Would you like to better understand and obtain the full services and benefits available from your UC-sponsored medical, dental and vision plans or employee assistance program? Are you having problems with one of the plans which you have been unable to resolve yourself?
The Health Care Facilitator Program was initiated by members of the University Faculty Welfare Committee, UC Emeriti Associations, UC Retiree Associations, and HR/Benefits staff at the Office of the President. In 1999 a one-year pilot program was launched at UC Irvine and UC Berkeley. In 2000, the program was expanded to UC Santa Barbara and UC Santa Cruz. In 2002, the program was expanded to all other UC campuses and laboratories.
The Health Care Facilitator’s services are confidential.
The Health Care Facilitator Program can assist you with:
- Understanding your insurance plan evidence of coverage booklet
- Medicare questions and problems
- Navigating your health plan systems
- Quality of care issues
- Escalated billing problems which you have been unable to resolve yourself
- Appeals and grievances
- Denial of treatment issues not related to enrollment/eligibility
The Health Care Facilitator Program enables members by providing:
- Information to help you understand your health plan coverage and patient rights
- Education on the use of plan benefits and how they coordinate with Medicare benefits
The Health Care Facilitator Program assists members by:
- Intervening to resolve problems of coverage, access and administrative processes.
- Referring problems concerning contract interpretation and coverage disputes to the Office of the President.
- Collecting aggregate data that can be used to improve health plan coverage, processes and communications and serve the future needs of members.
The Health Care Facilitator Program serves:
- Active and retired faculty and academics (and enrolled family members)
- Active and retired staff (and enrolled family members)
- Eligible surviving spouses and beneficiaries
Call the Health Care Facilitator Program when:
- You have a question about your UC health plan coverage and patient rights.
- You need help resolving a complex problem with your medical plan.
- You need assistance in understanding how Medicare benefits coordinate with UC-Sponsored medical plans.
ALL SERVICES ARE CONFIDENTIAL
Contact information for the HCF program at each of the UC locations is available in the HCF Program Brochure.
Helping you Make Full Use of Your Health Benefits
The Health Care Facilitator (HCF) is a confidential service designed to help you understand and obtain the full benefits and services available from your UC-sponsored health plans.
Who does the Health Care Facilitator serve?
- Active faculty and staff
- Retirees, emeritus and annuitants
- Enrolled family members and dependents
- Surviving spouses and beneficiaries
How can the Health Care Facilitator help you make full use of your benefits?
The Health Care Facilitator Program helps you become more actively involved with your health care by providing you with:
- Information tot help members understand their UC medical plan coverage.
- Education on the use of plan benefits and how they coordinate with Medicare (where applicable).
The Health Care Facilitator may also assist you by:
- Intervening to resolve problems of coverage, access and administrative processes,
- Assisting you for effective and timely resolutions to your health coverage or service problems,
- Referring problems concerning contract interpretation and coverage disputes of the Office of the President.
The Health Care Facilitator also serves the future needs of members by collecting aggregate data that can be used to improve health plan coverage, processes and communications.
When should you call the Health Care Facilitator?
If you need help resolving a health plan issue, call the Health Care Facilitator for individual guidance, intervention and help with problem resolution.
Here a few things you can do to resolve a simple problem:
Contact your doctor’s Office. Your most important relationship is the one you have with your doctor and other health care providers. Talk openly with your doctor about your concerns, and ask for help in resolving any care of service issues that arise.
If you are in an HMO, contact your medical group. Most medical groups have patient assistance departments that can help you find a doctor, work out billing problems or obtain referrals.
Call your health plan. A customer service representative at your health plan can explain the plan’s policies and procedures. Please visit UC Net Plan Contacts for health & welfare plan contact information.