The Health, Dental and Prescription Drug Card program available to CU GME Residents, Fellows, and their dependents is the: CU GME Health/Dental Benefits Plan.

Refer to the Plan Document NEW! Effective July 1, 2009 for details of health, prescription and dental insurance coverage.

The Provider Directory is your source for in-network providers and facilities.

PRE-CERTIFICATION IS REQUIRED on services specified in the Plan Document. Contact UPI Medical Management: phone: 303-493-7507; fax: 303-493-7501. If you are unsure of pre-certification requirement, ASK! It is the insured's responsibility to make certain pre-certification is obtained when required. When pre-certification is required and not obtained, all associated charges will be the responsibility of the insured. AVOID PROBLEMS. Pre-cert when required!!

To request a CUGME Health Plan ID card, please call AmeriBen Customer Care at 1-866-955-1498. Verify your home address with AmeriBen so your card is mailed to the correct address. Obtain your individual ID number from the AmeriBen representative. Print a temporary card to use until your new card arrives in the mail. This card, along with your individual ID number, is the information a provider needs to file a claim for you.

View:
CU GME July 2009-June 2010 Benefits SUMMARY
Notice of Privacy Practices for the CU GME Health Benefits Plan.
Medicare Part D Prescription Drug Coverage Information for CU GME Health Benefits Plan Insureds

Same Gender Domestic Partner (SGDP) add forms/information:
Affidavit
Tax Cert of Dependency

To View these files GET:

It is the resident's responsibility to know the terms of coverage.

This is a brief summary of benefits available to the residents. Benefits are subject to enrollment, verification of eligibility and may change without notice. Contract provisions prevail over any written or verbal interpretation.

Direct questions to:

Pre-certification:

In-Network Providers

No deductible
$20 copayment for office visits
$100 copayment Out-patient Surgery (per day)
$100 copayment for MRI, CT, PET scans (per scan)
$200 copayment In-patient Hospital (per confinement)
$200 copayment for maternity care per global physician fee.
Other copayments apply. See Plan Document and Highlights of Plan Changes.

$750 per person ($1200 per family) deductible per plan year
Plan pays 50% of usual, customary and reasonable charges (UCR) after deductible is met

This plan does not require PCP selection, however, residents are STRONGLY ENCOURAGED to establish care with a PCP. This will improve access to care should you become ill or have an injury, may help avoid an ER visit, etc. Many PCP providers have same day access when immediate care is necessary. Residents should seek medical attention when needed and know how to do so BEFORE an urgent situation arises.
Click here for "Urgent Care" options.

*A $100 co-pay per emergency room will apply unless patient is admitted directly to the hospital from the emergency room.

Certain benefits have plan year (July 1 - June 30) maximums. For example, adult wellness services have a $500 maximum paid per plan year.

• Copayments:
  • Participating local pharmacies
    • Generic drug $10 copay for up to 30-day supply
    • Brand name drug $25 copay for up to 30-day supply
  • Mail Order
    • Generic drug $20 copay up to 90-day supply
    • Brand name drug $50 copay up to 90-day supply
      
• Information or questions:
  • WellDyne RxWest, Inc., 303-793-9954;
  • GME Benefits 303-724-6024;