Enrolling in health insurance is the easy part. When it comes to understanding and actually using your benefits, it can get confusing. Our goal is to help you understand your coverage and feel confident in making the most of it — when you first enroll and every year after that. If you are a new member and you have enrolled in or would like to enroll in Compass Rose Medicare Advantage, please go to our Medicare Advantage center.
Look for your health plan member ID card in the mail. Keep your card with you to use at doctor visits and when filling prescriptions. If you misplace or lose your ID card, you can view and print a temporary card as well as order a new one through your myCompass account (see manage your account online below). You may also call UMR directly at (888) 438-9135 to request a replacement.
myCompass gives you access to tools and information designed to help you stay organized and save money. With a myCompass account you can:
The Compass Rose Health Plan uses the UnitedHealthcare Choice Plus network of doctors and hospitals to provide in-network care. Your out-of-pocket costs will be lower if you use an in-network provider.
NOTE: If you are looking for a behavioral health provider be sure to select the behavioral health directory link.
For payment purposes, the Compass Rose Health Plan considers primary care physicians (PCP) to be family practitioners, general practitioners, doctors of internal medicine, pediatricians, obstetrician-gynecologists (OB-GYN), nurse practitioners, physician assistants, and mental health/substance abuse providers. Any other type of health care provider type — like dermatologist, surgeons, etc. — are considered to be specialists. No referral is needed to visit a specialist.
We want to make sure you receive care within a reasonable time frame. Here are the access care standards for health care services received within our network at a primary care provider's office:
Staying healthy is important for you and your family. We are here to help.
Routine preventive care — like an annual physical exam, screenings and vaccinations — at every stage of life can help you stay healthy, avoid or delay the onset of disease and keep medical conditions you may already have from becoming worse or debilitating.
You can access a wide range of preventive care services at no cost when seeing a network provider. Services include screenings for conditions such as breast cancer, cervical cancer, colon cancer, lung cancer and high cholesterol. We also cover immunizations including flu shots and well-child visits. Plus, you can earn wellness reward points. For detailed information, please refer to the preventive care section in our FEHB Plan Brochure.
Speak to your primary care doctor about which preventive care services are recommended for you. Please note: To receive 100% coverage, your physician's bill must clearly state "Routine Physical Exam."
We offer many benefits, discounts, tools and wellness programs to help you meet your health goals and get the most out of your coverage. You can earn up to $350 per calendar year, connect with a doctor from your phone 24/7, get help losing weight, pay $0 for covered lab work and more — all at no cost to you!
NOTE: To start earning reward points, you must first opt into the Wellness Rewards Program. Sign into your myCompass account and click Wellness Rewards Program in the QUICK LINKS menu. Then, click the button that says Start Earning Rewards.
The key to understanding your health care coverage is learning about what services are covered, getting familiar with your costs and knowing the difference between in-network and out-of-network.
With the Compass Rose Health Plan you enjoy low copays and the freedom to choose your providers without needing a referral. Learn about common covered services and find out how much you can expect to pay in-network.
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Your prescription drug coverage is through Express Scripts, which gives you options for getting your prescriptions filled. Find out how you can obtain the prescriptions you need.
Claims are processed by our Claims Administrator, UMR (NOT UnitedHealthcare). Your provider is responsible for submitting claims on your behalf; however, there may be instances where you will need to submit medical claims directly to UMR, such as for out-of-network doctors or overseas claims.
To submit a claim online:
For covered services received outside the United States and Puerto Rico, you must submit a completed overseas claim form, itemized bills and proof of payment to UMR, our claims payer. If you are filing an overseas claim for prescription drugs, please use the overseas claim form and submit to UMR. Do not use the Express Scripts claim form or submit your claim to Express Scripts.
If another health plan is your primary payer and does not automatically submit claims to your secondary payer, you must submit a copy of the Explanation of Benefits (EOB) you received from your primary payer along with a claim form to UMR. NOTE: If you have Medicare primary coverage, Medicare generally sends the processed claim to UMR for secondary coverage consideration.
It is important to send all documents for your claim as soon as possible. You must submit the claim by December 31 of the year after you received the service. If you were unable to file on time because of Government administrative operations or legal incapacity, you must submit your claim as soon as reasonably possible.
To file a claim with UMR, you can either send a fax to (855) 405-2189 or mail to: UMR P.O. Box 8095 Wausau, WI 54402
Stateside Claim Form Overseas Claim Form
There are some advantages to having BOTH Medicare and the Compass Rose Health Plan, like decreased out-of-pocket costs.
Thank you for choosing the Compass Rose Health Plan for your health care needs. Our members’ feedback means a lot to us, which is why we would like to know why you chose our plan. Please take a moment to complete our online survey.
