Transcript EXPANDED UHC PowerPoint Template
Door Kewaunee Health Insurance Purchasing Cooperative – Sturgeon Bay
Your Health Care
Counts Specialty Discussion
Our Health Plan: What Do You Need to Know?
November , 2012
UNITEDHEALTHCARE DENTAL
Value Add Features
• • •
Prenatal Dental Care Program
Members may receive additional cleanings or perio maintenance during that period Covered at 100% Deductible does not apply
• •
Oral Cancer Screening
One screening per benefit period Adult Members
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UNITEDHEALTHCARE VISION
Vision Care and Your Health
• •
Facts:
Vision disorders are the 2
nd
most prevalent health problem
1
Eye exams may detect early warning signs of serious health conditions
2 diabetes hypertension high cholesterol vascular disease glaucoma cataracts
1 Employee Benefit News, April 15, 2009 2 Health News Digest, December 2008
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
In-Network Benefits At a Glance Comprehensive Eye Exam A complete pair of eyeglass lenses* Covered selection of contact lenses
(lens fitting included)* *after copay • Frame • Single vision, lined bi-focal, lined tri-focal or lined lenticular lenses (Other lens options available at a discounted rate) • Standard scratch coating
Lens Options Elective Contact Lenses
• Contact lenses that fall outside the covered selection.
(Copay does not apply)
Additional Materials Frequency
Every
12
months Every
12
months Every
24
months Every
12
months Covered in full
Benefits $15
copay
$30
copay
$130
allowance Covered in full Covered in full See benefit summary for details Every
12
months
20%
off
$105
allowance Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UNITEDHEALTHCARE Critical Illness and Accident Protection
What about Critical Illness?
Facts you should know:
•
Every 34 seconds someone has a heart attack 1
•
Men have a 44% chance of getting cancer and women have a 38% chance of getting cancer in a lifetime 2
•
Nearly 20% of insured Americans have problems paying their medical bills 3 1 Heart and Stroke Statistical Update, American Heart Association 2010 2 American Cancer Society, Cancer Facts & Figures 2010 3 Center for Studying Health System Change 2008 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Critical Illness What’s Covered?* 1 Cancer Cancer Carcinoma in Situ* 2 Cardiovascular Heart Attack Heart Failure Ruptured Aneurysm Stroke Coronary Artery Bypass* 3 Critical Illness – Other Chronic Renal Failure Paralysis Severe Burns Severe Brain Damage Coma Major Organ Failure (except heart) *Partial Benefit -- See Benefit Summary or Certificate of Coverage for specific provisions.
All features may not apply. Some states have restrictions.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Coverage Options Employee: Increments of $1,000 from $5,000 to a maximum of $20,000 Dependents: Spouse/Domestic Partner $10,000 Child(ren) $2,500 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Why Accident Insurance?
Facts you should know:
• • • •
Accidents are the 5 th leading cause of death in the United States 1 More than 180,000 people die from injuries each year – 1 person every 3 minutes 2 Injuries are the leading cause of death for people ages 1-44 in the US 3 42% of American workers say they are living paycheck to paycheck 4 1 National Vital Statistics Reports, January 2012 2 National Highway Traffic Safety Administration, 2008 3 National Highway Traffic Safety Administration , 2008 4 Careerbuilders, August 2011 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Accident What’s Covered?
Base Plan - 24 Hour Coverage Accidental Death & Dismemberment
Life Both hands or feet or combination One hand or foot Two or more fingers or toes or combination One finger or toe
Child benefit – 50% of employee/spouse
$20,000 $20,000 $10,000 $4,000 $2,000
Silver Plan Initial Care
Ground Ambulance Air Ambulance Emergency Room Treatment $200 $100
Hospital Care
Hospital Admission $1,200 Hospital Inpatient Stay (per day up to 365 days) Hospital Intensive Care Unit ICU Admission $800 $160 $2,500
Accidental Death Common Carrier (while on public transportation)
Child benefit – 50% of employee/spouse
Waiver Premium
$80,000 Physician Office Urgent Care (per visit) Yes $40 Hospital ICU Inpatient Stay (per day up to 30 days) $500
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
What’s Covered? Enhanced Plan
Enhanced Benefit Coverage (sample of benefits included) Scheduled Benefit Follow Up Care Major Diagnostic Exam $160 Follow Up Physician Visit Medical Appliances (equipment) Physical Therapy (per day up to six days} Prosthetic
•
One device
•
Two or more devices Rehabilitation Unit (per day up to 30 days) Common Injuries (for complete list, see Summary of Benefits) Abdominal/Thoracic (abdomen/chest) Surgery
•
Surgery to repair
•
Exploratory without repair Blood/Plasma/Platelets Burns
•
2 nd Degree (at least 36% of body surface)
•
3 rd
•
3 rd Degree (9-34 sq. inches) Degree (35 or more sq. inches) Skin Graft – 25% of burn benefit Coma Concussion (once per 12 month period) Dental Emergency Broken teeth repaired with crown(s) Broken teeth resulting in extractions Eye Surgery $40 $140 $ 30 $500 $1,000 $ 80 $1,000 $ 100 $280 $500 $8,000 $10,000 $140 $ 200 $80 $200 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Critical Illness and Accident Additional Features
Wellness Benefit -
Spouse $100 per year for Employee and • • • • • • • • Mammogram Colonoscopy Pap Smear Chest X-rays Fasting blood glucose test Blood test for triglycerides PSA (blood test for prostate cancer) Additional screenings listed in enrollment packet
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Q & A
15 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.