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Do you have comments or concerns about your Medicare coverage? Issues regarding getting your needed prescriptions from your Part D plan, or a Medicare Advantage plan representative's marketing practices? Let us know at .

We are dedicated to making Medicare's program work well for all beneficiaries. Your feedback from your own or your client's concerns and experiences with Medicare, will guide our Medicare advocacy efforts with key policy and decision-makers in both California and nationally with the Centers for Medicare and Medicaid Services (CMS) and Congress.

  • 18Nov

    With Thanksgiving upon us and the end of 2015 approaching, this is a good time to reflect on all the goodness in our lives and around us. We can look back and reflect on the challenges, lessons, successes, experiences, and blessings that have unfolded and see a bigger picture or perfection shining through. This reflection, feeling and giving of gratitude is a strong medicine. And it’s free and unfettered by the maze of Medicare and insurance plans! :) It feeds our heart and spirit and nourishes those around us too.

    Below is a short, powerful gratitude song to the world inspired by a 21-day gratitude challenge that had over 11,000 participants from 118 countries. May you enjoy it, maybe even dance to it with your friends and loved ones and enjoy a very Happy Thanksgiving and a happy grateful day everyday! Thank you for all you do in the world!

    Grateful: A Love Song for the World

    Some background on the song:

    Musicians Nimo Patel and Daniel Nahmod brought together dozens of people from around the world to create this beautiful, heart-opening melody. Inspired by the 21-Day Gratitude Challenge, the song is a celebration of our spirit and all that is a blessing in life. For the 21 Days, over 11,000 participants from 118 countries learned that “gratefulness” is a habit cultivated consciously and a muscle built over time. As a famous Roman, Cicero, once said, “Gratitude is not only the greatest of virtues, but the parent of all others.” This soul-stirring music video, created within a week by a team of volunteers, shines the light on all the small things that make up the beautiful fabric of our lives. – See more at:

    Written and produced by Nimo Patel and Daniel Nahmod.

    Video from KarmaTube

  • 12Nov

    This year, on Tuesday, December 1, 2015, we at California Health Advocates (CHA) are participating in #GivingTuesday, a global day dedicated to giving. Coming together with a unique blend of partners—nonprofits, businesses and corporations as well as families and individuals—to transform how people think about, talk about and participate in the giving season, we invite you to join us and consider giving to CHA! Any gift is doubled thanks to the matching grant of an anonymous donor of up to $1,000.

    Last year, more than 27,000 organizations in 68 countries came together to celebrate #GivingTuesday.  Since its founding in 2012, #GivingTuesday has inspired giving around the world, resulting in greater donations, volunteer hours, and activities that bring about real change in communities.

    Falling the the Tuesday after Thanksgiving, Black Friday and Cyber Monday, this day of generosity celebrates and provides incentives for people to give. It inspires people to take collaborative action to improve their local communities, give back in better, smarter ways to the charities and causes they celebrate and help create a better world. Through the #GivingTuesday movement, we can harness the power of social media to create a global moment dedicated to giving around the world.

    Please join us in this global movement of generosity and giving back and consider making a tax deductible donation to California Health Advocates. And as you prepare for the holidays, you can also support California Health Advocates through making purchases through AmazonSmile. It’s the same Amazon, yet by purchasing through AmazonSmile, Amazon donates 0.5% of the price of your purchase to CHA.






  • 09Nov
    SHIPs are facing an unprecedented 42% funding cut: Tell your legislators to vote no! 

    Send an email now

    In July, Medicare advocates were shocked and outraged that the Senate Appropriations Committee proposed a 42% cut in funding for the Medicare State Health Insurance Assistance Programs (SHIPs), from $52 million to $30 million. Now, Congressional leaders are deciding whether to retain this cut.

    This is the largest cut ever proposed in the history of the SHIP program. It would significantly erode the national SHIP network of unbiased, personalized Medicare benefits information counseling. In California, our SHIP is the Health Insurance Counseling and Advocacy Program, a program that serves our state’s 5 million Medicare beneficiaries, professionals and family members.

    Here’s how you can help:

    • If you can advocate: Email your Senators and Representative NOW and urge them to reject the proposed Senate cut in SHIP funding, and provide level funding of $52 million, as the House Appropriations Committee has recommended.
    • If you cannot advocate: Read and share details about the SHIP cut and upcoming Congressional process.
    • If you know others who can advocate: Please forward this alert from the National Council on Aging to them.

    The more emails we send to Congress, the better our chances for success. Please share this message widely with other Medicare advocates and beneficiaries in your state! Thank you!!

    This alert is provided by the National Council on Aging, November 9, 2015.

  • 02Nov

    Only 1% of people aged 65-74 live in a nursing home, according to the Census Bureau. Most people live in their home and desire to stay in their community as they age. The challenge is, as people age, they often need some assistance with daily activities of living, such as bathing, cooking, cleaning, dressing, etc. And few people plan for how to find and finance this kind of care. Many erroneously assume Medicare covers home care services, yet Medicare only covers certain services that are medically necessary, usually as part of a hospital discharge/rehabilitation plan. Below is a recent NY Times article addressing the terrain and challenges of navigating home care, gives an overview of expected costs, and some resources for more information. Bonnie Burns, our Training and Policy Specialist is also interviewed and quoted.

    Learning the Unfamiliar Language of Home Care

    GIVEN the tens of millions of people in retirement or about to enter it, it’s surprising how few plan for something most of them will eventually need: help doing basic tasks at home. But perhaps it is not so surprising: It’s like learning a difficult new language late in life.

    Only about 1 percent of those aged 65 to 74 live in nursing homes, the Census Bureau reports. Most retirees continue to live at home as they age, even though many do not have relatives nearby to assist them as it becomes harder to handle daily activities because of declining health, mobility or cognitive difficulties.

    Of those who need the help most, many won’t admit they need it or obtain assistance willingly on their own. They fear loss of independence and becoming a burden to their families. This is an issue I’m facing in my own family and it’s difficult to navigate.

    For most older people, it is far preferable to stay at home rather than enter a nursing home. But it isn’t easy to make it work. Just ask Coleen Wagner, who lives in Saratoga, Calif., and has helped several relatives find home care. That includes, most recently, her mother-in-law, who was 85 and had dementia at the time. She has since died.

    “We went through six people,” Ms. Wagner said, “And most stayed only a few months. It was difficult. Finally we found someone who was amazing. The caregiver also did gardening and cleaned up. We paid her $30,000 a year.”

    Home care, often referred to as caregiving or nonmedical in-home services, provides help with the activities of daily living. Professionals who perform these services may not need licensing or certification, although many are certified nursing assistants. Requirements vary from state to state.

    “Home care is about quality of life and ensures that chronic conditions are being addressed and gives family caregivers peace of mind that their loved ones are safe at home,” said Phil Bongiorno, executive director of the Home Care Association of America, a trade group. “A lot of people don’t know what home care is, but it’s playing an increasingly important role in maintaining the health and safety of seniors across the country.”

    Home health aides or assistants fill in the gaps for family members who either can’t be with a loved one or are unable to provide comprehensive services. Aides provide daily help with bathing, toileting, dressing, eating and shopping. They can stay for a few hours a day or overnight, depending upon the needs of the client. What they don’t do is provide nursing services, therapies or other medically related tasks, although they may assist with home health needs.

    The idea behind home care is to keep a person living independently at home for as long as possible. That will not only avoid the huge expense of an assisted-living facility or nursing home, but may lead to better overall health and quality of life.

    While continuing care communities offer a promising alternative for some, many require deposits of up to $1 million plus monthly fees running in the thousands of dollars. Providing home care is not only more cost-efficient, it’s least disruptive to loved ones.

    Mike Steiner, who is assisting his 94-year-old great-aunt Dorothy, sees home care as a way for her to remain in her home and relatively independent. He hired a veteran of the war in Afghanistan to care for her. At various times, he has also assisted his mother and stepmother with finding home care.

    Mr. Steiner, who served four years in the Navy and 20 years as a project manager for Motorola, turned his experience with his family into a business. When he was laid off from Motorola in 2012, he bought a Right at Home franchise, which now has 55 employees serving an area north of Chicago.

    Mr. Steiner’s great-aunt resisted in-home aid, but she eventually agreed. “The problem with me is that I’ve got a 50-year-old brain in a 94-year-old body and they just aren’t in sync anymore,” she told him. “I don’t really need a caregiver but I’m 94 years old and I’m going to indulge.”

    When deciding what kinds of home care services are needed, the first layer of decision-making is often dictated by medical professionals. If someone is being discharged from a hospital or rehab facility, they may need in-home medical care. That’s mostly covered by Medicare, but on a limited basis. Although there’s some local support for home care assistance, most Americans pay for it out of pocket. Some long-term care insurance policies may cover home care.

    Although regulated by the states in varying degrees, home health professionals are usually independent or employed by small private firms. Nearly five million Americans are being served by 12,000 home health agencies, which provide referrals in exchange for a portion of the service fee to clients, according to the Centers for Disease Control and Prevention. More than 80 percent are for-profit.

    Mr. Steiner’s firm charges $18 to $30 an hour, depending on the services needed. The highest rate is for 24-hour in-home care, where the assistant stays in the home. That typically averages from $250 to $500 a day.

    Nationally, home health aides and homemakers — the term for a professional who provides light housekeeping — charge a median rate of $20 per hour, according to a survey by Genworth, an insurance company. That compares with more than $220 a day for a nursing home and about $120 a day for assisted living.

    However you approach providing home care, keep in mind there are no uniform national or state standards. “It’s terribly fragmented,” said Bonnie Burns, a consultant with California Health Advocates. “We don’t have a system in this country for people who need this kind of care. That’s why we’re struggling.”

    To find home care support, you can contact local agencies or try county health departments or those providing services for the elderly. Internet searches will turn up a variety of agencies, although there’s no rigorous service rating system to evaluate these firms. The best advice often comes from someone from a family with personal experience.

    “It’s hard to get quality home care information and keep it up-to-date,” says Rosalie Kane, a professor at the University of Minnesota, who studies long-term care issues and needed home care services for her father and mother. “It’s caveat emptor.”

    When considering a home care company or professional for a loved one, you should insist that the firm do a thorough review of the daily needs of the client and offer a customized care plan. Make sure any agency or firm does complete background checks of its aides, has a quality control system and will handle any problems promptly and professionally.

    If you need specific medical services at home for yourself or a parent, the support system is much more elaborate. Medicare, for example, provides listings and evaluations of health care agencies through its Home Health Compare site. You can find nearby agencies through a ZIP code search and see patient care quality ratings and re-hospitalization rates. Medicare also covers some hospice care.

    When navigating the home care route, be prepared to roll with the punches. The person you’re trying to help may not want a stranger at home and may be mistrustful of the aide. Watch the situation closely and request changes if someone doesn’t work out. Finding the right person is often hit or miss.

    “It was a nightmare,” Ms. Wagner said of dealing with her mother-in-law, who thought people were stealing from her, believed nothing was wrong with her mind and didn’t want to pay for home services. “I just started calling people.”

    While it may take some time, finding a qualified home care professional is worth the effort. The right person can deal with the situation at hand and relieve some of the unrelenting anxiety and fear that vex a family when an older relative is living at home alone without support.


  • 26Oct

    We’ve created a new novella cartoon that shares a simple story to demonstrate some of the common Medicare marketing scams, and to empower beneficiaries to protect their Medicare, their choice of plans/coverage and to know where to report fraud or call for help. Below are some pics of beneficiaries enjoying the story and learning in the process. Please enjoy and  share! :)

  • 19Oct

    Health care fraud drives up costs for everyone in the health care system. And Medicare’s Open Enrollment season (now through Dec 7) is one of the hottest times for fraud.

    Fraud schemes often depend on identity thieves getting hold of people’s Medicare numbers.  So guard your Medicare number.  Treat it as you would a credit card.

    Follow these important steps to protect yourself from fraud:

    • Don’t share your Medicare number or other personal information with anyone who contacts you by telephone, email or by approaching you in person, unless you’ve given them permission in advance.  Medicare will NEVER contact you for your Medicare number or other personal information.

    • Tell your friends and neighbors to guard their Medicare number.

    • Don’t ever let anyone borrow or pay to use your Medicare number.

    • Review your Medicare Summary Notice to be sure you and Medicare are only being charged for actual services.

    • Be wary of salespeople who knock on your door or call you uninvited and try to sell you a product or service.

    • Don’t accept items received through the mail that you didn’t order.  You should refuse the delivery and/or return it to the sender.  Keep a record of the sender’s name and the date you returned the items.

    And if you’re looking to enroll in a Medicare plan:

    • Be suspicious of anyone who contacts you about Medicare plans unless you gave them permission

    • There are no “early bird discounts” or “limited time offers”

    • Don’t let anyone rush you to enroll by claiming you need to “act now for the best deal”

    • Be skeptical of free gifts, free medical services, discount packages or any offer that sounds “too good to be true”

    • Any promotional items you’re offered to enroll in a plan must be worth no more than $15, and these items can’t be given on the condition that you enroll in a plan

    A common ploy of identity thieves is to say they can send you your free gift right away – they just need your Medicare number to confirm.  Decline politely but firmly.  Remember, it’s not rude to be shrewd!

    Call 1-800-MEDICARE to report suspected fraud.  Learn more about protecting yourself from health care fraud by visiting or by contacting our California Senior Medicare Patrol (SMP) at 1-855-613-7080.

    This information was prepared by the U.S. Department of Health and Human Services.

  • 13Oct

    Good news!! Last week Governor Brown signed Senate Bill 575, which brings in new consumer protections around long-term care insurance. The new law protects consumers, specifically the elderly and their caregivers by requiring long-term care insurers to provide annual notification of the availability of nonforfeiture benefits and contingent benefits to the insured and the insured’s designated backup contact. This is helpful when elders who have lapsed on a policy long ago may not remember they still have benefits they can use years later.

    Another victory is the passage of Assembly Bill 332. This bill establishes a Long Term Care Insurance Task Force in the Department of Insurance, chaired by the Insurance Commissioner or his or her designee. The task force will be composed of specified stakeholders and representatives of government agencies charged with examining the components necessary to design and implement a statewide long-term care insurance program and presenting their recommendations to the Governor no later than July 1, 2018.

    California Health Advocates, and especially our Training and Policy Specialist, Bonnie Burns did much advocacy work to get these bills passed! Thank you, Bonnie!!!

    See the full press release on the California Department of Insurance website for more information on SB 575.

  • 08Oct

    No one likes an unexpected increase in payments. And when health care costs already consume close to 20% of seniors’ annual income, an increase in health care premiums and/or deductibles is not welcome news. While the estimated costs have not yet been formally adopted, the projected 2016 increase for Medicare’s Part B premium and deductible is 52%. That’s an increase from $104.90 to $159.30 per month for the Part B premium that would affect nearly 1/3 of all Medicare beneficiaries, or 16 million people, and an increase from $147 to $223 for the Part B annual deductible that would affect most Medicare beneficiaries with Original Medicare.

    Why such high premium and deductible increase?
    Medicare’s Part B premium and deductible increases are the result of the interaction of various Medicare and Social Security rules. By law, 25% of Medicare’s Part B costs are to be paid by beneficiaries. Yet, for most beneficiaries, the Part B premium can only increase as much as the COLA (cost of living adjustment) for the coming year. This is because of the “hold harmless” provision in Medicare law. In 2016, however, as in some years in the past, a 0% COLA is projected. This means that the 70% of beneficiaries protected under the hold harmless provision would not be allowed to have any increase in their 2016 Part B premium. Because Medicare must still have 25% of its Part B costs covered by beneficiaries, the biggest burden of the cost falls on the roughly 30% of beneficiaries not protected under the “hold harmless” provision. They would see a 52% increase in their Part B premium.

    What’s the hold harmless provision? Who is not protected by it?
    People who are on Medicare and have claimed their Social Security benefits must, by law, have their Part B premiums withheld from their monthly Social Security checks. The hold harmless provision mandates that Social Security benefits cannot decline from one year to the next. Normally this is not a problem for Medicare, as each October the new COLA is announced for the coming year and Medicare raises its Part B premiums accordingly. With a 0% COLA projected, the 30% of beneficiaries not protected by the hold harmless provision who shoulder the burden of the cost include:

    • People new to Medicare and whose Medicare Part B premiums have not been taken out of their Social Security checks for at least the last 2 months of the year before the increase (so in November and December of 2015) and/or are not yet receiving Social Security benefits. These beneficiaries’ premiums would rise from $104.90 in 2015 to $159.30 in 2016.
    • People with higher incomes (modified adjusted gross income greater than $85,000 for individuals and $170,000 for couples). Their premiums that have ranged from $146.90 to $335.70 a month in 2015 will increase sharply to a range of $223 to $509.80 in 2016.
    • Beneficiaries whose Part B premiums are paid by the state through one of the Medicare Savings Programs (MSPs). These MSPs include the Qualified Medicare Beneficiary, Specified Low-Income Medicare Beneficiary, and Qualified Individual programs.
    • Who is affected by the projected Part B deductible increase?
      People with Original Medicare would be hit the most by this 52% deductible increase, except for those with Medigap plans C and F, which pay that deductible. Those who are in Medicare Advantage plans would likely see little or no direct impact from the project Part B deductible increase. Medicare Advantage plans can set their own deductibles, and many do not charge one at all.

      What can you do about the projected Part B cost increases?

      You can sign an online petition to say “No” to these cost increases. You can also contact your Congress people at:

  • 02Oct

    Medicare Open Enrollment is a once-a-year window from October 15 – December 7 where beneficiaries can review and change their Medicare health plan and/or their Part D prescription drug plan. While people don’t have to switch plans, it’s important to review how their current plan will change in the new year. Otherwise people can end up paying hundreds of dollars for a drug that was covered under this year’s formula but not next year’s. This is especially true as certain drug prices have soared in the past few years. For example, a generic cholesterol medication recently went up from $27 for a year’s supply to $196. Doxycycline hyclate, a common antibiotic jumped from $20 for 500 capsules to $1,849 between Oct 2013 and April 2014.

    Open Enrollment is also an important time to be on heightened alert for scams. With so much information being thrown at seniors, the potential for confusion is high, and scammers feed off of this confusion. In a recent article, our Senior Medicare Patrol Project Director, Micki Nozaki, gave some important tips to avoid fraud, including:

    • Do not move out of your Medicare plan unless you want to.
    • Be leery of free prizes, giveaways or other gifts offered in exchange for signing Medicare forms.
    • Beware of unsolicited phone calls or knocks at your door by people claiming to be Medicare agents (Medicare will not call you or come to your door).
    • If someone calls saying you must switch Medicare plans to keep your doctor, contact the doctor’s office yourself to confirm.
    • Never give out your Social Security or Medicare number to strangers.

    For questions about your coverage and help reviewing your health care and drug plan options, contact your local Health Insurance Counseling and Advocacy Program (HICAP) at 1-800-434-0222. They provide free, individual and unbiased counseling on Medicare and other health insurance related issues. To report suspected fraud, call our California Senior Medicare Patrol (SMP) at 1-855-613-7080.

    Read the article, Medicare Sticker Shock: Soaring Drug Prices Could Trip Up Seniors, for more information on rising drug costs, tips on reviewing your coverage and ways to avoid scams. And, great job to Margaret Reilly, HICAP Program Manager, Micki Nozaki, our SMP Project Director, and Rajul Patel, assistant professor at University of the Pacific pharmacy school and one of our CHA board members, all quoted in this article. :-)

    Also, see our webpage on Medicare Open Enrollment.

  • 21Sep

    While Medicare’s fall open enrollment will begin in a few weeks on Oct 15, CalPERS (California Public Employee Retirement System) fall open enrollment has already begun. Their Medicare and non-Medicare members have from Sept 14 – Oct 9 to review and change their coverage, which is then effective January 1, 2016. For their members on Medicare, CalPERS is dropping most of their Medicare Advantage HMO plans in 2016. These plans include those currently offered by Anthem Blue Cross, Blue Shield of California, Health Net and Sharp. Kaiser Permanente will continue to offer its Medicare Advantage plan and the CalPERS preferred provider organization (PPO) Medicare Supplement plans will remain in place. CalPERS’ new offering to replace these several Medicare HMOs is a PPO plan through UnitedHealthCare (UHC).

    Those who enroll in this plan will have a $10 copayment for services and can see any provider or use any facility that accepts Medicare. There is a $1,500 out-of-pocket maximum, and optional dental and vision coverage available for $26.32 per month through the plan. The dental portion covers check-ups every 6 months and x-rays once per year with no copay. The vision benefits include an annual allotted amount of $999.00 and a $70 co-pay for glasses. A glasses allowance is provided every 24 months and an annual eye check-up is provided with no copay. Members can call 1-888-867-5581 for additional information. Here are also some FAQs on UHC’s Medicare PPO plan (PDF).

    In addition, pasted below is a list of the plans unavailable after December 31, 2015 and a list of plans available in 2016, and a question and answer sheet sent out to CalPERS members regarding their 2016 options. Visit for more information. You can also contact your local Health Insurance Counseling and Advocacy Program (HICAP) for free, individual and unbiased counseling on your options at 1-800-434-0222.

    2016 Medicare Changes

    Review our Medicare Quick Reference Guide(PDF) for an overview of whether you need to do anything during Open Enrollment. Also review the information below for specific details regarding plan availability, your status, and any actions you need to take.

    Medicare Health Plan Availability
    Unavailable after December 31, 2015

    • Anthem Blue Cross Medicare Preferred
    • Anthem Blue Cross Senior Secure
    • Blue Shield 65 Plus
    • Blue Shield Access+
    • Blue Shield Access+ EPO
    • Blue Shield NetValue
    • Health Net Seniority Plus
    • Sharp Performance Plus

    Available January 1, 2016


    UnitedHealthcare (UHC) Group Medicare Advantage

    PPO Plan Questions & Answers


    A: CalPERS moved to a single non-Kaiser Medicare option for HMO subscribers in 2016 because it will provide our members with more extensive Medicare coverage and reduce costs. The UnitedHealthcare (UHC) Group Medicare Advantage PPO plan has HMO-like pricing and the geographic freedom of a PPO. The UHC Medicare plan will allow members to receive care from any provider who accepts Medicare. They’ll be able to use it in all 58 California counties and anywhere in the United States and its territories.


    A: The UHC Group Medicare Advantage PPO plan will replace the HMO Medicare health plans offered by Anthem Blue Cross, Blue Shield of California, Health Net and Sharp. Kaiser Permanente will continue to offer its Senior Advantage Medicare plan and the CalPERS PPO Medicare supplement plans for PERS Select, PERS Choice and PERSCare will remain in place.


    A: Yes, it will cover Medicare Parts A, B and D (prescription drug coverage). In addition, the UHC Medicare plan includes an optional dental and vision benefit for retirees in public agencies who don’t have those benefits through their former employer. The retiree will pay the full cost of the dental and vision premium directly to UHC.


    A: No. The dental and vision benefit will only be available to those in the UHC Group Medicare
    Advantage PPO plan.


    A: Yes. In the unlikely event that your provider says it does not accept your coverage or isn’t contracted with UnitedHealthcare, contact UHC. Their staff will work to get your coverage accepted and ensure your services are paid for.


    A: Yes, subscribers and all their dependents must receive health benefits through the same insurance carrier. If you switch to the UHC Group Medicare Advantage PPO plan, your spouse will move to the UHC Basic plan, Signature Value Alliance. You and your spouse may also choose to switch to the Kaiser Permanente (if Kaiser offers both the Medicare and Basic plans in your area) or CalPERS PPO Medicare Supplement plans.


    A: Some people in combination plans may find that they have to change doctors when they switch to the UHC Medicare and Basic plans. However, the majority of people who switch will find that they won’t have to change doctors. Very often the same doctors who accept Medicare and Basic coverage under our current non-Kaiser HMO plans will also accept the UHC plans.


    A: You can find a current list of Medicare doctors and providers in the UHC network online at Click on “Find a Provider” and follow the prompts.


    A: Members enrolled in the UHC Group Medicare Advantage PPO plan will have a co-pay of $10. Your co-pay will be same whether you live in California or out of state.


    A: An out-of-pocket maximum places a limit on how much money you pay out of your pocket for your covered medical expenses in a calendar year. With this plan, the maximum amount that you would pay out of your pocket for covered medical expenses in a single year is $1,500. Once you have paid $1,500 in covered medical expenses, including your co-payments, your UHC Medicare Advantage plan pays 100 percent of the cost of your covered medical care expenses for the rest of the year.


    A: The UHC Group Medicare Advantage PPO plan includes over 65,000 regional and local pharmacies in its network including major national retail pharmacies. Some examples include: Walgreens, CVS, Target, Costco, Rite Aid and many others.


    A: Yes.  The UHC Medicare Advantage Prescription Drug benefit will allow you to obtain a refill of your maintenance medications by providing your UHC ID card at the local pharmacy (i.e., CVS, Walgreens, Longs, Rite Aid, Safeway, Costco, and Target etc.). You may obtain up to 90-day supply of maintenance medication at the local pharmacy or use the mail order service.

    The Medication Transition Coverage for new members in the plan may cover up to a 30-day transition fill (for drugs with new Prior Authorization, Quantity Limit or Step Therapy requirements or drugs that are not covered) during the member’s first 90 days with the plan.  This transition prescription fill will give you time to talk to your doctor about switching to an alternate therapy or to request an exception.


    A: On the CalPERS website at, or at You may also contact the UHC Retiree Customer Service line at (888) 867-5581.


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