Retired Employee Medicare Plans

Advantage Plans

AvMed Medicare Access HMO-POS (Miami-Dade and Broward) New Plan

  • No referral to see specialists
  • Initial Coverage Limit – $4,500
  • Primary Care Physician required
  • Primary Care Physician co-pay $0
  • Specialist Office visit no referral needed – $10
  • Rx Tier 1 and 2 – $0 co-pay; Tier 3 and 4 set co-pay; Tier 5 co-insurance
  • Rx mail away available
  • Transportation allowance – up to 8 one-way trips
  • $10,000 Point-of-Service Benefit for out-of-network care

AvMed Medicare Choice HMO (Miami-Dade and Broward)

  • The Initial Coverage Limit – $4,500
  • Hearing Aid allowance – $1,200
  • Healthyperks Rewards – up to $125 for healthy behaviors

AvMed Medicare Circle HMO (Miami-Dade and Broward)

  • Maximum Out-of-Pocket – $2,500
  • Initial Coverage Limit – $6,000
  • Hearing Aid allowance – $1,500
  • Eyewear allowance – $350 (Miami-Dade); $350 (Broward)
  • Transportation allowance – unlimited trips
  • Healthyperks Rewards – up to $125 for healthy behaviors
  • Over the Counter allowance – $50 monthly

AvMed Medicare Premium Saver HMO (Broward) New Plan

  • Primary Care Physician required
  • Primary Care Physician co-pay $0
  • Specialist Office visit referral needed – $25
  • Rx Tier 1 and 2 – $0 co-pay; Tier 3 and 4 set co-pay; Tier 5 co-insurance
  • Rx mail away available
  • Part B Premium Reimbursement up to $100 per month

Leon Medicare (Miami-Dade)

  • Decreased Maximum Out of Pocket amount to $1,000
  • Increase in Tier 3 90-supply drug copay at preferred pharmacies
  • New virtual doctor visits (telehealth) added at $0 copay
  • New Acupuncture benefit added with $0 copay
  • New home delivered Meal benefit for members with End Stage Renal Disease

Humana Zero Premium HMO

(contact Humana directly for a list of participating Counties)

  • Plans vary by County of residence
  • Primary Care Physician required
  • NEW: Post-Discharge Transportation and Post-Discharge Personal Home Care benefits
  • Includes Extra Benefits such as SilverSneakers and Go365 rewards program

Humana Passive PPO

  • Flexibility to see any provider accepting Medicare and willing to bill Humana
  • Same level of coverage for in and out of network providers
  • No deductible
  • Annual Maximum Out-of-Pocket
  • NEW: Post-Discharge Transportation and Post-Discharge Personal Home Care benefits
  • Includes Extra Benefits such as SilverSneakers and Go365 rewards program

Humana National Traditional PPO

  • No deductible
  • Annual Maximum Out-of-Pocket
  • NEW: Post-Discharge Transportation and Post-Discharge Personal Home Care benefits
  • Includes Extra Benefits such as SilverSneakers and Go365 rewards program
  • Flexibility to see any provider accepting Medicare and willing to bill Humana
  • Different coverage level for in-&-out of network providers

UnitedHealthcare (UHC) Differential PPO

  • Increase in Initial Coverage Limit
  • Increase in Catastrophic Coverage limit

UnitedHealthcare (UHC) Passive PPO

  • Increase in Initial Coverage Limit
  • Increase in Catastrophic Coverage limit

UNITEDHEALTHCARE (UHC) MEDICARE SUPPLEMENT PLANS (DOES NOT INCLUDE MEDICARE PART D):

  •  Both plan design and premiums are pending approval by the Centers for Medicare and Medicaid Services (CMS)

  • Freedom of choosing physicians of your choice

  • Plan F will only continue to be offered to anyone who became a Medicare recipient prior to 1/1/2020

  • Rates are based on the applicant’s date of birth, place of residence and tobacco usage

  • Supplements Medicare coverage

 

NOTE: Pre-65 Medicare recipients are not eligible for the Supplement plans.

UNITEDHEALTHCARE (UHC) PHARMACY PLANS (MEDICARE PART D ONLY):

UHC continues to offer Prescription Drug Plans (PDP). Participants currently enrolled in a PDP only may enroll in any of the School Board sponsored Medicare Group Healthcare plans. The following PDP plans are being offered for the 2021 plan year:

  • UHC 4-Tier low option tier 1 gap only coverage
  • UHC 4-Tier high option full gap coverage
  • UHC 5-Tier Formulary Standard Coverage in Gap

 

You must contact the Medicare healthcare company directly for assistance with your enrollment. Proof of Medicare enrollment in both parts A & B must be provided at the time of enrollment.

 

AvMed Medicare Access HMO-POS (Miami-Dade County Only; Broward County Only)

AvMed Medicare Choice HMO:
(Miami-Dade County Only and Broward County Only)

AvMed Medicare Circle HMO:
(Miami –Dade County Only and Broward County Only)

AvMed Medicare Premium Saver (Broward County Only)

Enrollment Telephone Number: 1-800-835-6137 (TTY 711)

Post enrollment for Member Engagement Center: 1-800-782-8633 (TTY 711)

Leon Medicare Advantage Plan 1-866-266-8917 (TTY 711); 8 am – 8 pm, 7 days a week
Humana Zero Premium HMO
(Miami-Dade, Broward and Palm Beach Counties), Humana Passive PPO and Humana Traditional PPO
Enrollment Telephone number: 1-800-824-8242
Mon – Fri, 8 am – 8 pm EST (TTY 711)
Post enrollment: 1-866-396-8810
Mon – Fri, 8 am – 9 pm EST (TTY 711)

UnitedHealthcare (UHC):

Medicare Advantage Plans

Medicare Supplement Plans

Prescription Drug Plans (PDP)

Enrollment  Call Center: 1-877-870-7923
Customer Service:
Medicare Advantage and PDP: 1-888-867-5548
Medicare Supplement: 1-800-523-5800
8 am – 8 pm (EST), 7 days a week

 

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Office of Risk and Benefits Management
1501 N.E. 2nd Avenue, Suite 335
Miami, Florida 33132
Mon - Fri, 8 a.m. to 4:30 p.m. ET
www.dadeschools.net
305-995-7129

FBMC Service Center
Monday - Friday, 7 a.m. – 7 p.m.
1-855-MDC-PS4U (1-855-632-7748)