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Benefits

UK Indemnity Health Plan

What You Need to Know: 

The UK Indemnity plan is available to out-of-state residents and Medicare-eligible retirees. 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. For covered services, there is an annual deductible that must be met before the health plan begins paying a benefit. 

Factors to Consider

  • Complete freedom to receive services from any provider.
  • If you will be out of the UK-HMO, UK-PPO, 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.

Summary of Health Plan Benefits

2013-2014 Major Plan Benefits Benefits for Covered Services
Out-of-Pocket Amount

 

Annual deductible
Out-of-pocket maximum (excludes deductible, prescription coinsurance, 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 mammogram and Pap smears
Routine child care and immunizations (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 certain diagnostic lab and X-rays)
Lab tests and X-rays
Allergy injections
Inpatient services
Outpatient surgery and diagnostic tests
80% after deductible
Hospital Services

 

 

 

 

 

 

Inpatient care (semiprivate room and board, nursing care, ICU)
Physician visits to emergency room
Outpatient surgery, outpatient nonsurgical care
Outpatient tests, lab and X-ray
Ancillary services
Organ Transplants
80% after deductible
Emergency room

 

80% after $100 copay per visit (waived if admitted)
Other Medical Services

 

 

Skilled nursing facility (up to 100 days per plan year)
Home health care (up to 100 visits per plan year)
Ambulance
Hospice
Durable medical equipment
Physical, speech,hydroptherapy, occupational and acupuncture therapy (limited to 30 visits per condition, per plan year, combined)
80% after deductible

 

 

Mental Health and Substance Abuse Inpatient (up to 31 days per plan year)
Outpatient (up to 20 visits per plan year)
80% after deductible