2017 Plan Materials

(Coverage Year: January 01, 2017 to December 31, 2017) 

As a member of University Care Advantage (UCA), you will find documents and links below to provide you with information related to your benefits and the health plan.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. 


Annual Notice of Changes

The Annual Notices of Changes (ANOC) booklet tells about the changes between plan benefit years 2016 and 2017. Please select your county below.

Documents by County

Cochise County  English Español
Gila County  English Español
Graham County English Español
Greenlee County English Español
La Paz County English Español
Pima County English Español
Pinal County English Español
Santa Cruz County English Español
Yavapai County English Español
Yuma County English Español


Evidence of Coverage

This booklet gives you the details about your Medicare and Arizona Health Care Cost Containment System or AHCCCS (Medicaid) health care and prescription drug coverage from January 1, 2017 – December 31, 2017. It explains how to get coverage for the health care services and prescription drugs you need. This is an important legal document.

Documents by County

Cochise County English Español
Gila County English Español
Graham County English Español
Greenlee County English Español
La Paz County English Español
Pima County English Español
Pinal County English Español
Santa Cruz County English Español
Yavapai County English Español
Yuma County English Español

Drug Formulary

The drug formulary contains information about the drugs we cover in this plan.

A drug formulary is a list of covered medications selected by University Care Advantage in consultation with a team of health care providers. The drug formulary represents the prescription therapies believed to be a necessary part of a quality treatment program.
Our plan will usually cover the drugs listed in our formulary as long as the drug is medically necessary. The prescription is filled at a University Care Advantage network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.

You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy network, and/or co-payments/co-insurance may change on January 1, 2017, and from time to time during the year.

Related Documents

2017 Drug Formulary (Comprehensive)

(Updated 11/01/2017); Effective 12/01/2017)

English Español

2018 Drug Formulary (Comprehensive)

(Updated 8/01/2017; Effective 1/01/2018)

English

Español

Prior Authorization Criteria

(Updated 11/01/2017); Effective 12/01/2017)

English

Step Therapy Criteria

(Updated 11/01/2017); Effective 12/01/2017)

English

Future Formulary Changes

(Updated 3/2017; Effective 5/01/2017)

English

Future Formulary Changes

(Updated 4/2017; Effective 5/01/2017)

English

Future Formulary Changes

(Updated 7/2017; Effective 9/01/2017

English

Future Formulary Changes

(Updated 8/2017; Effective 10/01/2017

English
 

Provider and Pharmacy Directory

You can find a network provider and/or pharmacy by using our online, searchable directories by using the links below. Our most current version of providers and pharmacies will always be updated online. 

This directory was last updated on 7/15/2016. To access the most recent version of providers, please use the links above. 


If you would like a Provider and Pharmacy Directory mailed to you, or if you need help finding a network provider and/or pharmacy, please call our Customer Care Center. You may also email your request for the directory at UAHPRequests@bannerhealth.com


Summary of Benefits

This is a summary of drug and health services covered by University Care Advantage (HMO SNP) January 1, 2017 - December 31, 2017. The benefit information provided is a summary of what we cover and what you pay. It does not list every service that we cover or list every limitation or exclusion. To get a complete list of services we cover, call us and ask for the “Evidence of Coverage.”

Documents by County

Cochise County English Español
Gila County English Español
Graham County English Español
Greenlee County English Español
La Paz County English Español
Pima County English Español
Pinal County English Español
Santa Cruz County English Español
Yavapai County English Español
Yuma County English Español