The UK-PPO plan is available at the same monthly cost as the UK-HMO and offers greater flexibility to choose a doctor or health care facility. While the monthly premiums are the same as the UK-HMO, members of the UK-PPO plan pay for this extra flexibility through deductibles and higher co-pays for certain services. UK HealthCare facilities and physicians are in the UK-PPO network and are available at lower co-pays and co-insurance than services outside of UK HealthCare.

 

Coverage Level Monthly Rate* UK Credit Monthly Cost to Employee
Employee only $523 $495 $28
Employee + child(ren) $783 $649 $134
Employee + spouse $1,044 $783 $261
Employee + family $1,307 $922 $385

* Regular part-time and temporary employees (less than 0.75 FTE or work less than an average of 30 hours per week in a 12 month measurement period), who are not eligible for the UK credit toward the costs of coverage, pay this rate.

Find a doctor

Anthem provides a Find a Doctor tool to show which providers in your area accept your insurance plan.

Full coverage information

Complete information about the UK-PPO plan is available in this Summary of Benefits Coverage or this medical benefits booklet.
 

2017-2018 UK-PPO Major Plan Benefits UK HealthCare Providers Anthem Providers Out-of-Network Providers
Lifetime Maximum Benefit Unlimited Unlimited Unlimited Unlimited
Out-of-Pocket Amount Annual deductible $250/member; $500/family $500/member, $1,000/family $1,500/member; $3,000/family
Medical out-of-pocket maximum $2,750/member; $5,500/family $3,000/member; $6,000/family N/A
Prescription out-of-pocket maximum $3,850/member; $7,700/family $3,850/member, $7,700/family $3,850/member, $7,700/family
Preventive Care
* Coverage under preventive care category depends on age, symptoms and diagnosis
 
Routine immunizations (through age 18)
Routine mammogram and Pap smears
Routine child care (through age 18)
Routine adult physical exam (19 years and above)
Routine outpatient lab tests and X-rays 
100% 100% 50% after deductible
Physician Services  Office visits (excludes diagnostic lab and X-ray) 100% after $15 co-pay per primary care visit or $40 co-pay per specialist visit  100% after $25 co-pay per primary care visit or $50 co-pay per specialist visit 50% after deductible 
Lab tests and X-rays 100% after office visit co-pay 100% after office visit co-pay  50% after deductible 
Allergy injections  100% after $10 co-pay per visit  100% after $10 co-pay per visit 20% after deductible
Inpatient services 
Outpatient surgery and diagnostic tests
90% after deductible  80% after deductible  50% after deductible
Physician visits to emergency room 80% 80%  50% 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 80% after deductible 50% after deductible
Emergency room 80% after $100 co-pay per visit (waived if admitted) 80% after $100 co-pay per visit (waived if admitted) 80% after $100 co-pay per visit (waived if admitted)
Urgent treatment center N/A 100% after $50 co-pay per visit 50% after deductible
Other Medical Services Skilled nursing facility (up to 100 days/plan year) 80% after deductible 80% after deductible 50% after deductible
Home health care (up to 100 visits/plan year) and hospice services 80% after deductible 80% after deductible 50% after deductible
Durable medical equipment  80% after deductible 80% after deductible 50% after deductible
Ambulance 80% after deductible 80% after deductible 80% after deductible
Chiropractic care*, physical, speech, music, hydrotherapy, occupational and acupuncture therapy (limited to 45 visits per plan year, combined) *Maximum 20 visits for chiropractic care 100% after $20 co-pay/visit 100% after $30 co-pay/visit 50% after deductible
Mental Health and Substance Abuse Inpatient 90% after deductible 80% after deductible 50% after deductible
Outpatient 100% after $40 co-pay/visit 100% after $50 co-pay/visit 50% after deductible

Employee health plans

UK-HMO
UK-RHP
UK-PPO
UK-EPO

Employee health plans

UK-HMO
UK-RHP
UK-PPO
UK-EPO

Dental Plans

UK Dental
Delta Dental