2014 2015 OE United Healthcare 2014 OE 100-10413 : Page 2

OPTIONS PPO PLAN COVERED SERVICES Th is plan covers all of the basic health care services required by law, including: 1 } Doctor offi ce visits } Emergency services 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. } 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 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. PERSONAL CARE AND SUPPORT Th e plan includes a number of services to help you improve your health, fi nd 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 off er confi dential 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. MEET TEKOA KUNTZ Tekoa needed heart surgery. Before he was even born, UnitedHealthcare helped his mom and dad fi nd 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. 1 This may not be a complete list of the services covered under this plan. See your health plan documents for coverage details.

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