PO Box 292167 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. Provider Services Claims: (888) 865-5290. % Online/Remote - Candidates ideally in. Please note that the address for the Funds Medical Management office has been changed. Maximum allowable of $150 per month per benefit. She recently took over the dental practice from Dr. Florendo. Non-Medicare beneficiaries must have services approved by the Funds' Precertification Department at 1-800-292-2288. <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page/Parent 22 0 R>> The United Mine Workers of America Health and Retirement Funds 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 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. 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. Medicare Prescription Drugcoverage (Part D) may cover: Generally does not cover over-the-counter medications, 18354 Quantico Gateway Drive We work closely with brokers and clients to deliver custom benefits solutions. Provider must obtain precertification for any DME items over $300. 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. Navy Federal is the largest natural member (or retail) credit union in the United States, both in asset size and in membership. The beneficiary will be responsible for any copayments or coinsurance due after the Medicare Part B payment is made. Providers will find it beneficial to become a Cooperating Funds Provider. Get access to thousands of forms. 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 Complete all of the requested boxes (they are yellowish). <>stream More savings when you stay in-network 1. Wisdom teeth are the third set of human molars that typically emerge during the college years, between the ages of 17 to 25. In many ways they are: healthy people can go without a dentist or optomologist for a few years. Dental Insurance Plans | Humana Individual and family dental insurance plans From budget-friendly monthly premiums to low office-visit copays, Humana has a dental plan that is sure to fit your needs. Until it is confirmed that you are in the Funds Medicare Part B plan, your doctors should continue to bill Medicare Part B for all services. Experience a faster way to fill out and sign forms on the web. Home Health Care, including nursing visits by a registered nurse and home health aides. 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. 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. If you decide to terminate your other coverage you will need to mail the Funds a copy of the termination letter from your other insurance plan to: Funds Health Call Center Click here to learn more! Benefits for necessary repairs and maintenance, except the replacement of batteries, will be provided after the expiration of the warranty period. Choose the template you want in the collection of legal form samples. When you get your maintenance drugs through the Funds pharmacy mail service you will pay a lower co-payment than at retail pharmacies and receive a 90-day supply of your medications. Your medical provider should call 1-800-292-2288 to pre-certify services. 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. Calling all veterans! Your doctor can contact our Provider Services department at (888) 865-5290, if they have any questions. If you keep your other insurance, please call the Call Center (800-291-1425, option 2) to provide information about your other insurance. See Vision fee schedule for reimbursement amounts. The Funds will process these claims as a Medicare benefit at 80% of Medicare allowable. 1. With the Dental Preferred Provider Organization (PPO) plan: Search for a dentist in the PPO network, Building a foundation of health, preventive care coverage and more. bNM;8_l}X+O5|:kDx#JPG{%1hx. Employee Contributions Elective Deferrals, Resolution of Disputes re: New Inexperienced Miner Status, Appeal Non-Medicare Eligible Beneficiary, Prescription Drug Plan Benefits Providers. UMWA Health and Retirement Funds Washington, DC 4 months ago 188 applicants 188 applicants She has a very sweet personality and her staff is very nice too! 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. 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. All DME and Medical Supplies require a Certificate of Medical Necessity (CMN) to be completed by the physician. 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. The beneficiary will be responsible for a significant portion of the charges for routine vision care. Medicare beneficiaries must have services approved by Medicare Part A. Medicare Part A is the primary payer. Start today at: 1-866-443-9160 to have your prescription drugs transferred. Nursing home stays for custodial care (personal care, feeding, toileting, etc.) 4 0 obj These providers have a relationship with the Funds and will not balance bill you for services after the Funds payment, except for applicable copayments. We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs. 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 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. 2121 K Street, NW
Health & Well Being: Medical/Dental/Vision Insurance Paid Time Off Various Personal and Parental Leave Programs Universal Life Insurance Retirement Programs & Matching Employee Contributions: 401K & RRSP Employee Recognition & Anniversary Programs Training, Development, and Growth Opportunities USLegal fulfills industry-leading security and compliance standards. Welcome to Funds information for health care providers. Yes, the Funds covers routine eye exams, eyeglasses, and contact lenses once every 24 months with payment limitations. Your insurance company might pay anywhere from 60 to 80% of the cost for these services, with you covering the rest of the cost. CBF/1992 Plans Age limit does not apply to any beneficiary. With a focus on prevention, dental insurance typically covers professional services like routine check-ups, cleanings and exams at 100%. 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. The resources offered by eHealth can help you navigate your Medicare Plan options and choose the right Medicare plan for you and your spouse, based on your budget and needs. 8 [sfHD%0y Benefits are available if the medical care is not available near the beneficiarys home and the beneficiary must be taken out of area, or if the beneficiary requires frequent transportation, such as for radiation or physical therapy. Business. Your information is securely protected, because we keep to the most up-to-date security standards. %PDF-1.4 Highest customer reviews on one of the most highly-trusted product review platforms. 2 0 obj Listed on 2023-02-27. endstream Click here for more information. More "I urge Congress to take the necessary steps to quickly pass the PRO Act. 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. k%+fm0HsYr In some cases, infections in your mouth can cause serious problems elsewhere in your body. Theft, Personal Dental benefits may not be available from UMR through your employer. Professional Institutional Dental: WMI004: Western Mutual Insurance/TPA_Beech: Direct Payor: Professional Institutional Dental: 37247: Western Mutual Insurance/WMI-TPA . Medicare Advantage plans often have dental benefits. Get information about eligibility for benefits. Privacy Policy. May God Bless each and every one of you and may he bless the United Mine Workers of America. 3. Precertification: (800) 292-2288. Qualifying for COBRA Warning: usage of this Web site requires acceptance of our Site Usage Agreement. You'd have to pay out-of-pocket. For the fortunate ones, wisdom teeth erupt upright, perfectly aligning . 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