Hello Everyone,
I pray that you all have been great. As your Health Insurance Broker, I am reaching out to remind you that the Annual Open Enrollment Period (AEP) from October 15th through December 7th has begun.
Please review the key updates for the upcoming 2027 plan year below:
1. General Plan Updates & Deductibles
– Automatic Renewal: If you are happy with your current plan, no action is required. You will automatically be renewed into the 2027 version of your plan.There are really no changes to the plans, with the exception:
– Part A & B / MAPD (Medicare Advantage Prescription Drug) Costs: Out-of-pocket maximums and some Part A and B service copays (inpatient and outpatient) have increased slightly across MAPD HMO, CSNP (Chronic Special Needs Plan), and Patriot plans. The premiums for the plans remain a $0 cost, with the exception of one MAPD plan (that has always had a premium). Medical deductibles remain at $0 for all plans.
– Name Changes: Three D-SNP (Dual Special Needs Plan) names are updating their ending numbers:
– UHC DSNP CO-S002 is going to UHC DSNP CO-Q1
– UHC DSNP CO-V001 is going to UHC DNSP CO-V1
– UHC DSNP CO-S001 is going to UHC DSNP CO-Q2
2. Prescription Drug Coverage (Part D & Formularies)
– Part D Provisions: Following the Inflation Reduction Act changes of 2025, which eliminated the Coverage Gap “donut Hole”, provisions continue to place financial responsibility on plan sponsors. So in saying that, you’ll see slightly increased deductibles, coinsurance and out-of-pocket maximums for prescriptions in Tiers 3–5.
– Formulary Exceptions: Non-formulary drugs that receive an exception will continue to be rated as Tier 4.
– Action Item: Please check the attached Drug List (Formulary) documents to verify that your medications remain covered for 2027—especially if you have a stand alone Prescription Drug Plan (PDP) alongside a Medicare Supplement Plan. Everybody take a look at the back of your UCard to see the name of the MAPD,CSNP, Stand Alone PDP and or DSNP you have. That way you’ll know which Formulary book to look through (there are 9 Complete formulary guides).
3. Transition from VBID to SSBCI (Dual Complete / D-SNP Members) happened at the beginning of 2026.
The Medicare Advantage Value-Based Insurance Design (VBID) model ended on December 31, 2025, and was replaced by the Special Supplemental Benefits for the Chronically Ill (SSBCI) program.
– Impact on Food & Utility Benefits: To continue receiving healthy food and utility benefits, D-SNP members must continue to meet specific qualifying chronic conditions and clinical criteria verified by UnitedHealthcare.
– Verification Process: Per CMS (Center for Medicare and Medicaid): Annual Re-Verification Required: Eligibility does not automatically roll over from year to year. It must be confirmed at the start of each plan year using updated clinical records.
However, I have seen that UHC has already transferred and or kept those individuals who currently have a D’SNP onto the DSNP they have verified them for. UHC has internal records of your qualifying condition. So it looks as if you have been auto-verified for 2027 with no action needed. Let’s have a conversation with UHC to make sure.
Unlike this year where you were able to self attest that you have a chronic condition and still receive benefits (Healthy food, OTC and Utilities), No More Self-Attestation for 2027: Members or incoming members can no longer check a box or sign a personal form declaring they qualify. Eligibility must be proven entirely through objective clinical evidence.
What that means is Healthy foods and Utility benefits can not be assessed until a provider verifies the Chronic Condition(s) (the SSBCI program).
– If Not Verified: Members who are not verified will retain standard Over-The-Counter (OTC), wellness, and fitness benefits.
– Action Item: If you are enrolled in a Dual Complete plan, please reach out to me so we can discuss your eligibility and options before December 7th.
4. New UCards & Mobile App
– New UCard: Everyone will receive 2 new cards. One is a member ID card (for doctor and pharmacy) and the other a UCard (for OTC, Benefit,Gym and Rewards). Please activate the UCard upon arrival to use your ancillary benefits (OTC, healthy food, utilities, gym services). Activation is not required for doctor visits or prescriptions.
– You are now able to add Target to the list of places you can also use your OTC benefits.
– UHC App: You can track benefit balances, covered items and so much more by using the UnitedHealthcare mobile app or by visiting uhc.com (https://www.uhc.com).
Attachments
Please review the attached files for complete details:
1. 2027 Complete Drug List (Formulary) 1-3 – MAPD HMO Plans
2. 2027 Complete Drug List (Formulary) 1-3 – D-SNP Plans
3. 2027 Complete Drug List (Formulary) 1-2 – Stand Alone PDP
4. 2027 Complete Drug List (Formulary) 1 – CSNP
If you have questions, need help checking whether your doctors and medications are in-network, or would like to explore changing your plan, please don’t hesitate to call 720-975-5513 or go to the Contact tab at the top of this website. The contact page will take you to a medicare button where you will push it and be able to fill out your contact information for us to reach you.
Again, if you’re happy with your plan, you don’t have to do anything but let it renew automatically for 2027.
It is an honor to serve as your broker, and I look forward to assisting you.