2014 2015 OE United Healthcare - 2014 OE 100-10413

Options PPO Plan

2014-07-09 05:50:07

You have the freedom to use any doctor or hospital you want. But you can save money when you choose doctors (including specialists), hospitals, labs and pharmacies in the Options PPO network. Health care providers who are in our network have agreed to charge lower prices. You also have coverage if you choose to receive care outside the network. However, you will likely pay more for the service. You do not need to choose a primary care provider. But a primary care provider (PCP) can be helpful in managing your care. You do not need a referral to see a specialist. See any doctor, including specialists, without referrals. About the network • More than 750,000 doctors and health care professionals (that’s 2 out of every 3 doctors) • More than 6,600 hospitals and health care facilities • Local access fo 98% of the US population • Emergency care covered anywhere in the world COVERED SERVICES This plan covers all of the basic health care services required by law, including: • Doctor office visits • Emergency services • Hospital care • Lab services • Mental health and substance use disorder services • Outpatient care services • Pregnancy and newborn care • Prescription drugs • Preventive care services • Rehabilitative services and devices • Wellness services PERSONAL CARE AND SUPPORT The plan includes a number of services to help you improve your health, find the right care and get personal attention when you need it. 24-hour registered nurses You can call and speak directly with a registered nurse anytime. Healthy Pregnancy Program We provide personal support for soon-to-be-mothers throughout their pregnancy. Employee Assistance Program We offer confidential support for a wide range of personal and work-related needs. Treatment Decision Support We can help you understand and select treatments that best meet your needs. HOW THE PLAN WORKS 1 You will likely pay a co-payment for doctor visits and prescriptions.2 A co-payment is a fixed amount of money you have to pay each time you see a doctor or fill a prescription. 2 You will likely have a deductible.2 The deductible is the amount you owe for covered services before your plan starts to pay. 3 If you paid the deductible, your plan will likely have co-insurance.2 Co-insurance is when the plan shares the cost of covered services with you. The plan will pay a percentage of each service, and you will pay the rest. For example, if your plan pays 80% of the cost, you will pay 20%. 4 You are protected with an out-of-pocket limit.3 This is the most you will pay during a plan year for covered services. If you reach the limit, the plan will pay 100% of covered services for the rest of the plan year. You may be required to have approval for certain services before they can be covered by your plan. See your health plan documents for coverage details. Visit welcometouhc.com • Find a network doctor. • Estimate the cost of the plan. • Find a network pharmacy. • See recommended preventive care services. • Learn how we can help you make the move from another health plan or network. What does PPO mean? It stands for preferred provider organization (PPO). This is a type of health plan that contracts with health care providers, such as doctors and hospitals. These providers make up the plan network. You have coverage for a wide range of prescriptions. There are thousands of retail pharmacies in our network, including large national chains and many local pharmacies. Home delivery helps you save. With OptumRX mail service pharmacy, you may save money with a three-month medication supply. It’s delivered to your home at no additional cost. Your preventive care is covered 100% in our network. You don’t have to pay any out-of-pocket costs for preventive care as long as you use a network doctor. MEET TEKOA KUNTZ Tekoa needed heart surgery. Before he was even born, UnitedHealthcare helped his mom and dad find a UnitedHealth Premium® surgeon at a children’s hospital that is recognized for treating complex heart conditions. Four years later – and after three surgeries – Tekoa loves to go to the pool. And he can leap off the couch like a super hero. Learn more about the UnitedHealth Premium program at welcometouhc.com. HELPFUL ONLINE TOOLS Health Care Lane® Learn more about the Options PPO Plan. Visit Bert’s Barber Shop at healthcarelane.com. Just Plain Clear™ English and Spanish Glossary Thousands of health and insurance terms are defined in plain, clear language at justplainclear.com. UHC TV UHC TV is an internet TV network with you in mind. Tune in for short, original videos about good health and living well. Visit UHC.TV. Source4WomenTM Join online seminars, read expert blogs, find healthy recipes and more at Source4Women.com. @Source4Women Source4WomenUHC Source4Women Source4Women Take charge of your health care with myuhc.com® and the UnitedHealthcare Health4Me™ mobile app. Visit welcometouhc.com to learn more. Before you enroll, take some time to: • See if your doctor or pharmacy is in the network • Understand the plan details, including costs • Learn more about the services included with your plan

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