Unitedhealthcare Er Copay

Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year. UnitedHealthcare Senior Care Options (HMO SNP) Plan. At Hospital Emergency Room $100 copay, then subject to Deductible & 10% Coinsurance; waived if admitted Emergency Care in Urgi-Center $15 PCP/$25 Specialist copay per visit Subject to Deductible & 30% Coinsurance MATERNITY CARE Prenatal 1st Visit $15 PCP/$25 Specialist copay per initial visit Subject to Deductible & 30% Coinsurance. Emergency Room Copay Waived for BadgerCare Plus Members. Due to the changes the Wisconsin Department of Health Services has made to the Medicaid program, some members may have to pay an $8 copay if they choose to get medical care in the emergency room when it’s not an emergency. UnitedHealthcare Community Plan is waiving this copay for our. Know your options before you go to the ER, UnitedHealthcare will help you understand when to go to the ER vs. Urgent Care and other fast professional care alternatives.

MEDICAL PLAN
Plan	Low-Deductible	Low-Deductible	Balanced	Balanced	Low-Premium	Low-Premium	Low-Deductible	Balanced	Low-Premium	WellMed 1^st Tier* Tier 1/2**	UHC of Nevada HMO	UHC of Nevada POS Tier 1/2 Coverage	SignatureValue	SignatureValue Harmony	Hawaii PPO	Accountable Care	Bind	Monument Health 2,000/4,000 ** Tier 1/Tier 2 Coverage**	Doctors	M Health Fairview – Primary Care	SignatureValue Advantage	Kelsey-Seybold Primary Care
In-Network Benefits
ANNUAL DEDUCTIBLE
Individual	$1,400	$1,400	$2,800	$2,800	$3,300	$3,300	$1,400	$2,800	$3,300	$0/$1,250	$1,000	$0/$1,000	$0	$0	$150	$1,100	$0	$2,000/$4,000	$1,100	$500	$0	$500
Family	$2,800	$2,800	$5,600	$5,600	$6,600	$6,600	$2,800	$5,600	$6,600	$0/$2,500	$2,000	$0/$2,000	$0	$0	$450	$2,200	$0	$4,000/$8,000	$2,200	$1,000	$0	$1,000
HSA COMPANY CONTRIBUTION
Employee-only	$500	$500 (Choice Plus Network) $1,000 (Advocate Network)	$500	$500 (Choice Plus Network) $1,000 (Advocate Network)	$500	$500 (Choice Plus Network) $1,000 (Advocate Network)	$500 (Choice Plus Network) $1,000 (Kelsey-Seybold Network)	$500 (Choice Plus Network) $1,000 (Kelsey-Seybold Network)	$500 (Choice Plus Network) $1,000 (Kelsey-Seybold Network)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Family	$1,000	$1,000 (Choice Plus Network) $2,000 (Advocate Network)	$1,000	$1,000 (Choice Plus Network) $2,000 (Advocate Network)	$1,000	$1,000 (Choice Plus Network) $2,000 (Advocate Network)	$1,000 (Choice Plus Network) $2,000 (Kelsey-Seybold Network)	$1,000 (Choice Plus Network) $2,000 (Kelsey-Seybold Network)	$1,000 (Choice Plus Network) $2,000 (Kelsey-Seybold Network)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
COINSURANCE
After Deductible	20%	20%	20%	20%	20%	20%	20%	20%	20%	$0/30%	20%	$0/30%	20%	20%	10%	20%	N/A	20%/40%	20%	20%	N/A	20%
OFFICE VISIT*
Primary Care	20%	20%	20%	20%	20%	20%	20%	20%	20%	$20 copay/30%	$15 copay	$15/$35 copay	$40 copay	$10 copay	10%	Tier 1: $20 copay Other In-Network: 50%	Average $40 copay	Tier 1: $15 (first three visits covered at 100%) Tier 2: $40	Covered 100%	$20 copay	$10 copay	$20 copay
Specialist	20%	20%	20%	20%	20%	20%	20%	20%	20%	$30 copay/30%	$30 copay	$30/$55 copay	$55 copay	$35 copay	10%	Tier 1: $30 copay Other In-Network: 50%	up to $85 copay	$50 copay	$100 copay	$30 copay	$35 copay	$30 copay
Preventive Care	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%	Covered 100%
URGENT CARE*	20%	20%	20%	20%	20%	20%	20%	20%	20%	$50 copay/30%	$30 copay	$40 copay	$40 copay	$10 copay	10%	$50 copay	$150 copay	$50 copay	Covered 100%	$50 copay	$10 copay	$50 copay
EMERGENCY ROOM COVERAGE FOR EMERGENCY SITUATIONS*	20%	20%	20%	20%	20%	20%	20%	20%	20%	$300 copay	20%	$500 copay	$300 copay	$200 copay	10%	$300 copay	$400 copay	$150 copay then 20%	$500 copay plus 20%	$300 copay	$200 copay	$300 copay
OUT-OF-POCKET MAX
Individual	$4,200	$4,200	$5,600	$5,600	$6,600	$6,600	$4,200	$5,600	$6,600	$3,550	$6,250	$6,850	$5,000	$3,500	$2,650	$4,000	$6,000	$6,000	$5,000	$3,300	$3,500	$3,300
Family	$8,400	$8,400	$11,200	$11,200	$13,200	$13,200	$8,400	$11,200	$13,200	$10,650	$12,500	$13,700	$15,000	$7,000	$7,950	$8,000	$12,000	$12,000	$10,000	$6,600	$7,000	$6,600

* Coinsurance percentage applies after deductible.

*** WellMed 1^st Tier is only available to employees assigned to work in the WellMed business unit who reside or work in certain locations in San Antonio. If you are eligible for the WellMed 1^st Tier option, it will be reflected in the benefits enrollment site.

Here is a high-level summary of the medical plans available in your location.

HSA-eligible plans support your overall health and well-being and are available to all U.S. employees and their families, except those in Hawaii.

Details

You can see any provider, but you'll save when you use a network provider.
The HSA-eligible plans use the Choice Plus network, a broad network with coverage for both in-network and out-of-network providers and is available in most areas.
For most in-network services, you pay the full cost until you’ve met your deductible. Then you’ll pay 20% coinsurance.
You have three plans to choose from:
- The Low-Deductible Plan has a higher premium, but offers the lowest deductible allowed by the IRS for an HSA-eligible plan. You might want this plan if you prefer to pay more each paycheck in exchange for a lower deductible, or if you expect to incur high medical or prescription drug costs.
- The Balanced Plan offers a moderate premium and deductible. It’s a good choice if you want to balance your health care spending throughout the year.
- The Low-Premium Plan has the lowest premium, but the highest deductible. You may want to consider this plan if you prefer to pay less each paycheck in exchange for higher costs when you receive care.

Health Savings Account

When you enroll in one of the HSA-eligible plans, an Optum Bank Health Savings Account (HSA) will automatically be opened. Visit Health Savings Account to learn more about HSAs.

Prescription Drug Coverage

The HSA-eligible plans use the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network. Visit Prescription Drug Coverage to learn more.

And more!

You have access to Health Care Advisor , your 24/7 resource for personalized health care support and guidance.
Contribute to a Limited-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

The HSA-eligible medical plans work together with an Optum Bank Health Savings Account(HSA) to help you support your overall health and well-being. You get the most out of your coverage when you actively engage in your health care and decision-making.

Employees and their families who live in select ZIP codes in Chicago, Illinois, have the choice between two networks, the value-based Advocate Health System and the UnitedHealthcare Choice Plus network.

Visit the benefits enrollment site to see your network eligibility.

Details

For most network services, you pay the full cost until you’ve met your deductible. Then you’ll pay 20% coinsurance.
You have three plans to choose from:
- The Low-Deductible Plan has a higher premium, but offers the lowest deductible allowed by the IRS for an HSA-eligible plan. You might want this plan if you prefer to pay more each paycheck in exchange for a lower deductible, or if you expect to incur high medical or prescription drug costs.
- The Balanced Plan offers a moderate premium and deductible. It’s a good choice if you want to balance your health care spending throughout the year.
- The Low-Premium Plan has the lowest premium, but the highest deductible. You may want to consider this plan if you prefer to pay less each paycheck in exchange for higher costs when you receive care.

Network Providers

The HSA-eligible plans allow you to pick a network of providers. You can choose a broad network or a value-based network designed to provide better health outcomes and more savings to you. Value-based networks are often referred to as “focused” networks because there are fewer network providers and a primary care physician (PCP) who is entrusted with clinical oversight for care. A focused network features a team‐based approach on prevention, early detection and ongoing intervention of chronic and complex diseases.

When choosing a network for the HSA-eligible plans, consider the following:

Advocate Health System	Choice Plus Network
Network Type	Focused Advocate Health System has more than 450 Advocate Health Care locations, 12 acute-care hospitals, more than 5,000 physicians, home health services and outpatient centers.	Broad
Network Preventive Care	100% covered
Network Services	You pay the full cost until you’ve met your deductible. Then you’ll pay 20% coinsurance.
Out-of-network Coverage	There is no coverage for out-of-network services except for emergencies.	You can see any provider, but you'll save significantly more when you use a network provider. The deductible and out-of-pocket maximum is double when you receive services out-of-network.
Primary Care Physician (PCP)	Necessary¹	Recommended
Referrals to Specialists	Required	Not Required
HSA Company Contribution	$1,000 employee-only $2,000 family	$500 employee-only $1,000 family

¹Additional coordination is required if you cover a dependent who lives out of state. Your dependent must have a PCP in the state where you reside and receive a referral from that PCP for services where the dependent lives.

Health Savings Account

When you enroll in one of the HSA-eligible plans, an Optum Bank Health Savings Account (HSA) will automatically be opened. Visit Health Savings Account to learn more about HSAs.

Prescription Drug Coverage

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Limited-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

Resources

Visit the Advocate Health System Provider Directory to research in-network physicians and facilities before enrolling
Visit the Choice Plus Provider Directories to research in-network physicians and facilities before enrolling

The HSA-eligible medical plans work together with an Optum Bank Health Savings Account (HSA) to help you support your overall health and well-being. Install virtualbox catalina. You get the most out of your coverage when you actively engage in your health care and decision-making. Employees and their families who live in select ZIP codes in Houston, Texas, including Sugarland have the choice between two networks, the Kelsey-Seybold Health System and the UnitedHealthcare Choice Plus network.

Ultrasurf vpn free download. Visit the benefits enrollment site to see your network eligibility.

Details

For most network services, you pay the full cost until you’ve met your deductible. Then you’ll pay 20% coinsurance.
You have three plans to choose from:
- The Low-Deductible Plan has a higher premium, but offers the lowest deductible allowed by the IRS for an HSA-eligible plan. You might want this plan if you prefer to pay more each paycheck in exchange for a lower deductible, or if you expect to incur high medical or prescription drug costs.
- The Balanced Plan offers a moderate premium and deductible. It’s a good choice if you want to balance your health care spending throughout the year.
- The Low-Premium Plan has the lowest premium, but the highest deductible. You may want to consider this plan if you prefer to pay less each paycheck in exchange for higher costs when you receive care.

Network Providers

The HSA-eligible plans allow you to pick a network of providers. You can choose a broad network or a value-based network designed to provide better health outcomes and more savings to you. Value-based networks are often referred to as “focused” networks because there are fewer network providers and a primary care physician (PCP) is entrusted with clinical oversight for your care. A focused network features a team‐based approach on prevention, early detection and ongoing intervention of chronic and complex diseases.

When choosing a network for the HSA-eligible plans, consider the following:

Kelsey-Seybold Health System	Choice Plus Network
Network Type	Focused	Broad
Network Preventive Care	100% covered
Network Services	You pay the full cost until you’ve met your deductible. Then you’ll pay 20% coinsurance.
Out-of-network Coverage	There is no coverage for out-of-network services except for emergencies.	You can see any provider, but you'll save significantly more when you use a network provider. The deductible and out-of-pocket maximum is double when you receive services out-of-network.
Primary Care Physician (PCP)	Necessary¹	Recommended
Referrals to Specialists	Required	Not required
HSA Company Contribution	$1,000 employee-only $2,000 family	$500 employee-only $1,000 family

Health Savings Account

When you enroll in one of the HSA-eligible plans, an Optum Bank Health Savings Account (HSA) will automatically be opened. Visit Health Savings Account to learn more about HSAs.

Prescription Drug Coverage

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Limited-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

Resources

Visit the Kelsey-Seybold Provider Directory to research in-network physicians and facilities before enrolling
Visit the Choice Plus Provider Directories to research in-network physicians and facilities before enrolling

The Kelsey-Seybold Primary Care Plan is a network-only plan available to eligible employees and their families who live in select ZIP codes in the Houston, Texas service area, including Sugarland, Texas.

The Kelsey-Seybold Primary Care Plan gives you access to a network of providers, hospitals and other health care professionals that delivers coordinated, high-quality, cost-effective care to help you achieve better health outcomes.

To see if you are eligible for the Kelsey-Seybold Primary Care Plan, visit the benefits enrollment site.

Details

Except for emergencies, benefits are paid only for care or services received from providers in the Kelsey-Seybold network. There is no coverage for out-of-network services.
You’ll have access to Kelsey-Seybold's hospital partners, including C-H-I St. Luke’s Health, Texas Children’s Hospital and Memorial Hermann.
You and each enrolled dependent must select a Kelsey Seybold primary care physician (PCP) to coordinate all care, including referrals to specialists.
You do not need in-network referrals for certain services such as:
- Obstetricians/gynecologists
- Behavioral health and substance-use disorder clinicians
- Convenience care clinics, urgent care clinics or emergency rooms
Additional coordination is required if you cover a dependent who lives out of state. Your dependent must have a PCP in the state where you reside and receive a referral from that PCP for services where the dependent lives.

Prescription Drug Coverage

The Kelsey-Seybold Primary Care Plan uses the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network. Visit Prescription Drug Coverage to learn more.

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

SignatureValue HMO is a network-only plan and is available to employees and their families who live in select ZIP codes in California. To see if you are eligible for the SignatureValue HMO, visit the benefits enrollment site.

Details

No deductible.
Except for emergencies, benefits are paid only for care or services provided inside the network and when authorized through your Primary Care Physician (PCP).
Access to the full SignatureValue HMO network for in-network benefits.
You pay 20% coinsurance for some services
Your PCP will coordinate all of your care, including referrals to specialists. In most cases, if you see a specialist without a referral from your PCP, it will not be covered.
You do not need in-network referrals for certain services such as:
- Obstetricians/gynecologists
- Behavioral health and substance-use disorder clinicians
- Convenience care clinics, urgent care clinics or emergency rooms

And more!

Prescription drug coverage is provided through the network retail pharmacies and OptumRx home delivery service pharmacy.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

Contact Us

Call UnitedHealthcare of California HMO Customer Service at 877-669-3855

SignatureValue Harmony HMO is a network-only plan available to employees and their families who live in select ZIP codes in California. To see if you are eligible for the SignatureValue Harmony HMO, visit the benefits enrollment site.

Details

No deductible.
Except for emergencies, benefits are paid only for care or services provided inside the network and when authorized through your Primary Care Physician (PCP).
Access to the SignatureValue Harmony network for in-network benefits. This is a distinct subnetwork of UHC’s full HMO network of participating physician groups.
You pay 20% coinsurance for some services
Your PCP will coordinate all of your care, including referrals to specialists. In most cases, if you see a specialist without a referral from your PCP, it will not be covered.
You do not need in-network referrals for certain services such as:
- Obstetricians/gynecologists
- Behavioral health and substance-use disorder clinicians
- Convenience care clinics, urgent care clinics or emergency rooms

And more!

Prescription drug coverage is provided through the network retail pharmacies and OptumRx home delivery service pharmacy.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

Contact Us

Call UnitedHealthcare of California HMO Customer Service at 877-669-3855

WellMed 1^st Tier Plan is a network-only medical plan available to WellMed business unit employees and their families who live in certain ZIP codes or work in certain locations in the San Antonio, Texas, service area. To see if you are eligible for the WellMed 1^st Tier Plan, visit the benefits enrollment site.

Details

Except for emergencies, benefits are paid only for care or services provided inside the network.
It is recommended that you choose a primary care physician (PCP) who will work with you to coordinate your care.
You get the highest level of benefits when you use a Tier 1 PCP. Tier 1 physicians are recognized as providing high-quality care at a cost-effective price – in other words, the best value.
- Look for the Tier 1 'Blue Dot' symbol when searching the network for a PCP to ensure you are selecting a Tier 1 provider.
- Tier 1 includes WellMed-affiliated providers who participate in the UnitedHealthcare Choice Plus Network.

Prescription Drug Coverage

The WellMed 1^st Tier Plan uses the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network. Visit Prescription Drug Coverage to learn more.

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

UnitedHealthcare of Nevada HMO is a network-only medical plan and is available to employees who live in Las Vegas, Nevada. To see if you are eligible for the UnitedHealthcare of Nevada HMO Plan, visit the benefits enrollment site.

Details

Except for emergencies, benefits are paid only for care or services provided inside the network.
Your PCP will coordinate all of your care, including referrals to specialists. In most cases, if you see a specialist without a referral from your PCP, it will not be covered.
You do not need in-network referrals for certain services such as:
- Obstetricians/gynecologists
- Behavioral health and substance-use disorder clinicians
- Convenience care clinics, urgent care clinics or emergency rooms

And more!

Prescription drug coverage is provided through network retail pharmacies and a home delivery service.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

Contact Us

Call UnitedHealthcare of Nevada at 877-291-4894

UnitedHealthcare of Nevada POS combines elements of an HMO and PPO and is available to employees and their families who live in select ZIP codes in Las Vegas or Reno, Nevada. To see if you are eligible for the UnitedHealthcare of Nevada POS Plan, visit the benefits enrollment site.

Details

You can choose to receive care from HMO providers (Tier 1), PPO providers (Tier 2) or out-of-network providers (Tier 3). The level of benefit you receive is determined by your choice of provider.
Your deductible and copays depend on the tier you choose when you receive care.
You receive the highest benefit when you choose a Tier 1 PCP.
Your PCP will coordinate all of your care, including referrals to specialists. In most cases, if you see a specialist without a referral from your PCP, it will not be covered.
You do not need in-network referrals for certain services such as:
- Obstetricians/gynecologists
- Behavioral health and substance-use disorder clinicians
- Convenience care clinics, urgent care clinics or emergency rooms

And more!

United Healthcare Medicare Advantage Copay

Prescription drug coverage is provided through network retail pharmacies and a home delivery service.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

Contact Us

Call UnitedHealthcare of Nevada at 877-291-4894

The Hawaii Preferred Provider Organization (PPO) is available to employees and their families if they live in Hawaii.

Details

You can see any provider, but you'll save when you use a provider who participates in the Hawaii PPO network.
You will generally pay 10% coinsurance for in-network services.

Prescription Drug Coverage

The Hawaii Preferred Provider Organization (PPO) uses the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network. Visit Prescription Drug Coverage to learn more.
There is a separate out-of-pocket maximum for prescription drugs of $4,200 per individual and $5,750 for family.

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

The Accountable Care Plan is a network-only plan available to eligible employees and their families in select locations based on your home ZIP code.

An Accountable Care Organization (ACO) gives you access to a value-based, focused network of providers, hospitals and other health care professionals who work together to provide you coordinated, high-quality, cost-effective care. The fundamental purpose of a high-performing ACO is to help you achieve better health outcomes.

To see if you are eligible for the Accountable Care Plan, visit the benefits enrollment site.

Details

Except for emergencies, benefits are paid only for care or services received from providers in the Nexus network. There is no coverage for out-of-network services.
You and each enrolled dependent must select a primary care physician (PCP).
- You get the highest level of benefits when you use a Tier 1 PCP and Tier 1 specialist. Tier 1 physicians are recognized as providing high-quality care at a cost-effective price – in other words, the best value.
- Look for the Tier 1 'Blue Dot' symbol when searching the network for a PCP to ensure you are selecting a Tier 1 provider.
For non-Tier 1 PCP and specialist visits, you pay the full cost until you’ve met your deductible. Then you’ll pay 50% coinsurance.
Your PCP will coordinate all of your care, including referrals to specialists. In most cases, if you see a specialist without a referral from your PCP, it will not be covered.
You do not need in-network referrals for certain services such as:
- Obstetricians/gynecologists
- Behavioral health and substance-use disorder clinicians
- Convenience care clinics, urgent care clinics or emergency rooms
If you cover a child who lives out of state, call Health Care Advisor to request a PCP assignment in the state they live.

Prescription Drug Coverage

The Accountable Care Plan uses the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network.
Visit Prescription Drug Coverage to learn more.

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

The Bind Plan is available to eligible employees and their families in select locations based on your home ZIP code.

Bind is on-demand health insurance with no deductible. The Bind Plan offers price transparency and customizability to fit your healthcare needs. You can find out the total cost of care and what your copay will be before you obtain care via the Bind app. You can also see when you might be able to save money by selecting a different provider or service location.

To see if you are eligible for the Bind Plan, visit the benefits enrollment site.

Details

Generally, when you obtain care, all of your costs are bundled and you pay only one price for that care. The plan pays the rest.
With this plan you get preventive, primary, specialty, urgent, emergency and hospital care and prescriptions. Coverage also includes care for chronic conditions, cancer and maternity. Prices will vary based on your recommended care plan and where you receive care.
Bind uses the UnitedHealthcare Choice Plus network. You have coverage both in- and out-of-network, but you pay less for care when you use an in-network provider. Note: there are variances in the Choice Plus network with Bind. This includes, but may not be limited to, the PHCS network in Buffalo, N.Y. Be sure to research your providers and facilities at choosebind.com/uhg. (access code UHG2021)
You do not need:
- To select a primary care physician (PCP)
- A referral for services
Bariatric surgery and infertility treatments are not covered under this plan.
With the Bind Plan, you can adjust your coverage if your health care needs change. Activate coverage at any time of the year – at least three days in advance of a procedure – for 44 plannable procedures that vary in cost, treatment and setting.
- Procedures that require activation are paid for through additional paycheck contributions for a set duration. You may also pay a clear price to your provider, which varies based on the procedure and provider or location you select.
- The procedures that require activation are for things most people don’t need annually, such as endoscopy, knee replacement, tonsillectomy/adenoidectomy and ear tubes. Check choosebind.com/uhg (access code UHG2021) for a full list of these procedures.

Prescription Drug Coverage

The Bind Plan uses the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network. Visit Prescription Drug Coverage to learn more.

And more!

Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

Contact Us

If you are currently enrolled in the Bind Plan:
- Employees log in to mybind.com
- Spouse or domestic partner log in to mybind.com
New employees visit choosebind.com/uhg and enter access code UHG2021.
Call the Bind Help Team at 855-472-7778, from 6 a.m. to 7 p.m. CT, Monday through Friday.

Monument Health 2000/4000 is available to employees and their families who live in select ZIP codes in Grand Junction, Colorado. To see if you are eligible for the Monument Health Plan, visit the benefits enrollment site.

Details

You have the choice between a Tier 1 or Tier 2 provider. You get the highest level of benefits when you use a Tier 1 PCP.
- Tier 1: Monument Health Network (most coordinated and lowest cost for care) includes six Mesa County primary care practices to serve as your medical home, including more than 125 primary care providers; two local hospitals (St. Mary's Medical Center and Colorado Canyons Hospital & Medical Center); many local specialists who are either independently owned or affiliated with St. Mary's Medical Center or Family Health West; and all SCL Health providers and facilities in Denver and surrounding counties.
- Tier 2: Includes the Rocky Mountain Health Plan statewide network of providers.
Generally, when you obtain care, all of your costs are bundled and you pay only one copay for that care. Your plan pays the rest.
Separate deductible amounts for Tier 1 and Tier 2. Tier 1 and Tier 2 out-of-pocket maximums are combined.
Out-of-network coverage is provided, but you will pay more for those services. All out-of-network services have separate deductibles and out-of-pocket maximums.

And more!

Learn more about Rocky Mountain Health Plans' Wellness Program.
Prescription drug coverage is provided through network retail pharmacies and a home delivery service.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

Resources

Call Rocky Mountain Health Plans at 800-843-0719
Manage your claims and access information regarding services provided through your medical plan by creating an account at rmhp.org.
Find Tier 1 and Tier 2 providers at rmhp.org.

The Doctors Plan is a network-only plan available to employees and their families who live in certain ZIP codes in Denver, Colorado. It is built around deepening the relationship between you and your primary care physician (PCP). To see if you are eligible for the Doctors Plan, visit the benefits enrollment site.

Details

Except for emergencies, benefits are paid only for care or services received from providers in the network. There is no coverage for out-of-network services.
This plan helps you save money on your health care costs because it has a low premium and no copays for PCP office visits, urgent care, convenience care or Virtual Visits.
For other services like minor X-ray and lab tests, you'll pay a $25 copay
You and each enrolled dependent must select a PCP in the Doctors Plan network.
- You will have access to PCPs including those from Centura Health, Colorado Health Neighborhoods, New West Physicians and other community physicians.
  - Your PCP will coordinate all of your care. For services within the network, no referral is required.
  - Additional coordination is required if you cover a dependent who lives out of state. Your dependent must have a PCP in the state where you reside.

Prescription Drug Coverage

The Doctors Plan uses the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network.
Visit Prescription Drug Coverage to learn more.

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

The M Health Fairview Primary Care Plan is a network-only plan available to eligible employees and their families who live in certain ZIP codes in Minneapolis and St. Paul, Minnesota.

The M Health Fairview Primary Care Plan is an Accountable Care Organization (ACO). An ACO gives you access to a value-based, focused network of providers, hospitals and other health care professionals who work together to provide you coordinated, high-quality, cost-effective care. The fundamental purpose of a high-performing ACO is to help you achieve better health outcomes.

With this plan, you’ll have access to over 4,000 doctors and other health care professionals from M Health Fairview and several popular independents like Voyage Healthcare (formerly North Clinic) and Entira Family Clinics.

To see if you are eligible for the M Health Fairview Primary Care Plan, visit the benefits enrollment site.

Details

Except for emergencies, benefits are paid only for care or services received from providers in the Fairview medical group, its affiliated hospitals and other facilities in the network. There is no coverage for out-of-network services.
This plan helps you save money on your health care costs because it has a low premium and low office visit copays and deductibles.
With this plan, you and your family will have access to Fairview's hospital partners, including University of Minnesota Health and North Memorial Health.
You do not need:
- To select a primary care physician (PCP)
- A referral for services if you see a provider within the Fairview network

Prescription Drug Coverage

The M Health Fairview Primary Care Plan uses the OptumRx Select Network. This network includes 50,000 pharmacies such as major drug stores, mass retailers, local pharmacies and supermarkets, as well as home delivery and specialty pharmacy services. Please note that CVS does not participate in the OptumRx Select Network.
Visit Prescription Drug Coverage to learn more

And more!

You have access to Health Care Advisor, your 24/7 resource for personalized health care support and guidance.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.
When you use a UnitedHealthcare Hearing provider, the plan will pay 80% after the deductible for an assessment and hearing aids with a maximum benefit of $3,000 every three years. Call Health Care Advisor at 800-357-1371 for more information.

SignatureValue Advantage is a network-only HMO available to employees and their families who live in select ZIP codes in California. To see if you are eligible for the SignatureValue Advantage HMO, visit the benefits enrollment site.

Details

No deductible.
Except for emergencies, benefits are paid only for care or services provided inside the network and when authorized through your Primary Care Physician (PCP).
Access to SignatureValue Advantage performance network.
You pay 20% coinsurance for some services
Your PCP will coordinate all of your care, including referrals to specialists. In most cases, if you see a specialist without a referral from your PCP, it will not be covered.
You do not need in-network referrals for certain services such as:
- Obstetricians/gynecologists
- Behavioral health and substance-use disorder clinicians
- Convenience care clinics, urgent care clinics or emergency rooms

And more!

Prescription drug coverage is provided through the network retail pharmacies and OptumRx home delivery service pharmacy.
Contribute to a Full-Purpose Health Care Flexible Spending Account (FSA) to help cover eligible medical, dental and vision costs with pretax dollars.

Resources

Call UnitedHealthcare of California HMO Customer Service at 877-669-3855.

You slipped on the stairs and feel your ankle throbbing. Or your child spikes a high fever in the middle of the night. You call your primary care doctor first, but you can't get a same-day appointment. So do you go to the emergency room (ER) or urgent care? Or would a virtual visit work best?

If it’s not actually an emergency situation, rushing to the ER for non-life threatening ailments may cost patients far more than visiting a more appropriate care setting. In addition, seeking care in the ER may mean longer wait times and an increased exposure to germs, plus potentially unnecessary tests or treatments. Using the ER for all your health care needs may also mean you’re missing an opportunity to create a long-term relationship with a primary care physician who can provide preventive care before more serious issues arise.

That’s why understanding the most appropriate care setting is an important step to help you receive the simplest experience with the best outcomes.

Here’s what to consider when deciding where to go for care:

Urgent care center

Urgent care centers are not for emergencies but can help you when you need care quickly. If you can’t get in with your primary care physician, this may be another option. Remember, it’s first-come, first-served. You may consider urgent care if you have symptoms like the following:

Fever without a rash
Moderate flu-like symptoms
Sprains and strains
Small cuts that may require stiches

The average cost for an urgent care visit is $180*.

Emergency room

The hospital emergency room provides medical care for life-threatening injuries or illness. While some people may be tempted to utilize ER services because it’s open 24/7, the wait time is typically two hours on average. Patients with life-threatening emergencies or critical conditions will be treated first so if you’re experiencing a minor ailment, it may not be the best place to seek care. Some of the symptoms that require an emergency room visit include, but are not limited to:

Chest pain
Numbness
Slurred speech
Fainting
Serious burns
Concussion
Broken bones and dislocated joints
Fever with a rash
Seizures

The average cost for an emergency room visit is $2,200*.

Have you considered a virtual visit?

If you are faced with a non-emergency health condition – like a migraine, sore throat or stomachache – but your doctor’s office is closed, you may consider a virtual visit. This allows you to virtually chat face-to-face with a doctor, day or night, and may help you save money compared to a visit to the ER**. Virtual visits – along with telehealth resources increasingly available through local health care providers – are especially important for medical advice related to the on-going COVID-19 situation.

The average cost for a virtual visit is less than $50*.

Still not sure?

UnitedHealthcare plan members can also compare quick care options with UnitedHealthcare’s online resource, as well as use a symptom checker to help with your COVID-19 concerns. If you or a loved one are experiencing what you feel to be life-threatening symptoms other than those listed, go to the emergency room or call 9-1-1.

*Information about treatment costs are estimates and reflect the average costs of guidance and care delivered through UnitedHealthcare owned and contracted service providers to members of UnitedHealthcare health plans. Costs for specific guidance and treatments may be higher or lower than the costs represented here. Emergency room cost estimates include facility charge and initial physician consultation.

United Healthcare Medication Copays

**Check your official health plan documents to see what services and providers are covered by your health plan. Virtual visits are not an insurance product, health care provider or a health plan. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times or in all locations.