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The UniCare group medical program contains the following features:
1. There are actually three plans:
(a) a PPO in-network plan;
(b) a PPO out-of-network plan-which has lower benefits if a participant is located in one of the PPO service areas and does not use in-network providers; then, reimbursement will be lowered to 70% after the deductibles are met;
(c) a traditional 80% indemnity plan for employees located outside a service area.
2. When in-network providers are used, there are no claim forms to file. At this point, if you have to go to a doctor and are in a network service area, the doctor's office can get all the information needed on your Unicare card or may call 1-800-288-8630 to confirm your eligibility. Your Social Security number and Policy number 130174 are all the details that will be needed. Most everyone in or close to cities of any size are in the PPO network. If you have any doubt, please call (901-276-4572 ex. 204) or e-mail Mark Duck.
3. The in-network plan includes a $25 co-payment feature for visits to a doctor's office and required diagnostic tests and lab work.
4. All three plans include a three tier formulary co-payment prescription drug program. Generic drugs may be obtained for a $15 co-payment, brand name formulary drugs for a $30 co-payment, and non-formulary drugs for a $40 co-payment. Whether you are in the PPO network or not, all participants are included in the prescription drug plan. If you don't have your card, a pharmacist may call 1-888-218-4844 to verify your eligibility. Again, your SSN and policy number 130174M001 is the information that is needed. YourChoice Rx is Unicare's mail order prescription drug provider.
5. All three plans also include a hospital pre-certification requirement with a $200 penalty for non-compliance. However, when in-network providers are used, it is their responsibility to comply with this cost control feature.
6. Effective March 1, 2006, the monthly premium for employee only coverage is $570.00; the additional monthly premium for dependents is $640.00; employee and dependent coverage (family coverage) is a monthly cost of $1,250.00.
Directories and other information about the plan are available on request.
With the continued support of elders, ministers, churches and presbyteries, the Cumberland Presbyterian Church Group Life and Medical Insurance Program will continue into the future.
HOME BENEFITS INSURANCE For more information, contact Mark Duck
Page updated on September 5, 2008 Information updated on September 5, 2008 Pages maintained by Elinor Swindle Brown