Page 4 - 2021 Benefits Overview_Neat
P. 4
Health and Wellbeing
Medical and Pharmacy Benefits
myuhc.com express-scripts.com
The Texas Mutual medical plan, which is a PPO plan, is
through UnitedHealthcare and the pharmacy plan is through
Express Scripts. Virtual office visits for health and mental
are available and the pharmacy plan offers cost savings
features for filling maintenance medications.
In-Network Medical Plan Design
$0 Preventative Care
Physician visit copays
$0 Virtual Office Visit
$20 Primary Physician
$45 Specialist Physician
$10 - Tier 1
Pharmacy Copay $40 - Tier 2
$60 - Tier 3
$750 Individual
Deductible
$2,250 Family
Co-Insurance 80% in-Network
$3,000 Individual
Out of Pocket Max
$7,500 Family
Vision Insurance
myuhcvision.com
Vision care is provided by UnitedHealthcare and is included
in the medical plan. Coverage includes eye exams, lenses,
and frames, or contacts in lieu of glasses.
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