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The HMO health plan is available to employees and retirees living in 10 Central Kentucky counties. Plan members have the UK HealthCare provider network available to them.

For the July 1, 2022, to June 20, 2023, plan year, WINFertility benefits are not available on the UK-HMO plan.

HMO Plan Booklet PDF
Summary of coverage and benefits PDF

Anderson, Bourbon, Clark, Fayette, Franklin, Jessamine, Madison, Mercer, Scott or Woodford

Service coverage and costs

All employee health insurance plans provide one annual preventive care visit with your primary care provider at $0 co-pay within specified networks. 

For other common visits, this is what you’ll pay with UK-HMO.

$10
Primary care co-pay
$30
specialist co-pay
$25
urgent care co-pay

Coverage highlights

HMO health plan Maximums UK HealthCare
Lifetime Maximum Benefit   Unlimited
Out-of-Pocket Amount Annual deductible $0/member; $0/family
  Medical out-of-pocket maximum $3,000/member; $6,000/family
  Prescription out-of-pocket maximum $4,900/member; $9,800/family

Employee monthly rates

2021-2022 HMO, PPO, SAVER PLAN, INDEMNITY
Coverage level Total monthly cost* UK pays You pay
Employee only $599 $564 $35
Employee + children $899 $752 $147
Employee + spouse $1,199 $927 $272
Employee + family $1,498 $1,098 $400
2022-2023 HMO
Coverage level Total monthly cost* UK pays You pay
Employee only $612 $577 $35
Employee + children $921 $774 $147
Employee + spouse $1,226 $954 $272
Employee + family $1,531 $1,131 $400

* 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.

Coverage for common services

HMO health plan Service UK HealthCare
Preventive Care (Coverage under preventive care category depends on age, symptoms, and diagnosis) Routine Pap smears, mammograms, PSA, screening colonoscopy, and sigmoidoscopy $0
  Routine child care and immunizations (through age 18) $0
  Routine adult physical exam (19 years and above, one per plan year) $0
Physician Services Primary care office visits (excludes certain diagnostic lab and X-ray) $10 co-payment for primary care physician
  Specialist office visits (excludes certain diagnostic lab and X-ray) $30 co-payment for specialist
  Lab tests, X-rays and diagnostic tests $0
  Allergy injections $10 co-payment
  Inpatient services $0
  Outpatient surgery and diagnostics $0
  Physician visits to emergency room $0
Hospital Services Inpatient care (semi-private room and board, nursing care, ICU) $200 co-payment per admission
  Hospital observation stay $100 co-payment
  Organ transplants $0
  Outpatient nonsurgical care $0
  Outpatient tests, lab, X-ray and other diagnostic tests $0
  Ancillary services $0
  Outpatient surgery $75 co-payment
  Outpatient diagnostic testing (high costs - MRI, MRA, CT and PET scans) $75 co-payment
Emergent/Urgent Services Emergency room $100 co-payment (waived if admitted)
  Urgent treatment center $25 co-payment
  UK Children's Twilight Clinic $15 co-payment
  Ambulance $75 co-payment
Other Medical Services Skilled nursing facility (up to 30 per plan year) and hospice services $0
  Home health care (up to 60 visits per plan year) 20% co-insurance
  Durable medical equipment, orthotics, and prosthetics 20% co-insurance up to $500 member cost per year
  Hearing aids 20% co-insurance 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) $15 co-payment per visit for all therapies
Mental Health and Substance Abuse Inpatient mental health or substance abuse $200 co-pay per admission

PROVIDER NETWORK UK HealthCare

HMO plan members have access to the expertise of UK HealthCare providers.

Eligibility and enrollment

Your first 30 days

Welcome to UK! You can sign up for benefits depending on your FTE. Enroll in your benefits quickly in myUK.

Qualifying events

If you experience a major life change outside of open enrollment you can also make changes to your insurance. This is known as a qualifying event. You'll need to fill out and submit a form within 30 days.

Benefits Open Enrollment

Our Benefits Open Enrollment happens every year so you can make changes. Changes can be made in myUK, or with paper forms.

Retirees

Please use the Retiree Benefits Enrollment form and return to Scovell Hall.

How to change your benefits

Signing up as a new employee or making changes during Benefits Open Enrollment can be done in myUK, or with paper forms.

Step-by-step tutorial

Making changes at other times of the year due to a qualifying event are completed using our Benefits Enrollment Form.

Paper forms can be emailed, faxed or brought to Scovell Hall.