Page 6 - 2015 NISC Open Enrollment
P. 6
Medical Benefits
MyHealthcare Cost
Estimator Network Non-Network
Deductible
The UHC Cost Estimator helps Individual
you determine heath care costs $2,000 $3,800
before you seek treatment. The Family $4,000 (1) $7,600
Estimator allows you to evaluate Out-of-Pocket Maximum (2)
the cost and quality of services Individual $4,000 $11,500
that best it your needs, by Family $8,000 (3) $23,000
providing various treatment and Physician Care
cost options for each service. To Ofice Visits 80% after ded. 60% after ded.
access: Specialty Care 80% after ded. 60% after ded.
z Log in MyUHC.com Preventive Care (Physician’s Ofice) 100% no ded. 60% after ded.
Immunizations 100% no ded. 60% after ded.
z Select "Estimate Health Care Well-Baby Care 100% no ded. 60% after ded.
Costs"
Hospital Charges
z Begin exploring your health Inpatient 80% after ded. 60% after ded.
service options! Outpatient Hospital/Surgical Center 80% after ded. 60% after ded.
Outpatient Lab and X-rays 80% after ded. 60% after ded.
Outpatient Therapies: PT, OT, Speech 80% after ded. 60% after ded.
Emergency Room/Urgent Care 80% after ded. 60% after ded.
Other Care
Chiropractic Care 80% after ded. 60% after ded.
Emergency Transport 80% after ded. 80% after ded.
Inpatient Mental Health 80% after ded. 60% after ded.
Outpatient Mental Health 80% after ded. 60% after ded.
Inpatient Alcohol/Drug 80% after ded. 60% after ded.
Outpatient Alcohol/Drug 80% after ded. 60% after ded.
Skilled Nursing 80% after ded. 60% after ded.
Durable Medical Equipment 80% after ded. 60% after ded.
(1) Individual deductible of $2,600; this increase is due to IRS guidelines for 2015
(2) Includes the deductible
(3) Individual out-of-pocket maximum of $6,400
National Information Solutions Cooperative 6
MyHealthcare Cost
Estimator Network Non-Network
Deductible
The UHC Cost Estimator helps Individual
you determine heath care costs $2,000 $3,800
before you seek treatment. The Family $4,000 (1) $7,600
Estimator allows you to evaluate Out-of-Pocket Maximum (2)
the cost and quality of services Individual $4,000 $11,500
that best it your needs, by Family $8,000 (3) $23,000
providing various treatment and Physician Care
cost options for each service. To Ofice Visits 80% after ded. 60% after ded.
access: Specialty Care 80% after ded. 60% after ded.
z Log in MyUHC.com Preventive Care (Physician’s Ofice) 100% no ded. 60% after ded.
Immunizations 100% no ded. 60% after ded.
z Select "Estimate Health Care Well-Baby Care 100% no ded. 60% after ded.
Costs"
Hospital Charges
z Begin exploring your health Inpatient 80% after ded. 60% after ded.
service options! Outpatient Hospital/Surgical Center 80% after ded. 60% after ded.
Outpatient Lab and X-rays 80% after ded. 60% after ded.
Outpatient Therapies: PT, OT, Speech 80% after ded. 60% after ded.
Emergency Room/Urgent Care 80% after ded. 60% after ded.
Other Care
Chiropractic Care 80% after ded. 60% after ded.
Emergency Transport 80% after ded. 80% after ded.
Inpatient Mental Health 80% after ded. 60% after ded.
Outpatient Mental Health 80% after ded. 60% after ded.
Inpatient Alcohol/Drug 80% after ded. 60% after ded.
Outpatient Alcohol/Drug 80% after ded. 60% after ded.
Skilled Nursing 80% after ded. 60% after ded.
Durable Medical Equipment 80% after ded. 60% after ded.
(1) Individual deductible of $2,600; this increase is due to IRS guidelines for 2015
(2) Includes the deductible
(3) Individual out-of-pocket maximum of $6,400
National Information Solutions Cooperative 6
