Benefits

Retiree - UK-PPO High

At a glance: UK-PPO High offers care through a broader network, including UK HealthCare facilities (such as Chandler Hospital, Good Samaritan Hospital and Kentucky Clinics), UK HealthCare physicians, and Humana/ChoiceCare networks. Lower deductible than UK-PPO, but UK-PPO High has a higher premium. Click here for full plan details. The Humana/ChoiceCare networks may be accessed on Humana's website at: www.humana.com.

UK-PPO High Factors to Consider

  • Lower out-of-pocket expenses than the UK-PPO.
  • Highest PPO premium.
  • 90% benefit after meeting your deductible (when applicable) when using an in-network provider.
  • 60% benefit after meeting your deductible when using an out-of-network provider.
  • Lower copayments for office visits (both primary care and specialist) than UK-PPO.
  • Lower copayments when using UK HealthCare providers for certain procedures.

Prior authorization is required for the following services: inpatient hospital services, skilled nursing facility services and all mental health, alcohol and/or chemical dependency services. Failure to obtain prior authorization will result in a 50% benefit penalty. This penalty does not accrue toward the maximum out-of- pocket limit.


UK-PPO High Option Summary of Health Plan Benefits

2008-2009

UK PPO High Major Plan Benefits

UK Healthcare Providers*

In-Network

Out-of-Network

Out-of-Pocket Amount

 

 

Annual Deductible

 

$250 per member
$500 per family

$250 per member
$500 per family

$750 per member
$1,500 per family

Out-of-pocket maximum (excludes deductible and mental health expenses)

$750 per member
$1,500 per family

$750 per member
$1,500 per family

$2,250 per member
$4,500 per family

Lifetime Maximum Benefit

 

Unlimited

Unlimited

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) Routine outpatient laboratory tests and X-rays

100% after $5 copay per visit

100% after $10 copay per visit

60% after deductible

Physician Services

Office visits (excludes diagnostic lab and X-ray)

100% after $5 copay per visit per primary care visit or $15 copay per specialist visit

100% after $10 copay per visit per primary visit or $20 copay per specialist visit

60% after deductible

 

 

Lab tests and X-rays

100% after office visit copay

100% after office visit copay

60% after deductible

Allergy injections

100%

100% after $5 office visit copay

60% after deductible

Inpatient services
Outpatient surgery and diagnostic tests

90% after deductible

90% after deductible

60% after deductible

Physician visits to emergency room

90% after deductible

90% after deductible

60% after deductible

Hospital Services

 

 

 

 

 

 

Inpatient care (semi-private room and board, nursing care, ICU)
Outpatient surgery
Outpatient nonsurgical care
Outpatient tests, lab and X-ray
Ancillary services
Organ transplants

90% after deductible

90% after deductible

60% after deductible

Emergency room

 

90% after $50 copay per visit (waived if admitted)

90% after $50 copay per visit (waived if admitted)

60% after deductible

Other Medical Services

 

 

 

 

Skilled nursing facility (up to 100 days)
Home health care (up to 100 visits per plan year)
Durable medical equipment
Hospice services

90% after deductible

90% after deductible

 

 

 

60% after deductible

 

 

 

Ambulance

90% after deductible

90% after deductible

90% after deductible

Physical, speech, hydrotherapy, occupational, and acupuncture therapy (limited to 30 visits per condition per plan year, combined)

100% after $10 copay per visit

100% after $15 copay per visit

60% 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)

90% after deductible

90% after deductible

60% after deductible

* - You may search for UK HealthCare providers online at www.humana.com.