Health Plans, Benefits, Human Resources, University of Kentucky

Overview Plan Options

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Health Plans - UK Indemnity

At a glance: The UK Indemnity plan is available to out-of-state residents and Medicare-eligible retirees.

Summary of UK Indemnity Health Plan Benefits
The UK Indemnity option is only available to those participants who live or travel out of state for extended periods of time.

Indemnity plans offer the freedom to receive care from any physician. Click here for full plan details. For covered services, there is an annual deductible that must be met before the health plan begins paying a benefit.

UK Indemnity Factors to Consider:

Complete freedom to receive services from any provider.
If you will be out of the UK-HMO, UK-PPO, UK-PPO High, or UK-EPO plan service areas for more than 120 days (4 months), you must elect the UK Indemnity plan.
Deductibles, expenses for mental health and substance abuse and prescription coinsurance do NOT accrue toward the maximum out-of-pocket limit.
Covered transplants include kidney, liver, pancreas, kidney/pancreas, heart, lung, heart/lung, bone marrow and cornea transplants.

Prior authorization is required for the following services: inpatient hospital services; inpatient mental health, alcohol and/or chemical dependency services; outpatient mental health, alcohol and/or chemical dependency services; and skilled nursing facility services. Failure to obtain prior authorization will result in a 50% benefit penalty.

UK Indemnity Option Summary of Health Plan Benefits

2008-2009	Major Plan Benefits	Benefits for Covered Services
Out-of-Pocket Amount	Annual deductible Out-of-pocket maximum (excludes deductible and mental health expenses)	$500 per member/$1,000 per family $1,500 per member/$3,000 per family
Lifetime Maximum Benefit		Unlimited
Preventive Care	Routine immunizations (through age 18) Routine mammogram and Pap smears Routine child care (through age 18) Routine adult physical exam (19 years and above, one per plan year)	80% after deductible
Physician Services	Routine outpatient laboratory tests and X-rays Office visits (excludes diagnostic lab and X-ray) Lab tests and X-rays Allergy injections Inpatient services Outpatient surgery and diagnostic tests	80% after deductible
Hospital Services	Physician visits to emergency room Inpatient care (semiprivate room and board, nursing care, ICU) Outpatient surgery Outpatient nonsurgical care Outpatient tests, lab and X-ray Ancillary services	80% after deductible
	Emergency room	80% after $50 copay per visit (waived if admitted)
	Organ transplants	80% after deductible
Other Medical Services	Skilled nursing facility (up to 100 days per plan year) Home health care (up to 100 visits per plan year) Ambulance Durable medical equipment Hospice services Physical, speech, occupational and acupuncture therapy (limited to 30 visits per condition, per plan year, combined)	80% after deductible
Mental Health and Substance Abuse (mental disorders, chemical and/or alcohol dependence)	Inpatient (up to 31 days per plan year) Outpatient (up to 20 visits per plan year)	80% after deductible