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Advantage U Plans

Notice: This Medicare Plan won't be offered in 2024.

Notice: This Medicare plan won’t be offered in 2024

This is a courtesy notice to let you know that beginning January 1, 2024, Advantage U Signature (PPO), Advantage U Signature Buyback (PPO) and Advantage U for University of Utah Retirees (PPO) will not be offered. This means you will need to obtain coverage from another Medicare plan for 2024.

Welcome to Advantage U

With so many Medicare coverage options out there, it can be hard to know which plan to choose.
Thankfully, there’s a plan you can trust that was born right in our backyard. A plan developed by Utahns with extensive health care experience and a dedication to providing Utahns like you with affordable coverage, benefits designed with you in mind and a network of doctors and hospitals you already know and trust.   That plan is Advantage U.

Advantage U Signature (PPO) and Advantage U Signature Part B Buyback (PPO) is available for Medicare beneficiaries in Davis, Salt Lake, Tooele, Utah, and Weber Counties.

Advantage U Signature (PPO) includes

    •  

      Hospital and Medical Coverage

      Advantage U offers the $0 Premium Advantage U Signature (PPO) plan.

       

      • $0 Monthly Premium (you must continue to pay your Part B Premium)
      • $0 Copay for In-network Primary Care Physician (PCP)
      • $25 Copay for In-network Specialist Visit

      For a complete listing of benefits please see Summary of Benefits.

       

    •  

      Prescription Drug Coverage

      Our plan features a formulary (or drug list) with a broad number of prescription drugs on Tier 1 and Tier 2, so you can save more.

      See Summary of Benefits for additional prescription drug coverage information.

       

      Retail Cost-Sharing
      Tier 30-Day Supply 60-Day Supply 100-Day Supply
      Tier 1 (Preferred Generics) $3 copay $6 copay $0 copay
      Tier 2 (Generics) $10 copay $20 copay $20 copay
      Tier 3 (Preferred Brands) $47 copay $94 copay $141 copay
      Tier 4 (Non-Preferred Drugs) $100 copay $200 copay $300 copay
      Tier 5 (Specialty Medications) 31% coinsurance Not offered Not Offered

      Senior Savings Model: For Select Insulins, $28 copay for one-month supply is applicable in the Deductible, Initial Coverage and Coverage Gap phases of the Part D Benefit.

      Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you even if you haven't paid your deductible. Call Member Services for more information.

      Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible. A $28 copay for 30 days applies to Select Insulins for the Advantage U Signature PPO plan (see the formulary below for a list of insulins included in the program)

    •  

      Dental

      Our plan includes preventive dental coverage with a $0 copay and comprehensive dental coverage for fillings, extractions, crowns, implants or adjunctive periodontal care. Up to $1,500 annual benefit for comprehensive coverage. Authorization rules apply.

      See Summary of Benefits for additional dental benefits.

    •  

      Vision

      We offer a $0 copay for routine vision exam along with coverage for eyeglasses or contact lenses ($120 limit on eyeglasses and contacts).

      See Summary of Benefits for additional vision benefits.

      Search Eye Doctors

    •  

      Hearing

      Our plan includes a $0 copay for routine hearing exams through TruHearing along with hearing aid coverage.

      See Summary of Benefits for additional hearing benefits.

    •  

      Fitness

      Enjoy a Fitness Center Membership to participating fitness centers and choose to receive Home Fitness Kits.

      You can visit a participating fitness center near you. You also have access to a variety of Home Fitness Kits. You can receive one Home Fitness Kits per benefit year.

      The Silver&Fit® program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit®is a federally registered trademark of ASH and used with permission herein. Kits are subject to change. Participating facilities and fitness chains may vary by location and are subject to change.

    •  

      Over-the-Counter (OTC)

      With our plan, members receive a $50 allowance each quarter to use for the purchase of select OTC products.

    •  

      Hospital and Medical Coverage

      Advantage U offers the $0 Premium Advantage U Signature (PPO) plan.

       

      • $0 Monthly Premium (you must continue to pay your Part B Premium)
      • $0 Copay for In-network Primary Care Physician (PCP)
      • $25 Copay for In-network Specialist Visit

      For a complete listing of benefits please see Summary of Benefits.

       

    •  

      Prescription Drug Coverage

      Our plan features a formulary (or drug list) with a broad number of prescription drugs on Tier 1 and Tier 2, so you can save more.

      See Summary of Benefits for additional prescription drug coverage information.

       

      Retail Cost-Sharing
      Tier 30-Day Supply 60-Day Supply 100-Day Supply
      Tier 1 (Preferred Generics) $3 copay $6 copay $0 copay
      Tier 2 (Generics) $10 copay $20 copay $20 copay
      Tier 3 (Preferred Brands) $47 copay $94 copay $141 copay
      Tier 4 (Non-Preferred Brands) $100 copay $200 copay $300 copay
      Tier 5 (Specialty Medications) 29% coinsurance Not offered Not Offered

      Senior Savings Model: For Select Insulins, $28 copay for 30-day supply is applicable in the Deductible, Initial Coverage and Coverage Gap phases of the Part D Benefit.

    •  

      Dental

      Our plan includes preventive dental coverage with a $0 copay and comprehensive dental coverage for fillings, extractions, crowns, implants or adjunctive periodontal care. Up to $1,500 annual benefit for comprehensive coverage. Authorization rules apply.

      See Summary of Benefits for additional dental benefits.

    •  

      Vision

      We offer a $0 copay for routine vision exam along with coverage for eyeglasses or contact lenses ($120 limit on eyeglasses and contacts).

      See Summary of Benefits for additional vision benefits.

      Search Eye Doctors

    •  

      Hearing

      Our plan includes a $0 copay for routine hearing exams through TruHearing along with hearing aid coverage.

      See Summary of Benefits for additional hearing benefits.

    •  

      Fitness

      Enjoy a Fitness Center Membership to participating fitness centers and choose to receive Home Fitness Kits.

      You can visit a participating fitness center near you. You also have access to a variety of Home Fitness Kits. You can receive up to 2 Home Fitness Kits per benefit year.

      The Silver&Fit® program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver

      is a federally registered trademark of ASH and used with permission herein. Kits are subject to change. Participating facilities and fitness chains may vary by location and are subject to change.

    •  

      Over-the-Counter (OTC)

      With our plan, members receive a $30 allowance each quarter to use for the purchase of select OTC products.

Advantage U Signature Part B Buyback (PPO) includes

  •  

    Hospital and Medical Coverage

    $0 Premium Advantage U Signature Part B Buyback (PPO)

     

    • $0 Monthly Premium (you must continue to pay your Part B Premium)
    • Up to $25 reduction for your monthly Medicare Part B Premium
    • $0 Copay for In-network Primary Care Physician (PCP)
    • $25 Copay for In-network Specialist Visit

    For a complete listing of benefits please see Summary of Benefits.

     

  •  

    Prescription Drug Coverage

    Our plan features a formulary (or drug list) with a broad number of prescription drugs on Tier 1 and Tier 2, so you can save more.

    See Summary of Benefits for additional prescription drug coverage information.

     

    Retail Cost-Sharing
    Tier 30-Day Supply 60-Day Supply 100-Day Supply
    Tier 1 (Preferred Generics) $10 copay $20 copay $30 copay
    Tier 2 (Generics) $20 copay $40 copay $60 copay
    Tier 3 (Preferred Brands) $47 copay $94 copay $141 copay
    Tier 4 (Non-Preferred Drugs) $100 copay $200 copay $300 copay
    Tier 5 (Specialty Medications) 25% coinsurance Not offered Not Offered

    Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you even if you have not paid your deductible. Call Member Services for more information.

    Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, even if you have not paid your deductible.

  •  

    Dental

    Our plan includes preventive dental coverage with a $0 copay and comprehensive dental coverage for fillings, extractions, crowns, implants or adjunctive periodontal care. Up to $1,500 annual benefit for comprehensive coverage. Authorization rules apply.

    See Summary of Benefits for additional dental benefits.

  •  

    Vision

    We offer a $0 copay for routine vision exam along with coverage for eyeglasses or contact lenses ($120 limit on eyeglasses and contacts).

    See Summary of Benefits for additional vision benefits.

    Search Eye Doctors

  •  

    Hearing

    Our plan includes a $0 copay for routine hearing exams through TruHearing along with hearing aid coverage.

    See Summary of Benefits for additional hearing benefits.

  •  

    Fitness

    Enjoy a Fitness Center Membership to participating fitness centers and choose to receive Home Fitness Kits.

    You can visit a participating fitness center near you. You also have access to a variety of Home Fitness Kits. You can receive one Home Fitness Kits per benefit year.

    The Silver&Fit® program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver &Fit®is a federally registered trademark of ASH and used with permission herein. Kits are subject to change. Participating facilities and fitness chains may vary by location and are subject to change.

  •  

    Over-the-Counter (OTC)

    With our plan, members receive a $30 allowance each quarter to use for the purchase of select OTC products.

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