2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Complete (PPO) Table of Contents 2024 Evidence of Coverage Table of Contents Chapter 1: Getting started as a member................................................................................1 Section 1 Introduction.................................................................................................2 Section 2 What makes you eligible to be a plan member?......................................3 Section 3 Important membership materials you will receive................................... 4 Section 4 Your monthly costs for the plan.................................................................5 Section 5 More information about your monthly premium...................................... 8 Section 6 Keeping your plan membership record up to date..................................8 Section 7 How other insurance works with our plan................................................ 9 Chapter 2: Important phone numbers and resources..........................................................11 Section 1 UnitedHealthcare® Group Medicare Advantage PEBB Complete (PPO) Contacts (how to contact us, including how to reach Customer Service)......................................................................................................12 Section 2 Medicare (how to get help and information directly from the federal Medicare program)...................................................................................17 Section 3 State Health Insurance Assistance Program (free help, information, and answers to your questions about Medicare)...................................18 Section 4 Quality Improvement Organization......................................................... 27 Section 5 Social Security.......................................................................................... 38 Section 6 Medicaid....................................................................................................39 Section 7 Information about programs to help people pay for their prescription drugs..........................................................................................................46 Section 8 How to contact the Railroad Retirement Board.....................................59 Section 9 Do you have “group insurance” or other health insurance from an employer?..................................................................................................59 Chapter 3: Using the plan for your medical services........................................................... 61 Section 1 Things to know about getting your medical care as a member of our plan............................................................................................................ 62 Section 2 Using network and out-of-network providers to get your medical care ................................................................................................................... 63 Section 3 How to get services when you have an emergency or urgent need for care or during a disaster..........................................................................65 QuestionsQuestions?? Call Call CustomCustomer Serviceer Service at at 1-8551-855-873-32-873-326868, TTY , TTY 711711, , 8 a.m.-8 p.m8 a.m.-8 p.m. local time. local time, , Monday-FridayMonday-Friday