Welcome to the CU GME Health/Dental Benefits Plan, the health, dental, and prescription drug card program available to eligible CU GME residents, fellows, and their dependents.
Refer to the July 1, 2013 Plan Document for details of health, prescription and dental insurance coverage.
The July 1, 2014 Plan Document is undergoing final revision. The following updates will be effective July 1, 2014:
1. Navitus Health Solutions is the Pharmacy Benefits Manager for the CU GME
Health Benefits Plan.
2. Documentation of dependent eligibility is required to enroll dependents
on the plan, e.g. birth certificate for newborn or marriage certificate for
3. Dental coverage through the Plan is an excepted benefit. Residents may
choose to opt out of (waive) dental coverage and enroll for medical coverage
4. In compliance with the Affordable Care Act (ACA) the Plan will provide
coverage for routine patient costs incurred by a qualifying individual who is
participating in an approved clinical trial.
Please contact CU GME Benefits, 303-724-6024 or firstname.lastname@example.org with questions.
Medical/Surgical Providers and Facilities:
Use this Provider Directory as your source for in-network medical/surgical providers and facilities.
Behavioral Health Services Providers and Facilities Use this Search Tool as your source for in-network providers for behavioral health services. Please call Mines & Associates, 303-953-4043 or 1-800-873-7138, with provider network questions.
PLEASE NOTE: The Mines & Associates Behavioral Health Services Provider Network includes practitioners who may provide services that are not covered by the CU GME Health Plan. If you have questions regarding which services are covered by your plan, consult the Plan Document or contact AmeriBen's Customer Care at 1-866-955-1498.
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! Please note: pre-certification is NOT A GUARANTEE of payment. All services are subject to plan provisions.
CU GME Health Plan Required Notices:
It is the resident's responsibility to know the terms of coverage.
Final determination of a claim is possible only when the actual claims for services rendered is received and reviewed. Any oral or written statement or representation that alters, modifies, amends or is inconsistent with the written terms of the Plan is invalid and unenforceable.
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.
A $100 co-pay per emergency room will apply unless patient is admitted directly to the hospital from the emergency room.
Residents are not allowed to provide treatment or prescribe medication that is self prescribed, prescribed by one resident for another, prescribed by resident for a family member, or prescribed by resident for a family member of another resident.