2024-2025 Armor Health_OE Benefit Guide

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.

7

Made with FlippingBook - Online Brochure Maker