Iron Workers Local 395 Trust Fund moves to Anthem

Effective January 1, 2025, Iron Workers Local 395 will offer a PPO plan from Anthem. Medical benefits for Iron Workers Local 395 retirees will be provided through a PPO from Anthem, which includes the National Access Plus benefit. The PPO plan allows members to receive services from any provider, as long as the provider is eligible to receive payments from Medicare Advantage.

Iron Workers Local 395 members’ copay or coinsurance percentage will be the same whether their provider is in or out of network. Locally or nationwide, doctors or hospitals, member share-of-cost (SOC) will not change.

Non-contracted providers may continue treating Iron Workers Local 395 members and will be reimbursed 100 percent of Medicare Advantage’s allowed amount for covered services, less any member SOC.

Medicare Advantage offers the same hospital and medical benefits that Medicare covers while covering additional benefits that Medicare does not, such as LiveHealth Online and SilverSneakers.

The prefix on the Medicare Advantage member ID cards is YVK.

Detailed prior authorization requirements are also available to contracted providers by accessing the Provider Self-Service Tool at https://Availity.com.

Providers will follow their normal claim filing procedures for Iron Workers Local 395 member claims.

Call Provider Services at 833-910-4432 for eligibility, prior authorization requirements, and any questions about the Iron Workers Local 395 member benefits or coverage.