UK Human Resources


Factors to Consider

  • Lowest premium out of pocket compared to other UK plans
  • Must use Lexington Service Area network -- Chandler Hospital, Good Samaritan Hospital, and Kentucky Clinics -- and UK HealthCare physicians (provider list here).
  • No referrals are required for specialty care services provided within the network.
  • No deductibles to meet.
  • No coverage for out-of-network services unless it is life or limb threatening.
  • UK-HMO is available in these Kentucky counties: Anderson, Bourbon, Clark, Fayette, Franklin, Jessamine, Madison, Mercer, Scott, and Woodford

Continue below for an overview of benefits. For more details, view the UK Benefits booklet or the summary of benefits coverage.

Summary of Benefits



Major Plan Benefits


Benefits for Covered Services Provided at Participating Providers

Lifetime Maximum Benefit

Out-of-Pocket Amount




$2,500/member; $5,000/family

Copayment Limits

Individual and Family


Preventive Care




Routine Pap smears, mammograms, PSA, screening colonoscopy and sigmoidoscopy
Routine child care and immunizations (through age 18)
Routine adult physical exam (19 years and above, one per plan year)




Physician Services







Office visits (excludes certain diagnostic lab and X-ray)

100% after $10 copayment for primary care physician,
100% after $30 copayment for specialist,

Lab tests, X-rays and diagnostic tests


Allergy injections

100% after $10 copayment

Inpatient services
Outpatient surgery and diagnostics
Physician visits to emergency room


Hospital Services





Inpatient care (semi-private room and board, nursing care, ICU)

100% after $200 copayment per admission

Organ transplants
Outpatient nonsurgical care
Outpatient tests, lab and X-ray, and other diagnostic tests
Ancillary services


Outpatient surgery
Outpatient diagnostic testing (high costs - MRI, MRA, CT and PET scans)

100% after $75 copayment

Emergent/Urgent Services

Emergency Room


Urgent Treatment Center


UK Children's Twilight Clinic

100% after $100 copayment (waived if admitted)

100% after $25 copayment

100% after $15 copayment

Other Medical Services





Skilled nursing facility (up to 30 days per plan year) & Hospice Services



100% after $75 copayment

Home health care (up to 60 visits per plan year)


Durable medical equipment, orthotics and prosthetics

80%, maximum member responsibility of $500/plan year for all services combined

Hearing aids

100% for children under 18

Speech therapy, music therapy, pulmonary rehab therapy, physical therapy, occupational therapy, cardiac rehab, manipulative therapy, hydrotherapy and acupuncture therapy (limited to 45 visits per plan year, combined)


100% after $15 copayment per visit for all therapies

Mental Health and Substance Abuse

Inpatient mental health or substance abuse

100% after $200 copayment per admission

Outpatient mental health or substance abuse

100% after $30 copayment