The Traditional Plan is a PPO medical plan that offers you and your family comprehensive medical coverage. The plan is designed with a higher benefit level if you choose in-network providers for your health care services. The plan provides the highest level of benefits when you seek treatment at a UH facility.
How the Plan Works
- Under the Traditional Plan, you pay a flat dollar copay for most eligible Tier 1 and Tier 2 practitioner services. For example:
- Most office visits have a copay, which is the amount you pay out of pocket.
- Urgent care and emergency services have higher copay amounts than office visits.
- For 2010, a deductible of $200 individual/$400 family for Tier 1 or $400 individual/$800 family for Tier 2 applies to inpatient and outpatient facility charges. If you access care from a Tier 2 facility, you will be responsible for paying coinsurance once you have met your deductible.
- If you choose to receive your care out of network at the Tier 3 level of benefits, you will be responsible for paying an annual deductible in 2010 of $1,000 individual/$2,000 family and coinsurance. You will also be responsible for paying any amount above reasonable and customary charges as determined by Anthem.
See the 2010 Schedule of Benefits for plan details, including copayment and deductible amounts.
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The Traditional Plan covers preventive care at 100% with no deductible
or copay for Tier 1 and Tier 2 providers. This includes
exams, screenings and immunizations for adults and children
based on national guidelines. |
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