Medical Benefits
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit umr.com.
In-Network |
|
|---|---|
Deductible |
$1,000/$2,000 |
Out-of-Pocket Max |
$5,000/$10,000 |
Member Coinsurance |
10% |
Physician Visits |
|
Primary Care Visit |
$20 Copay |
Preventive Care |
100% |
Specialist Visit |
$20 Copay |
Teladoc (Mental Health/Urgent Care) |
$0 Copay |
Hospital Services |
|
Physician Services |
Deductible + 10% |
Inpatient Hospitalization |
Deductible + 10% |
Outpatient Surgery |
Deductible + 10% |
Basic Outpatient Diagnostics |
Deductible + 10% |
Urgent Care |
$50 Copay |
Emergency Room |
$500 Copay |
Retail Prescriptions |
|
Tier 1 |
$10 |
Tier 2 |
$45 |
Tier 3 |
$75 |
Mail Order Prescriptions |
|
Tier 1 |
$30 |
Tier 2 |
$135 |
Tier 3 |
$225 |
Per Pay Period Cost |
Non-Smoker |
|
|---|---|---|
Employee Only |
$70.64 |
$63.72 |
Employee + Spouse |
$347.48 |
$340.56 |
Employee + Spouse Surcharge |
$393.63 |
$386.71 |
Employee + Child(ren) |
$279.08 |
$272.16 |
Employee + Family |
$482.40 |
$475.47 |
Employee + Family Surcharge |
$528.55 |
$521.63 |
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit umr.com.
In-Network |
|
|---|---|
Deductible |
$2,500/$5,000 |
Out-of-Pocket Max |
$5,000/$10,000 |
Member Coinsurance |
50% |
Physician Visits |
|
Primary Care Visit |
$25 Copay |
Preventive Care |
100% |
Specialist Visit |
$50 Copay |
Teladoc (Mental Health/Urgent Care) |
$0 Copay |
Hospital Services |
|
Physician Services |
Deductible + 50% |
Inpatient Hospitalization |
Deductible + 50% |
Outpatient Surgery |
Deductible + 50% |
Basic Outpatient Diagnostics |
Deductible + 50% |
Urgent Care |
$75 Copay |
Emergency Room |
$500 Copay |
Retail Prescriptions |
|
Tier 1 |
$10 |
Tier 2 |
$60 |
Tier 3 |
$100 |
Mail Order Drugs |
|
Tier 1 |
$30 |
Tier 2 |
$180 |
Tier 3 |
$300 |
Per Pay Period Cost |
Non-Smoker |
|
|---|---|---|
Employee Only |
$42.00 |
$35.08 |
Employee + Spouse |
$205.53 |
$198.61 |
Employee + Spouse Surcharge |
$251.69 |
$244.76 |
Employee + Child(ren) |
$188.04 |
$181.12 |
Employee + Family |
$284.21 |
$277.29 |
Employee + Family Surcharge |
$330.36 |
$323.44 |