The Standard Benefit Guide

United Healthcare

UNITED HEALTHCARE STANDARD POS

UNITED HEALTHCARE AMAZING POS

UNITED HEALTHCARE OMG! POS

Out of Network

Out of Network

Out of Network

In Network

In Network

In Network

Calendar Year Deductible (Single/Family)

$2,000/$4,000 $4,000/$8,000 $500/$1,000 $1,000/$2,000 $250/$500 $1,000/$2,000

Calendar Year Out-of-Pocket Maximum (Single/Family)

$5,000/$10,00 0

$10,000/$20,00 0

$3,500/$7,000 $7,000/$14,000 $2,500/$5,000 $5,000/$10,000

Preventive Services

No Charge Not Covered No Charge Not Covered No Charge Not Covered

$40/$50 copay (deductible waived)

$25/$50 copay (deductible waived)

$20/$40 copay (deductible waived)

40%after deductible

40%after deductible

20%after deductible

Office Visits (Primary/Specialist)

Telemedicine

$40 copay

$25 copay

$20 copay

X-Ray 40% after deductible, Lab Not covered

X-Ray 40% after deductible, Lab Not covered

X-ray 20% after deductible, Lab Not covered

Lab & X-ray

No Charge

No Charge

No Charge

Complex Radiology (includes CT, PET and MRI)

20% after deductible

40% after deductible

20% after deductible

40% after deductible

0% after deductible

20% after deductible

Inpatient Hospital Services (includes Maternity)

20% after deductible

40% after deductible

20% after deductible

40% after deductible

20% after deductible

$500 copay

20% after deductible

40% after deductible 40% after deductible

20% after deductible

40% after deductible 40% after deductible

0% after deductible

20% after deductible 20% after deductible

Outpatient Surgery

Urgent Care

$50 copay

$50 copay

$50 copay

Emergency Room (Co-pay waived if admitted)

20% after deductible

$200 copay per visit

$150 copay

Ambulance

20% after deductible

$200 copay per visit

$150 copay

Calendar Year Drug Deductible

No Deductible

No Deductible

No Deductible

$15/$35/$50 + the Difference in Cost

$15/$35/$50 + the Difference in Cost

$15/$35/$50 + the Difference in Cost

Retail Prescription (up to a 31-day supply) (tier1/tier2/tier3)

$15/$35/$50

$15/$35/$50

$15/$35/$50

$37.50/$87.50/ $125

Mail-Order Prescription (up to a 90-day supply) (tier1/tier2/tier)

$37.50/$87.50/ $125

$37.50/$87.50/ $125

Not Covered

Not Covered

Not Covered

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