2019 Medical Comparison
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- Chloe Ross
- 5 years ago
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1 09 Medical Comparison
2 UNITEDHEALTHCARE CHOICE PLUS: CDHP PLAN A Plan Provision In-Network Out-of-Network Plan Deductible $,00 single maximum; $,000 family maximum $,000 single maximum; $6,000 family maximum Out-of-Pocket Maximum $,800 single maximum; $,600 family maximum $,600 single maximum; $,00 family maximum Employer HSA Contributions $00 for employee only; $,000 for employee and one or more dependents Maximum Benefits Unlimited Unlimited Doctors Services Office visits (except mental health and substance use) (adult) (well child) OB/GYN exam (including two pap smears and related lab tests) Routine vision exam 80% 00%, no 60% of Reasonable and Customary (R&C) per visit 60% of R&C 00%, no 60% of R&C 00%, no 00%, no 60% of R&C 60% of R&C UHC Virtual Visits 80% N/A Hospital Services (semi-private room rate) 80% 60% of R&C Outpatient 80% 60% of R&C Physician Hospital Services 80% 60% of R&C Maternity Services Hospital services (semi-private room & board) Physician services (includes pre- and post-natal care for mother plus care for baby during hospital stay) Emergency Room (for true emergencies only) 80% 60% of R&C 80% 60% of R&C 80% 60% of R&C Urgent Care Centers 80% 60% of R&C Lab Tests/X-rays 80% 60% of R&C Excludes charges above Reasonable and Customary limits. You must notify UHC five days before an elective admission or within one day of a non-elective admission. You must notify UHC five days before an elective admission or within one day of a non-elective admission or benefits reduce to 0% of R&C. A true emergency is an illness or injury that, if not treated immediately, could result in serious medical complications, loss of life or permanent impairment to bodily functions. Examples include loss of consciousness or excessive bleeding; or an illness or injury that may otherwise be determined, in accordance with generally accepted medical standards, to have been an acute condition requiring medical attention.
3 UNITEDHEALTHCARE CHOICE PLUS: CDHP PLAN B Plan Provision In-Network Out-of-Network Plan Deductible $,000 single maximum; $6,000 family maximum $6,000 single maximum; $,000 family maximum Out-of-Pocket Maximum $6,0 single maximum; $,00 family maximum $,000 single maximum; $6,00 family maximum Employer HSA Contributions $00 for employee only; $,000 for employee and one or more dependents Maximum Benefits Unlimited Unlimited Doctors Services Office visits (except mental health and substance use) (adult) (well child) OB/GYN exam (including two pap smears and related lab tests) Routine vision exam 80% 00%, no 60% of Reasonable and Customary (R&C) per visit 60% of R&C 00%, no 60% of R&C 00%, no 00%, no 60% of R&C 60% of R&C UHC Virtual Visits 80% N/A Hospital Services (semi-private room rate) 80% 60% of R&C Outpatient 80% 60% of R&C Physician Hospital Services 80% 60% of R&C Maternity Services Hospital services (semi-private room & board) Physician services (includes pre- and post-natal care for mother plus care for baby during hospital stay) Emergency Room (for true emergencies only) 80% 60% of R&C 80% 60% of R&C 80% 60% of R&C Urgent Care Centers 80% 60% of R&C Lab Tests/X-rays 80% 60% of R&C Excludes charges above Reasonable and Customary limits. You must notify UHC five days before an elective admission or within one day of a non-elective admission. You must notify UHC five days before an elective admission or within one day of a non-elective admission or benefits reduce to 0% of R&C. A true emergency is an illness or injury that, if not treated immediately, could result in serious medical complications, loss of life or permanent impairment to bodily functions. Examples include loss of consciousness or excessive bleeding; or an illness or injury that may otherwise be determined, in accordance with generally accepted medical standards, to have been an acute condition requiring medical attention.
4 UNITEDHEALTHCARE CHOICE PLUS: PLAN 90 Plan Provision In-Network Out-of-Network Plan Deductible $0 per person; $70 family maximum $00 per person; $,00 family maximum Out-of-Pocket Maximum $,00 per person; $,000 family maximum $,000 per person; $0,000 family maximum Employer HSA Contributions N/A N/A Maximum Benefits Unlimited Unlimited Doctors Services Office visits (except mental health and substance use) (adult) (well child) OB/GYN exam (including two pap smears and related lab tests) Routine vision exam 90% 70% of R&C 00% 70% of R&C 00% 70% of R&C 00% 00% 70% of R&C 70% of R&C UHC Virtual Visits 00% N/A Hospital Services (semi-private room rate) 90% per admission 70% of R&C per admission Outpatient 90% per admission 70% of R&C Physician Hospital Services 90% per admission 70% of R&C Maternity Services Hospital services (semi-private room & board) Physician services (includes pre- and post-natal care for mother plus care for baby during hospital stay) Emergency Room (for true emergencies only) 90% per admission 70% of R&C per admission 00% (initial visit only) 70% of R&C 90% 6 70% (waived if admitted 7 ) Urgent Care Centers 90% 70% of R&C Lab Tests/X-rays 90% 70% of R&C Excludes charges above Reasonable and Customary limits. You must notify UHC five days before an elective admission or within one day of a non-elective admission. You must notify UHC five days before an elective admission or within one day of a non-elective admission or benefits reduce to 0% of R&C. A true emergency is an illness or injury that, if not treated immediately, could result in serious medical complications, loss of life or permanent impairment to bodily functions. Examples include loss of consciousness or excessive bleeding; or an illness or injury that may otherwise be determined, in accordance with generally accepted medical standards, to have been an acute condition requiring medical attention. 6 You must notify UHC within 8 hours of an admission. If you are admitted to the hospital directly through the emergency room, your hospital stay is subject to the per admission hospital coinsurance amount. 7 You must notify UHC within 8 hours of an admission, or benefits reduce to 0% of R&C. If you are admitted to the hospital directly through the emergency room, your hospital stay is subject to the per admission hospital coinsurance amount.
5 UNITEDHEALTHCARE CHOICE PLUS: ADDITIONAL SERVICES Plan Provision Infertility Artificial and in vitro insemination, GIFT, ZIFT Physician services, facility expenses, diagnostic tests Fertility medication dispensed or injected by a physician Mental Health Care and Substance Use Treatment CDHP Plan A (with HSA) CDHP Plan B (with HSA) Plan 90 In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network $,000 individual lifetime maximum applies to all of the following UHC infertility benefits combined. $,000 individual lifetime maximum applies to all of the following UHC infertility benefits combined. $,000 individual lifetime maximum applies to all of the following UHC infertility benefits combined. per admission 70% of R&C 70% of R&C 70% of R&C 70% of R&C per admission Outpatient 00% after 70% of R&C You must notify UHC within 8 hours of an admission. You must notify UHC within 8 hours of an admission, or benefits reduce to 0% of R&C. EXPRESS SCRIPTS: PRESCRIPTION DRUG PLAN All UnitedHealthcare Choice Plus medical plan options have the same prescription drug coverage.* Plan Provision CDHP Plan A (with HSA) CDHP Plan B (with HSA) Plan 90 Annual Plan Deductible Deductible applies Deductible applies None Retail (participating retail pharmacy) Retail (non-participating retail pharmacy) Home Delivery (90-day supply) (After is met) $0 copay (Tier ) $ copay (Tier ) $0 copay (Tier ) (After is met). times retail pharmacy copay: $ (Tier ) $87.0 (Tier ) $ (Tier ) (After is met) $0 copay (Tier ) $ copay (Tier ) $0 copay (Tier ) No coverage (After is met). times retail pharmacy copay: $ (Tier ) $87.0 (Tier ) $ (Tier ) $0 copay (Tier ) $ copay (Tier ) $0 copay (Tier ). times retail pharmacy copay: $ (Tier ) $87.0 (Tier ) $ (Tier ) * The Medco/Express Scripts prescription drug plan options use three prescription drug categories Tier, Tier and Tier to determine your copay for each prescription. To determine the way in which specific drugs are categorized within the three tiers, go to
6 MONTHLY MEDICAL COVERAGE COSTS Your medical contributions will be based on three levels of salary ranges, as follows: CDHP Plan A (with HSA) CDHP Plan B (with HSA) Plan 90 Coverage Tiers 09 Monthly Contribution $00,000 and Below Employee Only $. $.8 $0.7 Employee + Spouse $99.7 $8.6 $8.8 Employee + Child(ren) $86. $. $97.07 Family $.08 $. $.90 $00,00 to $7,999 Employee Only $87.6 $8.8 $. Employee + Spouse $9.8 $07.9 $.67 Employee + Child(ren) $66. $9.7 $89.0 Family $80.8 $6.0 $86.79 $7,000 and Over Employee Only $9.97 $8.78 $00. Employee + Spouse $8.9 $86. $. Employee + Child(ren) $6.9 $6.08 $80.99 Family $.89 $7.9 $6.67 Medical Comparison, 0/8 6
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Non-Union Support Staff and Local 2110 2017 Open Enrollment is October 31 November 18, 2016 Your Columbia University Benefits As a member of Non-Union Support Staff or Local 2110, you can take advantage
Anthem BlueCross BlueShield Eastern Kentucky University Economy Coverage Period: {01/01/ /31/2013} Summary of Benefits and Coverage:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-888-650-4047. For prescription
Anthem Blue Cross Your Plan: Modified Value HMO 30/40/30% Your Network: California Care HMO
Anthem Blue Cross Your Plan: Modified Value HMO 30/40/30% Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This
Covered 100%; deductible waived 30%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $2,000 Individual $20,000 Individual $4,000 Family $40,000 Family All covered expenses accumulate simultaneously toward both the preferred
Anthem Blue Cross of California Your Plan: Anthem Bronze PPO 6500/0%/6500 w/hsa Your Network: Prudent Buyer PPO
Anthem Blue Cross of California Your Plan: Anthem Bronze PPO 6500/0%/6500 w/hsa Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection
Retirees with Medicare (RETIREMENT DATE ON or AFTER March 1, 2015) Benefits Comparison Benefits effective January 1, December 31, 2019
Pelican HRA1000 Magnolia Local Plus Network Blue Cross and Blue Shield of Louisiana Preferred Care Providers & Blue Cross National Providers Blue Cross and Blue Shield of Louisiana Preferred Care Providers
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
AN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible $300 Individual $800 Individual $900 Family $2,400 Family All covered expenses accumulate toward the preferred or non-preferred Deductible. Unless otherwise
Western Health Advantage: WHA Bronze 60 HMO 6000/70 w/child Dental. Coverage Period: 1/1/ /31/2016
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.westernhealth.com or by calling 1-888-563-2250. Important
Retirees with Medicare (RETIREMENT DATE BEFORE March 1, 2015) Benefits Comparison Benefits effective January 1, December 31, 2019
Network Eligible OGB Members Pelican HRA1000 Blue Cross and Blue Shield of Louisiana Preferred Care Providers & Blue Cross National Providers Magnolia Local Plus Blue Cross and Blue Shield of Louisiana
PLAN DESIGN AND BENEFITS - PA POS COST-SHARING 3.4 ($1,500 DED) PARTICIPATING PROVIDERS. $1,500 Individual
Plan Coinsurance * Out-of-Pocket Maximum (per calendar year, includes deductible) $3,000 Individual $6,000 Family 50% $6,000 Individual $12,000 Family Amounts over the Recognized Charge, failure to pre-certification
PLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $150 Individual $600 Individual $300 Family $1,200 Family All covered expenses accumulate separately toward the preferred or non-preferred
Anthem Blue Cross Your Plan: Anthem Elements Choice HMO 1500 (Essential Formulary $5/$20/$50/$65/30% $500 Deductible) Your Network: Select HMO
Anthem Blue Cross Your Plan: Anthem Elements Choice HMO 1500 (Essential Formulary $5/$20/$50/$65/30% $500 Deductible) Your Network: Select HMO This summary of benefits is a brief outline of coverage, designed
Oscar Silver 70 EPO Plan Coverage Period: 01/01/ /31/2016
This is only a summary. If you want more detail about coverage and costs, you can get the complete terms in the policy or plan document at www.hioscar.com or by calling 1-855-OSCAR-55. Important Questions
Anthem Blue Cross Your Plan: Custom Premier HMO 25/100% (Custom $5/$20/$30/$50/30%) Your Network: Select HMO
Anthem Blue Cross Your Plan: Custom Premier HMO 25/100% (Custom $5/$20/$30/$50/30%) Your Network: Select HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection
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Anthem Blue Cross: Anthem Silver DirectAccess, a Multi-State Plan Coverage Period: 01/01/ /31/2014
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com/ca or by calling 1-855-333-5730. Important
PLAN DESIGN AND BENEFITS - PA POS COST-SHARING NO-REFERRAL 4.4 ($2,000 DED) $2,000 Individual
Plan Coinsurance * Out-of-Pocket Maximum (per calendar year, includes deductible) $4,000 Individual $8,000 Family 50% $8,000 Individual $16,000 Family Amounts over the Recognized Charge, failure to pre-certification
PLAN DESIGN AND BENEFITS - NJ HMO HSA COMPATIBLE NO-REFERRAL 3.1 CALYR (OVR50%/UND50%)
PLAN FEATURES Deductible (per calendar year) $2,500 Single Subscriber $5,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. The Single Subscriber Deductible
Medical Schedule of Benefits (Effective January 01, 2016) Johns Hopkins Bayview Medical Center Non-Union and Union Employees and Eligible Dependents
Plan Year Deductible Out-of-Pocket Maximum Lifetime Maximum EHP Network Provider Out of Network Provider Hopkins Preferred Network Provider Individual $100 $750 $0 Family $200 $1500 $0 Individual $2000
Auxiliary Organizations Association
Auxiliary Organizations Association Your Plan: Modified Premier HMO 20/200 admit/100 OP (Modified RX $5/$20/$60/20%) Your Network: California Care HMO This summary of benefits is a brief outline of coverage,
Open Access Plus (OAP1/OAP1N): University of Maine System Coverage Period: 01/01/ /31/2013
Open Access Plus (OAP1/OAP1N): University of Maine System Coverage Period: 01/01/2013 12/31/2013 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Individual
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-888-650-4047. Important Questions
Your Plan: Anthem Bronze Select PPO 6350/0%/6350 w/hsa Your Network: Select PPO
Your Plan: Anthem Bronze Select PPO 6350/0%/6350 w/hsa Your Network: Select PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
PLAN DESIGN AND BENEFITS - PA POS HSA COMPATIBLE NO-REFERRAL 2.4 ($2,500 Ded) PARTICIPATING PROVIDERS
PLAN FEATURES Deductible (per plan year) $2,500 Individual NON- $5,000 Individual $5,000 Family $10,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. All