Factors to Consider
UK-HMO's Lexington Service Area network consists of UK HealthCare facilities (including Chandler Hospital, Good Samaritan Hospital, and Kentucky Clinics) and UK HealthCare physicians.
UK-RHP (Regional Health Plan) Area network includes the UK HealthCare facilities, UK HealthCare physicians and Anthem BlueCross and BlueShield providers (use the UKHMO RSA provider link on the Anthem page).
Both plans do not require referrals for specialty care services provided within the network.
Both plans have no deductibles to meet.
Both plans have no coverage for out-of-network services unless it is life or limb threatening.
Both plans offer the lowest monthly premiums and lowest out-of-pocket costs.
Both plans covered transplants including: kidney, liver, pancreas, kidney/pancreas, heart, lung, heart/lung, bone marrow and cornea transplants.
Prior authorization is requred for the following services: Durable medical equipment (over $750), home health care and hospice services and other services as listed in the certificate of coverage. Available urgent care options include: Urgent Treatment Centers in Lexington (Dove Run Road, Custer Drive, and Boardwalk Street), Nicholasville (Bellaire Drive) as well as the UK Children's Twilight Clinic.
UK-HMO vs UK-RHP: What's the Difference?
The two plans provide similar levels of coverage, but are available in different areas of Kentucky and offer different provider networks. The UK-HMO plan covers Fayette surrounding counties and includes a network comprised primarily of UK HealthCare providers. The UK-RHP plan covers every other county in Kentucky and offers a select network of local providers, as well as UK HealthCare providers.