United HealthCare HMO - HIGH Option Plan

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	[High HMO] [Standard HMO]


	Last Updated Friday, February 23, 2001


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QuickStat	PPO Net	Maternity
7.0	Select	Incl.


	HIGH OPTION PLANS- United offers two "high option" HMO plans. One with a Prescription card, the other without. There is no reason to not select the prescription card benefit which has a $10 copay at participating pharmacies. All plans include maternity benefits. Office visits are $10 copay's, specialists are a $20 copayment.




	Plan Options Available:

Maternity	Included
Dental	No
Life	No
Disability	No


	Plan Availability:

Chicago Area Only

Surgeries and hospitalizations have no copayment or coinsurance as long as it was ordered by your primary care physician. Emergency care copayment range from $10 to $50 depending on where you obtain service. Other services such as prosthetics, implants, and medical equipment is covered at 60% to 80% of eligible charges.

Strengths - 100% coverage, good network, low copay's, flexible underwriting
Weakness- Unusually slow underwriting process.




	Claim Type

Office Visits and preventive Care

Medical Exams
Eye Exams
Well Child Care
Voluntary Family Planning
Immunizations

Outpatient Medical Care

Office Calls

Diagnostic Xray and Lab

Specialist Care and consultations.

Short Term Rehab Services (max:60 per cal. yr.)

Allergy Testing


	$10 per visit copayment when seen by your primary care physician or $20 per visit when referred to a specialist.

Inpatient Hospital Care

•Semi Private room • Surgery Anesthesia•Medications and Drugs •Physicians Care •Nursing care •X-ray and Lab •Intensive/ Coronary Care •Radiation Therapy •Blood, plasma and its administration •short-term rehab services (max:120 days per calendar year) •Detoxification services.

Maternity Care....................................
•Prenatal and postnatal care. (First Visit copayment only) •Hospitalization and Delivery •Newborn Care (while hospitalized)

No Copayment

Emergency Care At a Share participating Medical Office
At a Share primary care doctor ....................... $10 Copay
At a Share referred specialist .......................... $20 Copay
At a hospital (per visit) ....................................... $50 Copay
At a hospital ( if admitted) ................................... No Copay
Ambulance ............................................................. No Copay

Mental Health Inpatient - Up to 10 days per calendar year . ................... No Copay Outpatient - Evaluation, S-T Treatment, (limited to 20 visits per year (40 group) - ... $20 copay per visit. Detoxification - Outpatient - $20 copay per visit.

Prescription Drugs (Plans with Rx Only)............. $10 Copayment. at participating Share Pharmacy's.


	No preexisting condition clause if accepted.

		All treatment must be approved by your primary care doctor.


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	The following summary is NOT a solicitation to sell you insurance. Solicitations can only be made with state, and insurance company, approved brochures. Information contained in this web may contain generalities or inaccuracies. Please read the brochures and policies for specific limitations and exclusions.