2014 2015 OE United Healthcare 2014 OE 100-10413 : Page 3

HOW THE PLAN WORKS 1 You will likely pay a co-payment for doctor visits and prescriptions. 2 A co-payment is a fi xed amount of money you have to pay each time you see a doctor or fi ll a prescription. Patient pays co-payment to see a doctor or fi ll a prescription HELPFUL ONLINE TOOLS Health Care Lane ® 2 You will likely have a deductible. 2 Th e deductible is the amount you owe for covered services before your plan starts to pay. Patient pays 100% Plan pays 0% 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 defi ned in plain, clear language at justplainclear.com. Patient pays 20% Plan pays 80% Patient pays the deductible before the plan pays 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. Th e 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%. 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. Source4Women TM If deductible has been reached, co-insurance begins 4 You are protected with an out-of-pocket limit . 3 Th is 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. Patient pays 0% Plan pays 100% Plan pays 100% if out-of-pocket limit has been reached Join online seminars, read expert blogs, fi nd healthy recipes and more at Source4Women.com. @Source4Women Source4WomenUHC Source4Women Source4Women 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. 2 3 Co-payments, co-insurance and deductible payments do not apply for eligible preventive care expenses. Co-payments, co-insurance and the deductible are included in the out-of-pocket limit. welcometouhc.com

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