Page 10 - Dragados 2022 Benefits Guide

10
Dragados 2022 Benefits Guide
Important Information for
the UnitedHealthcare Medical/Rx Plans
Calendar Year Deductible
Covered family members must meet their individual deductibles before the plan pays co-insurance on the EPO and OAP options. All covered expenses will go toward the same family deductible on the HSA option.
Calendar Year Out-of-Pocket Maximum
The amount you pay for all covered expenses counts toward both your in-network or out-of-network out-of-pocket maximums.
UnitedHealthcare Choice Plus Network
When you receive care from an in-network provider, you will benefit from the discounts available through the negotiated rates and enhanced benefit coverage. You do not have to select a Primary Care Physician (PCP) and referrals are not necessary for specialty care. The UnitedHealthcare Choice Plus network is United’s largest national network of providers and facilities.
UnitedHealthcare Precertification Requirements
Precertification is the process of determining in advance whether a procedure, treatment or service will be covered under your healthcare plan.
It also helps ensure you get the right care in the right setting – potentially saving you from costly and unnecessary services. Precertification is required for inpatient hospitalization, outpatient surgery and major diagnostic services.
Call UnitedHealthcare at 866-633-2446 (OAP/EPO) or 866-816-3596 (HSA) to precertify.
In-network services: Your in-network provider handles the precertification requirements – but you should always confirm UnitedHealthcare approval.
Out-of-network services: You are responsible for all precertification requirements when out-of-network care is received. When you receive care from out-of-network providers, your out-of-pocket costs will be higher and your coverage may
be reduced or denied if you do not obtain precertification. Out-of-network services are not covered on the EPO plan option; however, emergency and urgent care services are covered according to the in-network benefits whether or not
the provider is in the UnitedHealthcare Plan. For approvals of any scheduled surgery/inpatient hospital stay approved by your previous carrier. Please call UnitedHealthcare at 866-633-2446 (OAP/EPO) or 866-816-3596 (HSA) to coordinate precertification approval.
In-Network Laboratories —Lab Corp and Quest Diagnostics
When using one of United’s in-network labs, the plan pays 100%. With LabCorp or Quest you’ll have access to thousands of service centers nationwide. Call or check on line for the lab nearest you:
LabCorp:
1-800-845-6167 labcorp.com
Quest Diagnostics
1-866-697-8378 questdiagnostics.com