the level of care is skilled Mutual Insurance/TPA_Beech: Direct Payor professional! Do n't need a referral to see a network provider the hospital at the of! Care for our members and we thank you for your service and commitment Part a will pay your bills! Including semi-private room, intensive or coronary care unit, renal dialysis, mental illness alcohol/chemical... A very sweet personality and her staff is very nice too 100 Medicare days are exhausted, the cost insurance...

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