* Eligible expenses are determined in accordance with the Claims Administrator's reimbursement policy. Most out-of-network services are covered at 60%* after the annual deductible of $850 per member. For example, inpatient hospital services require a $500 per admission copay outpatient hospital services, including lab and radiology, require a $150 copay.** In addition, after you reach the in-network out-of-pocket maximum of $4,750 for an individual and $9,500 for a family, the Plan pays 100% of covered in-network medical charges for the remainder of the calendar year. Copays apply for certain services and in some cases are dependent on where the service is received.
#Inoted healthcare plus
The Choice Plus 100 plan has a $200 deductible for some in-network services, such as such as professional fees for surgical and medical services. You can model different health scenarios for yourself and your family to estimate what your total out-of-pocket costs will be. Use SmartSelect, a comparison tool on CUBES, to help determine which medical plan is best for you.
If you don’t take the time to consider the total cost of each medical plan, you may end up paying for more coverage than you need. Since everyone is different-requiring different levels of care-it is important to consider the total costs for each medical plan option: the cost you pay at the time you use health care (e.g., your deductible, coinsurance or copay) plus the cost you pay out of your paycheck. Or, a particular option may have higher payroll deductions, but lower costs when you receive care.
Lower payroll deductions might make a particular plan option look inexpensive, but you may have a higher deductible to meet. But costs can be difficult to accurately calculate. Consider the CostsĪs with any major purchase decision, cost will likely play a factor when selecting your medical plan. Whenever you are having diagnostic or preventive tests, be sure to ask your physician if he/she is referring you to a provider who is in-network. If you see a provider who is out-of-network, you are responsible for obtaining precertification for most services except routine office visits. However, it is your responsibility to confirm that your provider has obtained the necessary authorizations from UHC. If you use an in-network provider, your participating network physician or hospital generally handles the precertification process. UHC requires precertification for some services. UHC’s Choice network is a national provider network and does not require a primary care physician or referrals to see specialists. Important Note on Referrals and Precertification For details on medical plans, review the Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC). Medical Plan DescriptionsĪll University medical plans cover medically-necessary services and supplies for the purpose of preventing, diagnosing or treating an acute sickness, injury, mental illness, substance abuse or symptoms. You have the flexibility to use in-network or out-of-network providers each time you seek care. However, you can minimize your out-of-pocket expenses when you use in-network providers. If you enroll in a medical plan, you will be automatically enrolled in prescription drug and vision coverage.Īll of the University's medical plans cover the same comprehensive set of services, and provide in-network preventive care, such as annual physicals, immunizations and well-baby visits, paid at 100% with no deductible.
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