UC San Diego Health Care Facilitator Program

Learn about how this program can help you work with your health plans.

About the Health Care Facilitator Program 

The Health Care Facilitator Program is a free and confidential service available to faculty, staff, retirees, survivors and eligible family members. They can help you solve complex problems with your medical, dental or vision plan. Health care facilitators are best used to handle complex problems that you can’t solve on your own. 

Areas of Assistance

 Health Care Facilitator Program staff are trained to handle issues such as:

• Helping with billing problems for services which are covered by the health plan.
• Providing a detailed comparison of your benefit options when you have a complex medical condition.
• Intervening on your behalf with health plan representatives.
• Explaining how Medicare benefits coordinate with UC-sponsored medical plans.
• Completing the Request for Employment Information Form (CMS-L564 (PDF)) to enroll for Medicare Part B. 

Before you get in touch with your facilitator, try these other avenues first:

• Call the number on your ID card when you have questions about coverage, authorization requirements and provider networks.
• If you receive a bill, contact their office directly to verify they have your correct insurance information. Benefits plan contacts
• Review the Evidence of Coverage (EOC) booklet for detailed information of what’s covered and not covered. For more information, click here:
  • Medical Plans for Active Employees & Non-Medicare Retirees
  • Medical Plans for Medicare Retirees 

2025

• 2025 Online Retiree Health Plan Premium Estimator
• 2025 Retiree Medical Plan Availability Tool (Excel)
• Which medical plan is right for you? (PDF)
• Which Medicare plan is right for you? (PDF)

*Please note: you must have Excel on your device to access these tools.

Benefits Hub

Time to Review Your UC Benefits as the School Year Begins

As summer winds down and students return to school, this is a great time to review your UC benefits and make sure you’re making the most of the resources available to you. Below are a few key benefits that may be especially relevant this time of year.

1. Dependent Care Flexible Spending Account (DepCare FSA)

Childcare and dependent care expenses can add up quickly, especially during the busy school year. The DepCare FSA allows you to set aside pretax dollars to pay for eligible dependent care expenses, helping you save on taxes while ensuring your loved ones are cared for while you work.

• This is a use-it-or-lose-it plan, with a grace period to spend your funds.
• For the 2025 plan year, the grace period ends March 15, 2026, and the deadline to submit claims is April 15, 2026.
• Keep in mind that any balance over the allowable carryover amount will be forfeited if not used by the deadline.

📄 [DepCare FSA Summary Plan Description (PDF)]

2. Health Flexible Spending Account (Health FSA)

The Health FSA lets you contribute up to the annual IRS limit ($3,200 in 2025) in pretax dollars for eligible health expenses. This lowers your taxable income and helps you save money on everyday health costs.

Eligible expenses include:

• Doctor, dentist, and optometrist copays
• Prescription and over-the-counter medications
• Sunscreen, menstrual products, and more
• The Health FSA is also a use-it-or-lose-it plan, but you may carry over up to $660 into the following year.
• For 2025, claims must be submitted by April 15, 2026.

Check out the alphabetical list of eligible expenses on the WEX website.

3. Medical Coverage for College Students Outside California

If your child is heading to college outside of California, don’t forget to review your UC medical plan options. Certain plans may offer better nationwide coverage to ensure your student has access to the care they need while away from home. Contact your plan administrator for guidance on available options.

CORE, UC Care, UC Health Savings Plan (UC HSP)

• Accolade (Health Care Advocate)
  (866) 406-1182, M-F, 5 a.m. – 8 p.m. PT
• Accolade Behavioral Health 
  (866) 406-1182, 24/7
• Navitus (pharmacy)
  (833) 837-4308, 24/7
• Health Equity (Health Savings Account for UC HSP)
  (866) 212-4729, 24/7

Kaiser HMO

• Kaiser Permanente — California 
  Members: (800) 464-4000, 24/7 
  Prospective members: (800) 324-9208, M-F, 7 a.m. – 6 p.m. PT
• Optum Behavioral Health (Access Code: 11280)
  (888) 440-8225, 24/7

UC Blue & Gold HMO

• Health Net (medical and pharmacy)
  (800) 539-4072, M-F, 8 a.m. – 8 p.m. PT
• Health Net Behavioral Health (behavioral health)
  (800) 663-9355, M-F, 8 a.m. – 8 p.m. PT

Taking a few minutes now to review your benefits can help you maximize your savings, avoid losing unused funds, and make sure your family’s needs are covered throughout the year.

Health Care Facilitator Help Desk

The Health Care Facilitator Program Help Desk is for active and retired faculty and staff to provide help and support with your UC health and welfare benefits. This is not a presentation – it’s your opportunity to ask questions about your benefits via Zoom. Registration is not required; click the Zoom link below at the start time of the session you'd like to attend.

Occurrence: Every 2nd and 4th Thursday of the month

September Sessions: 11th and 25th 
Time: 9 - 10 a.m.
Meeting URL: https://ucsd.zoom.us/j/95776112290 
Meeting ID: 957 7611 2290

Call-in if you don't have a Zoom account
Phone: (669) 900-6833
Meeting ID: 957 7611 2290

Presentation: Health Insurance After You Retire

This presentation will explain UC’s retiree health and welfare benefits; which benefits can continue into retirement; eligibility for retiree health benefits; the cost of retiree health benefits and what UC requires of you when you become eligible for Medicare. The Health Care Facilitator will also provide resources for those who do not qualify for UC’s retiree health and welfare benefits.

Occurrence: Every 3rd Wednesday of the month

Next presentation: Wednesday, September 17, 2025
Time: 10 - 11:30 a.m.
Meeting URL: https://ucsd.zoom.us/j/92651140824 
Meeting ID: 926 5114 0824
Call-in: (669) 219-2599 

2025 Download Health Insurance After You Retire presentation slides (PDF)

2024 Download Health Insurance After You Retire presentation slides (PDF)

Watch the video recording Health After You Retire presentation (2024 version):

Presentation: Medicare and Your UC-Sponsored Medical Plan

Many employees or their family members need help understanding their coverage options available to them when they approach Medicare eligibility. If you are planning to retire or if you decide to continue to work, you may find this informational session helpful. This workshop will cover the basics of Medicare, including when to enroll and how it works together with your UC-sponsored medical plans.

Time: 1:30 - 3 p.m. 
Dates:

• Thursday, September 25, 2025

Register: UC Learning Center

Download a copy of the presentation: Medicare and Your UC-Sponsored Medical Plan (PDF)

Watch the recording:

More Information