Medical Benefits
Health Savings Account (Available to Oxford HDHP $1,500/90% with Health Savings Account Enrollees Only) A Health Savings Account allows you to save money on a pre-tax basis, to payfor qualified medical, dental andvision expenses. An HSA is a personalsavings account you establish with a bank. If you wish to make pre-tax contributions, you must open an HSA with Optum Bank. Although there are annual limits on the amount you may contribute to an HSA, you decide when to spend the savings in your account. Youmay use the money to pay eligiblemedical, dental andvision bills. Or, you may choose to payyour current bills out-of-pocket and build your balance year over year to use for health care expenses in your retirement years. Even ifyou change jobs, or decide not to enroll in an HSA plan in the future, the balance is yours to spend.
The Contribution limit for is $3,850 for an Individual and $7,750 for a Family, inclusive of the Employer Matching Contribution. The Health Savings Account allows for an annual catch-up contribution of $1,000 for individuals age 55 or older.
Precertification The Oxford Plans require precertification for the following services and procedures:
In-Network Provideris responsible for obtaining precertification. ⮞ Dental Services – Accident Only ⮞ EmergencyHealthServices if you areadmitted to a non-network hospital ⮞ Transplantation Services ⮞ A single item of Durable Medical Equipment that costs more than $500 (either purchase price or cumulative rental) ⮞ Inpatient Mental Health Care – Available
Out-of-Network Youareresponsible for obtaining precertification. ⮞ Dental Services – Accident Only ⮞ Home Health Care ⮞ Hospice Care ⮞ Reconstructive Procedures ⮞ Elective Admissions toa Skilled Nursing Facility/Inpatient Rehabilitation Facility ⮞ Any Inpatient Hospital Stay including, but not
limited to that of a mother and/or newborn that will be more than 48 hours following a normal vaginal delivery and 96 hours following a cesarean section delivery ⮞ As soon as the possibility of a transplant arises (and before the time a pre-transplantation evaluation is per- formed ata transplantcenter) ⮞ A single item of Durable Medical Equipment that costs more than $1,000 (either purchase price or cumula- tive rental) ⮞ Inpatient Mental Health Care – Available benefits reduce to 50% of eligible expenses if precertificationis notobtained.
benefits will be reduced to 50% of eligible expenses if precertificationis not obtained.
⮞ Short Term Rehab, Habilitation Services, Chiropractic Services ⮞ Outpatient Surgery
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