Health Plans



Retirees under age 65 and those age 65 and over qualify for different health plans and rates. Retirees under the age of 65 are eligible for the same health plans that are available to active employees. Ages 65 and over are eligible for UK Medicare Carveout Classic which offers complete freedom to receive services from any provider who accepts Medicare. Retirees actively working at UK, regardless of any age, have the opportunity to receive reduced rates on their medical plan.



Rates



As indicated below, monthly health plan costs to retirees vary based on age, plan, and coverage, as well date of retirement eligibility.



Age 65 or Over: 2017 Medicare Carveout Plan Rates


The UK Medicare Carveout Classic plan for retirees age 65 and over automatically includes prescription benefit coverage. As a result, you do not need to apply for a separate Medicare Part D plan.


The University of Kentucky offers the UK Medicare Carveout Classic plan for retirees age 65 and over or those on long-term disability and eligible for Medicare. If you are currently on this plan, no action is required on your part during the regular UK Open Enrollment period. As you may know, the UK Medicare Carveout Classic plan features a different “plan year” from other UK benefit plans. The UK Medicare Carveout Classic plan year begins on January 1 and ends on December 31. You will be mailed any changes and information for the UK Medicare Carveout Classic plan in November 2017.


You must present your regular Medicare card and your UK Medicare Carveout Classic card for health coverage. For Medicare Parts A and B, you receive a card when you become eligible for Medicare. You will not be issued a new card each year.


Enrolling in the UK Medicare Carveout Classic Health Plan


Retirees enrolled in other UK health plans should enroll for Medicare Part B and the UK Medicare Carveout Classic plan at least 30 days prior to their 65th birthday. This coverage will automatically renew each year.Download a copy of the enrollment form, or to get a paper copy, call 859-257-9519, option 3.








Coverage Level

Monthly cost*

UK credit

Employee pays

Retireee only (eligible for credit)

$317

$285

$32

Retiree + spouse (eligible for credit)

$634

$285

$349

Retiree spouse (not eligible for credit)

$317

$0

$317

Surviving spouse (eligible for credit)

$317

$143

$174

Retiree + spouse (not eligible for credit)

$634

$0

$634


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 Medicare Carveout Classic plan is available in this Summary of Benefits Coverage or this benefits booklet.














2017-2018

UK Medicare Carevout Major Plan Benefits

Benefits for Covered Services Provided at Participating Providers

Lifetime Maximum Benefit

Unlimited

Unlimited

Out-of-Pocket Amount

Annual deductible

$183/member; $366/family

Medical out-of-pocket maximum

$3,000/member; $6,000/family

Prescription out-of-pocket maximum

$3,850/member; $7,700/family

Preventive Care

Routine mammogram and Pap smears, PSA, screning colonoscopy and sigmoidoscopy*

Routine child care and immunization (through age 18)

Routine adult physical exam (19 years and above, 

80% after deductible

Physician Services

Routine outpatient laboratory tests and X-rays

Office visits (excludes certain diagnostic lab tests and X-rays)

Lab tests and X-rays

Allergy injections

Inpatient services

Outpatient surgery and diagnostic tests

80% after deductible

Hospital Services

Inpatient care (semi-private 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

Other Medical Services

Emergency room

80% after $100 co-payment (waived if admitted)

Urgent treatment center

Skilled nursing facility (up to 100 days per plan year)

Home health care (up to 100 visits/plan year)

Ambulance services

Hospice services

Durable medical equipment

Physical, speech, hydrotherapy, occupational and acupuncture therapy (limited to 45 visits per plan year, combined)

80% after deductible

Mental Health and Substance Abuse

Inpatient mental health or substance abuse

Outpatient mental health or substance abuse

80% after deductible

Retiree enrollment form


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



 



UK-HMO, UK-RHP, UK-PPO Plan Rates




Monthly premium information for employees retired or eligible to retire as of July 1, 2007

 







Coverage Level

Monthly cost*

UK pays

Retiree pays

Retiree only

$801

$721

$80

Retiree + child(ren)

$1,199

$721

$478

Retiree + spouse

$1,598

$721

$877

Retiree + family

$2,001

$721

$1,280


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-HMO plan is available in this Summary of Benefits Coverage.

 




























2017-2018

UK-HMO Major Plan Benefits

Benefits for Covered Services Provided at Participating Providers

Lifetime Maximum Benefit

Unlimited

Unlimited

Out-of-Pocket Amount

Medical out-of-pocket maximum

$3,000/member; $6,000/family

Prescription out-of-pocket maximum

$3,850/member; $7,700/family

Preventive Care

*Coverage under preventive care category depends on age, symptoms, and diagnosis 

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)

100%

Physician Services 

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

100% after $10 co-payment for primary care physician

100% after $30 co-payment for specialist 

Lab tests, X-rays and diagnostic tests 

100%

Allergy injections 

100% after $10 co-payment

Inpatient services 

Outpatient surgery and diagnostics 

Physician visits to emergency room 

100%

Hospital Services

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

100% after $200 co-payment per admission 

Hospital observation stay

100% after $100 co-payment 

Organ transplants 

100%

Outpatient nonsurgical care 

Outpatient tests, lab, X-ray and other diagnostic tests 

Ancillary services 

100%

Outpatient surgery 

100% after &75 co-payment 

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

100% after $75 co-payment

Emergent/Urgent Services

Emergency room

100% after $100 co-payment (waived if admitted)

Urgent treatment center 

100% after $25 co-payment 

UK Children's Twilight Clinic 

100% after $15 co-payment 

Ambulance 

100% after $75 co-payment 

Other Medical Services

Skilled nursing facility (up to 30 per plan year) and hospice services

100%

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

80%

Durable medical equipment, orthotics, and prosthetics 

80% maximum member responsibility of $500/plan year

Hearing aids

80% for children under 18

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

100% after $15 co-payment per visit for all therapies 

Mental Health and Substance Abuse

Inpatient mental health or substance abuse

100% after $200 co-pay per admission


You may make all your benefits selections online, under the Benefits and Payment tab on Employee Self Service on myUK.
Employee form
Retiree form


The UK-RHP plan offers high-quality care for those who live outside Central Kentucky. The coverage matches the UK-HMO plan but makes services available to non-UK HealthCare facilities and physicians to those who live in outlying counties. 


More information on the UK-RHP plan:



  • Plan members may visit any Anthem provider in the 110-county UK-RHP network for primary care and specialist office visits and procedures performed in the office. View the UK-RHP physician/providers state-wide (PDF).

  • Please note: Surgeries and other certain specialty procedures must be performed in the plan member's designated facility network. The UK-RHP network includes hospitals and facilities in one of three regional areas throughout the state of Kentucky (see map below), including UK HealthCare providers in Lexington. As a UK-RHP member, you will automatically be enrolled as of July 1 in a regional facility network based on your home county (county of residence).

  • View the UK-RHP provider directory for Region A (PDF)

  • View the UK-RHP provider directory for Region B (PDF)


 







Coverage Level

Monthly cost*

UK pays

Retiree pays

Retiree only

$801

$721

$80

Retiree + child(ren)

$1,199

$721

$478

Retiree + spouse

$1,598

$721

$877

Retiree + family

$2,001

$721

$1,280

* 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-RHP plan is available in this Summary of Benefits Coverage.

 



























2017-2018

UK-RHP Major Plan Benefits

Benefits for Covered Services Provided at Participating Providers

Lifetime Maximum Benefit

Unlimited

Unlimited

Out-of-Pocket Amount

Medical out-of-pocket maximum

$3,000/member; $6,000/family

Prescription out-of-pocket maximum

$3,850/member; $7,700/family

Preventive Care

*Coverage under preventive care category depends on age, symptoms, and diagnosis

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)

100%

Physician Services

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

100% after $10 co-payment for primary care physician

100% after $30 co-payment for specialist 

Lab tests, X-rays and diagnostic tests

100%

Allergy injections

100% after $10 co-payment 

Inpatient services

Outpatient surgery and diagnostics 

Physician visits to emergency room

100%

Hospital Services

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

100% after $200 co-payment per admission

Hospital observation stay

100% after $100 co-payment 

Organ transplants 

100%

Outpatient nonsurgical care

Outpatient tests, lab, X-ray and other diagnostic tests

Ancillary services

100%

Outpatient surgery

100% after $75 co-payment

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

100% after $75 co-payment

Emergent/Urgent Services

Emergency room

100% after $100 co-payment (waived if admitted)

Urgent treatment center

100% after $25 co-payment

UK Children's Twilight Clinic

100% after $15 co-payment 

Ambulance

100% after $75 co-payment 

Other Medical Services

Skilled nursing facility (up to 30 days per plan year) and hospice services

100%

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

80%

Durable medical equipment, orthotics, and prosthetics

80% maximum member responsibility of $500/plan year

Hearing aids

80% for children under 18

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

100% after $15 co-payment per visit for all therapies 

Mental Health and Substance Abuse

Inpatient mental health or substance abuse 

100% after 200 co-pay per admission


You may make all your benefits selections online, under the Benefits and Payment tab on Employee Self Service on myUK.
Employee form
Retiree form


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 cost*

UK pays

Retiree pays

Retiree only

$801

$721

$80

Retiree + child(ren)

$1,199

$721

$478

Retiree + spouse

$1,598

$721

$877

Retiree + family

$2,001

$721

$1,280


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.

 























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


You may make all your benefits selections online, under the Benefits and Payment tab on Employee Self Service on myUK.
Employee form
Retiree form


UK-EPO Plan Rates



The UK-EPO plan offers flexibility to receive services outside of UK HealthCare. This plan has a higher monthly premium, but members of this plan have no co-insurance to pay or deductibles to meet. Employees who have (or whose spouse has) a chronic condition that requires frequent hospitalization most often take advantage of this plan.








Coverage Level

Monthly Rate*

UK Credit

Monthly Cost to Employee

Employee only

$1,022

$721

$301

Employee + child(ren)

$1,527

$721

$806

Employee + spouse

$2,039

$721

1,318

Employee + family

$2,552

$721

$1,831


 


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-EPO plan is available in this Summary of Benefits Coverage.

 























2017-2018

UK-EPO Major Plan Benefits

UK HealthCare Providers

Benefits for Covered Services Provided at Anthem Providers

Lifetime Maximum Benefit

Unlimited

Unlimited

Unlimited

Out-of-Pocket Amount

Medical out-of-pocket maximum

$3,000/member; $6,000/family

$3,000/member; $6,000/family

Prescription out-of-pocket maximum

$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, one per plan year)

100%

100%

Physician Services

Office visits (excludes certain diagnostic lab tests 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 

Lab tests and X-rays

Diagnostic tests 

100% after office visit co-pay 

100% after office visit co-pay 

Allergy injections 

100% after $10 co-pay per visit 

100% after $10 co-pay per visit 

Inpatient services

Outpatient surgery and diagnostics 

Physician visits to emergency room 

100%

100%

Hospital Services

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

100% after $300 co-pay per admission (limited to two co-pays per plan year)

100% after $500 co-pay per admission (limited to two co-pays per plan year)

Outpatient surgery 

100% after $100 co-pay per procedure 

100% after $150 co-pay per procedure 

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

100% after $75 co-pay per test

100% after $100 co-pay per test

Outpatient nonsurgical care 

Outpatient tests, lab, and X-ray

Ancillary services 

Organ transplant 

100%

100%

Emergent/Urgent Services

Emergency room

100% after $100 co-pay (waived if admitted)

100% after $100 co-pay (waived if admitted) 

Urgent treatment center 

N/A

100% after $50 co-pay per primary care

Ambulance services 

100% after $100 co-pay

100% after $100 co-pay 

Other Medical Services

Skilled nursing facility (up to 100 days per plan year)

Home health care (up to 100 visits per plan year)

Hospice services 

100%

100%

Durable medical equipment 

80% up to $500 member cost per year 

80% up to $500 member cost per year

Chiropractic care*, physical, speech, music, hydrotherapy, occupational and accupuncture therapy (limited to 45 visits per plan year, combined) *Maximum 20 visits for chiropractic care

100% after $20 co-payment per visit 

100% after $30 co-payment per visit 

Mental Health and Substance Abuse

Inpatient

100% after $300 co-pay per admission 

100% after $500 co-pay per admission 

Outpatient

100% after $40 co-payment per visit 

100% after $50 co-payment per visit


 


Eligibility



Read about the eligibility requirements for specific retiree medical plan benefits »



Enrollment



Print and complete the Retiree Benefits Enrollment form and return to:

Employee Benefits Office

112 Scovell Hall

Lexington, KY 40506-0064



Other Options



UK Indemnity



UK Indemnity is only available to those participants who live or travel out of state for extended periods of time. This plan offers the freedom to receive care from any physician for covered benefits.