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Plan Overview


i. How the Viva Health-RMC Health System Plan Works
1. Members on this plan may see any Viva Health participating provider for their health care. However, if you see a provider within the RMC or UAB+ network, you may enjoy cost savings through lower copays, coinsurance, and deductibles.

2. The RMC network (Tier 1) offers the lowest copays, coinsurance, and deductibles of any of the three coverage tiers. The RMC network consists of Regional Medical Center, Stringfellow Memorial Hospital, and all RMC satellite clinics.

3. The UAB+ network (Tier 2) offers copays, coinsurance, and deductibles a little higher than the RMC (Tier 1) network, but includes access to University Hospital, UAB Women and Infants Center, UAB Highlands, The Kirklin Clinic, Medical West, UAB Callahan Eye Hospital, Spain Rehabilitation Center, all UAB satellite clinics, and Children’s Hospital.

4. The Viva Health network (Tier 3) has the highest copays, coinsurance, and deductibles on the Plan but includes hospitals and health centers contracted with Viva Health but outside of RMC and UAB+.
ii. Will my doctor be covered under the Viva Health-RMC Health System Plan?
1. All physicians within Viva Health’s robust state-wide network are covered under the Viva Health-RMC Health System plan. However, your costs may be less if you use a provider at RMC Health System, UAB Health System, or Children’s of Alabama. To determine which tier your provider or a facility is in, you can call Viva Health at 1-800-294-7780. Remember: medical care you receive from providers who are not included in the Viva Health-RMC Health System Plan network will not be covered by the plan unless it is urgently needed or emergency medical care or approved by Viva Health’s medical director in advance.
iii. Worldwide Emergency and Urgent Care Coverage
1. If you are outside the service area and have an urgent and unforeseen need for care that can’t wait until you return home, you are covered. This includes care in a physician’s office for an unexpected illness or injury that would not be classified as an emergency, but does require immediate attention. Care in an emergency room is only covered for treatment of emergency medical conditions. Of course, this does not include routine or elective medical services, and you must return to the service area for any follow-up care. Still, if you’re on a weekend trip or an extended vacation, you can relax knowing that you are covered.
iv. Excellent Customer Service
1. We encourage you to put us to the test: When you dial the Viva Health Customer Service department during business hours (8am - 5pm, Monday through Friday), you’ll get a real person with real answers. You can also have your questions answered at the click of the mouse! By visiting our website at www.vivahealth.com, you can access all of the following information:

a. Summary of Benefits

b. Certificate of Coverage

c. Wellness Benefits

d. Access our Member Portal (www.vivamembers.com) or send an email to vivamemberhelp@uabmc.edu to request a new ID card, change your PCP, update your mailing address, or inquire about a claim.
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Phone: 205-558-7474 | Toll Free: 1-800-294-7780

TTY users, call: 711

Monday - Friday, 8am - 5pm

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If you have questions or complaints about your Viva Medicare plan or care that you have received, we want you to let us know right away.

You may also contact The Centers for Medicare & Medicaid Services (CMS) to file your complaint by clicking here and following the instructions on the form.  To find out more information about the Medicare Ombudsman, click here.

H0154_mcdoc581r19a_M_CMS Accepted 10/1/2024

Fraud Waste & Abuse First Tier, Downstream and Related Entities Nondiscrimination and Language Accessibility Notice Notice of Privacy Practices Accessibility

1Every year, Medicare evaluates plans based on a 5-star rating system. The Star Ratings referenced are for contract years 2016-2025.

Viva Medicare is an HMO plan with a Medicare contract and a contract with the Alabama Medicaid Agency. Enrollment in Viva Medicare depends on contract renewal.

Viva Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, ethnicity, color, national origin, age, disability, or sex (including sex characteristics, including interstitial intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-294-7780 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務. 請致電 1-800-294-7780 (TTY: 711).

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