2024-2025 Armor Health Benefits Guide
MEDICAL UnitedHealthcare
UnitedHealthcare’s Choice plan provides in-network only benefits. If you choose this plan, you will be automatically enrolled in Loomis Choice GAP plan which provides reimbursement of inpatient hospital and outpatient medical expenses you may incur using your UnitedHealthcare primary coverage. To search for a UnitedHealthcare Choice provider, visit myuhc.com and select “ Find a Doctor .” Follow the prompts and choose the plan’s network - Choice.
UnitedHealthcare INN Choice
Loomis Medical GAP Choice Compatible Plan
Provider Network
Choice
Benefits
In-Network Only
Per Insured DED Limit N/A First dollar coverage applied to in/out-patient out-of-pocket medical expenses Combined Inpatient / Outpatient Benefit
Calendar Year Deductible (DED) Individual / Family (Emb)
$8,150 / $16,300
Out-of-Pocket Maximum
Individual / Family
$8,150 / $16,300
$4,000 / $12,000
Member Coinsurance
0%
0%
Office Visits
Excluded
Preventive & Wellness Care
100% covered
Telemedicine
$30 copay $30 copay $55 copay
not covered
Primary Care Physician
Specialist
Non-Emergent Care
Excluded
Convenience Care Clinic
$30 copay
not covered
Emergency Care Emergency Room
Covered
$0 after ded $75 copay
outpatient benefit
Urgent Care
Hospital Services
Covered
Inpatient Care
$0 after ded $0 after ded
inpatient benefit outpatient benefit
Outpatient Surgery
Independent Diagnostic Facility
Covered
Labs/X-Rays
100% covered $0 after ded
outpatient benefit
Diagnostics & Complex Imaging
Prescription Drugs (retail 30 day supply)
Excluded
Tier 1 / Generic
$10 copay $45 copay $85 copay
Tier 2 / Brand and Generic Equivalent
prescriptions are not eligible as a covered expense under a gap plan
Tier 3 / Non-preferred Brand
Tier 4 / Specialty
30% / $250 max copay
Mail-Order (90 day supply) Excluded Network Access: Employees who reside AL, AK, HI, MS, MT, NC, NM or OK access the UnitedHealthcare Choice Plus network. 2.5x retail cost
*Designated Diagnostic Providers (DDP) – are outpatient imaging service providers that meet certain quality and efficiency requirements. To ensure you receive the highest level of coverage, you must use an in-network DDP, otherwise you will have a higher cost-share and end up paying more out-of-pocket for those services.
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