Via Benefits is a leading provider of retiree health benefit administration services and will give you and your eligible Medicare dependents personalized assistance to help you navigate through your health care options.
Sandia has partnered with Via Benefits to offer retirees access to the Sandia-sponsored Humana Medicare Employer HMO Plan in New Mexico, United Healthcare Group Medicare Advantage (PPO) Plan, and the Sandia-sponsored Kaiser Senior Advantage Plan in Northern California. Via Benefits also offers a variety of individual Medicare supplemental medical and prescription drug coverage options.
As a Sandia Medicare-eligible retiree, you have several options for medical and prescription drug coverage available through Via Benefits. Some of your plan options include:
This plan is fully insured through Humana for Pre 2012 eligible Medicare-primary participants residing in the Humana Medicare Employer HMO within these New Mexico counties; Bernalillo, San Miguel, Sandoval, Santa Fe, Torrance and Valencia. Benefits are available only from providers who are in the Humana Medicare Employer HMO network.
You can obtain information on this plan (including a provider directory, drug formulary list, etc.) by contacting Humana Customer Care at 1-866-396-8810 (TTY: 711) Monday- Friday 6 a.m. - 7 p.m., Mountain Standard Time.
This plan is available to Pre 2012 Medicare-primary retirees, surviving spouses, LTD terminees, and their eligible Medicare-primary Class I dependents who:
By enrolling in this plan, you will automatically be enrolled in the Medicare Part D prescription drug benefit and will receive all of your prescription drug benefits through this plan.
Humana Medicare Employer HMO Plan
Medicare Advantage PPO Plan
Kaiser Permanente Group Senior Advantage HMO Plan
Sandia National Laboratories has chosen to offer a UnitedHealthcare Group Medicare Advantage (PPO) plan. Only eligible retirees of Sandia National Laboratories and their eligible dependents can enroll in this plan. You can't get it anywhere else.
"Medicare Advantage" is also known as Medicare Part C. These plans have all the benefits of Medicare Part A (hospital coverage) and Medicare Part B (doctor and outpatient care) plus extra programs that go beyond Original Medicare (Medicare Parts A and B).
This plan is available to Medicare-primary retirees, surviving spouses, LTD terminees, and their eligible Medicare-primary Class I dependents who:
By enrolling in this plan, you will automatically be enrolled in the Medicare Part D prescription drug benefit and will receive all your prescription drug benefits through this plan.
You will not be required to enroll in an individual Medicare Part D or pay the additional Medicare Part D premium. You cannot be enrolled in the UnitedHealthcare Group Medicare Advantage (PPO) plan, which include prescription drug coverage and another Medicare Advantage plan or another Medicare Part D plan at the same time.
Note: Plans are pending Centers for Medicare & Medicaid Services (CMS) approval
The UnitedHealthcare Group Medicare Advantage (PPO) plan is a Preferred Provider Organization (PPO) plan. You have access to a national network of providers. You can see any provider (network or out-of-network) at the same cost share, as long as they accept the plan and have not opted out of or been excluded from Medicare.
Get access to benefits and programs like:
Referrals to specialists are not required.
Coverage is available worldwide for emergency and urgent care services
You can obtain information on this plan (including a provider directory, drug formulary list, etc.) by contacting UnitedHealthcare® at 1-844-496-0314, TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week.
For additional information, refer to the UnitedHealthcare Medicare Advantage Plan benefits information at www.UHCRetiree.com/SandiaRetiree.
This plan is now available to both Pre 2012 and Post 2012 eligible retirees.
The Kaiser Senior Advantage plan is a Medicare Advantage plan with prescription drug benefits. This plan is fully insured through Kaiser Permanente for eligible Medicare-primary participants who live in California, within Kaiser-designated service areas.
You can obtain information on this plan by contacting Kaiser Permanente Member Services Call Center at 1-800-464-4000, M-F 7 a.m. – 7 p.m., weekends 7 a.m. – 3 p.m., or by visiting Healthy.kaiserpermanente.org or, for additional information, refer to the Kaiser Senior Advantage Plan Evidence of Coverage and Kaiser Chiropractic Evidence of Coverage on this website. If there are any discrepancies between this and the Evidence of Coverage, then the Evidence of Coverage supersedes.
This plan is available to the following who live within a Kaiser-designated service area (currently, Alameda, Contra Costa, Marin, Sacramento, San Francisco, San Joaquin, San Mateo, Solano, and Stanislaus counties are entirely inside a Kaiser service area; service areas for other Northern California counties are determined by specific ZIP codes within those counties).
This plan is available to Medicare-primary retirees, surviving spouses, Long-Term Disability (LTD) Terminees, and their eligible Medicare-primary Class I dependents. Members must be enrolled in both Medicare Part A and Part B and continue to pay Medicare Part A (if applicable) and Part B premiums.
I am not making any changes to my coverage during open enrollment. Will I receive a confirmation notice of this?
Do I have to call Via Benefits during Open Enrollment if I don't want to change any of my coverage?
Can I elect the Your Spending Arrangement (YSA) option and use these funds to pay premiums for the Sandia-sponsored United HealthCare PPO, Blue Cross Medicare Advantage HMO, or Kaiser Senior Advantage Plan?
If I elect the YSA option, how does this work?
Why was the decision made to not allow retirees enrolled in another qualified federal medical plan to enroll in the YSA?
I am confused about the YSA option. Is Via Benefits the insurance company and I use the YSA to pay for my medical claims?
No, Via Benefits is not an insurance company. The Your Spending Arrangement option is being provided to primarily allow a Medicare individual to buy a Medicare plan through Via Benefits. This Exchange provides a multitude of Medicare plans that you can select from.
Once you enroll in a Medicare plan, you will receive an ID card from that plan. If you enroll in a Medicare Advantage plan, you will use this ID card, not your Medicare card, to access services. If you enroll in a Medigap plan, you will use both your Medicare card and the ID card you receive from the plan in which you enrolled to access services. You will pay your insurance plan directly and use the annual credit you receive through the YSA to pay for the premiums for the plan in which you enrolled. See below for more information.
Can I use the funds from the YSA option and buy my own medical coverage?
I enrolled in the YSA in a Medigap Plan F. I would like to change to a Medigap Plan N. Can I do this?
I switched enrollment from the United HealthCare PPO to a Medigap plan and a Medicare Part D plan. My Medicare Part D insurance provider is asking for a Certificate of Creditable Coverage? What is that and where can I get it?