Welcome to Chapter 3b – Gated Medical Plan Options Please remember: All Chapters provided in the 2016 Employee Presentation are intended to be part of

•Welcome to Chapter 3b – Gated Medical Plan Options•Please remember:

• All Chapters provided in the 2016 Employee Presentation are intended to be part of a module series

• There are 6 chapters• Follow along with and compile these into your own

presentation (see below) in the order they are presented

• Text items in red are variable. Please modify them as necessary in order to fit your customers’ needs

• Please pick and choose from the slides provided to create a custom presentation that is right for you and your customers. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

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Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Navigate® Plan

BENEFITS

This is plan that requires you to select a PCP. Your PCP will guide you through the health care system so you can get the right care at the right time.

•Pay less by using Tier 1 providers. They have been recognized for providing value.

•You need to select your personal PCP from the network. Each enrolled person must select a PCP.

•Save money by staying in our network. If you don’t use the network, you’ll have to pay for all of the costs.

•You need to get online referrals from your PCP to see a network specialist. If you see a network specialist without a referral, you will be responsible for the full cost of the service.

•Preventive care is covered 100% in our network.

For COVERAGE DETAILS, see your official health plan documents.

Your PCP will help you get the right care and save.

Find your PCP at welcometouhc.com/navigateadvanced

NAVIGATE ADVANCED


Your PCP:

Must be located in a town or city near where you (the subscriber) lives

Must be a general practice, family practice, pediatrician or internal medicine physician

Can be selected for the entire family or each covered dependent can select their own

When you sign up, have this information ready.

First name, last name and address

Physician ID number (you will find this number when you do a PCP search online)

Choosing your PCP

How can a PCP help you? Your PCP will get to know you and your health history.

They can help you prevent and catch health issues before they become more serious.

If you need special care, they can refer you to the right specialist.

One PCP can be selected for the entire family or each covered person can select their own. If you don’t select a PCP when you enroll, one will be assigned for you.

Find your PCP at welcometouhc.com/navigateadvanced

NAVIGATE ADVANCED


Pay less using our Tier 1 providers.

Look for Premium Tier 1 network care first.

It’s easy for you to find Premium Tier 1 physicians. These providers have been recognized for providing value. Look for the Tier 1 symbol when doing a search.

Where you go for care can make a big difference in cost. You’ll pay a lower [co-pay] [and] [co-insurance] when you use these Tier 1 providers.

UnitedHealth Premium® Tier 1 providers have been recognized for providing value.

[Tier 1 hospitals can charge less for the same services compared to other hospitals. Tier 1 hospitals are any hospitals that aren’t labeled Tier 2.]

Free-standing facilities and centers are medical facilities in the network that are not connected to hospitals or another medical facility. They usually charge less. They may include radiology centers, surgery centers, and more.

NAVIGATE


You don’t need a referral for everything.Online referrals are required to see most specialists. But you may not need to receive one to see the following providers as long as they are in the network:

Obstetricians/gynecologists (OB/GYNs)

Behavioral health or substance use disorder clinicians

Convenience care clinics

Urgent care clinics

Emergency care at an emergency room

Your PCP must submit all referrals online.

A paper referral will not be considered a valid referral. You can check all of your referrals online at myuhc.com.

For a COMPLETE LIST of providers and services that need referrals, see your plan documents.


Navigate® Plan, cont’d

BENEFITS

CO-PAYMENT* IN THE NETWORK OUT OF NETWORK

PCP <$XX> <$XX>

Specialist <$XX> <$XX>

DEDUCTIBLE*

[Self <$XXXX> <$XXXX>

[Family <$XXXX> <$XXXX>

CO-INSURANCE* <XX%> <XX%>

OUT-OF-POCKET LIMIT



Paying for care

*Preventive care is covered 100 percent so you won’t need to worry about these costs and payments.


Catalyst® Plan: Pre-deductible Allowance – two payments

BENEFITS

Navigate® Plus Plan

If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.


You need to select your personal PCP from the network. Each enrolled person must select a PCP.

There’s coverage if you need to go out of the network. Choose what’s best for you.

You get the highest coverage when your PCP submits an online referral for you to see a network specialist. But, referrals are not required.

Preventive care is covered 100% in our network.

Look for network care first.

To help you save money, we make it easy for you to find your PCP and other network providers.

Find your PCP at welcometouhc.com/navigateplus

NAVIGATE PLUS


Your PCP:







Choosing your PCP





Find your PCP at welcometouhc.com/navigateplus

NAVIGATE PLUS


You don’t need a referral for everything.Referrals aren’t required in this plan but they are encouraged. If you need a referral, it must be submitted online by your PCP to be accepted.

Referrals may not be needed to see the following providers as long as they are in the network:




Urgent care clinics







BENEFITS

Navigate Plus Plan, cont’d


PCP <$XX> <$XX>


DEDUCTIBLE*




OUT-OF-POCKET LIMIT



Paying for care



Charter® Plan

BENEFITS


•Pay less by using Tier 1 providers. They have been recognized for providing value.

•You need to select your personal PCP from the network. Each enrolled person must select a PCP.

•Save money by staying in our network. If you don’t use the network, you’ll have to pay for all of the costs.

•You need to get online referrals from your PCP to see a network specialist. If you see a network specialist without a referral, you will be responsible for the full cost of the service.

•Preventive care is covered 100% in our network.

For COVERAGE DETAILS, see your official health plan documents.

Your PCP will help you get the right care and save.

Find your PCP at welcometouhc.com/charteradvanced

CHARTER ADVANCED


Your PCP:







Choosing your PCP





Find your PCP at welcometouhc.com/charteradvanced

CHARTER ADVANCED


Pay less using our Tier 1 providers.

Look for Premium Tier 1 network care first.

It’s easy for you to find Premium Tier 1 physicians. These providers have been recognized for providing value. Look for the Tier 1 symbol when doing a search.

Where you go for care can make a big difference in cost. You’ll pay a lower [co-pay] [and] [co-insurance] when you use these Tier 1 providers.

UnitedHealth Premium® Tier 1 providers have been recognized for providing value.

[Tier 1 hospitals can charge less for the same services compared to other hospitals. Tier 1 hospitals are any hospitals that aren’t labeled Tier 2.]

Free-standing facilities and centers are medical facilities in the network that are not connected to hospitals or another medical facility. They usually charge less. They may include radiology centers, surgery centers, and more.

CHARTER


You don’t need a referral for everything.Online referrals are required to see most specialists. But you may not need to receive one to see the following providers as long as they are in the network:




Urgent care clinics






Charter® Plan, cont’d

BENEFITS


PCP <$XX> <$XX>


DEDUCTIBLE*




OUT-OF-POCKET LIMIT



Paying for care




BENEFITS

Charter® Plus Plan

If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.


You need to select your personal PCP from the network. Each enrolled person must select a PCP.

There’s coverage if you need to go out of the network. Choose what’s best for you.

You get the highest coverage when your PCP submits an online referral for you to see a network specialist. But, referrals are not required.

Preventive care is covered 100% in our network.

Look for network care first.

To help you save money, we make it easy for you to find your PCP and other network providers.

Find your PCP at welcometouhc.com/charterplus

CHARTER PLUS


Your PCP:







Choosing your PCP





Find your PCP at welcometouhc.com/charterplus

CHARTER PLUS


You don’t need a referral for everything.Referrals aren’t required in this plan but they are encouraged. If you need a referral, it must be submitted online by your PCP to be accepted.

Referrals may not be needed to see the following providers as long as they are in the network:




Urgent care clinics







BENEFITS

Charter Plus Plan, cont’d


PCP <$XX> <$XX>


DEDUCTIBLE*




OUT-OF-POCKET LIMIT



Paying for care


• This ends Chapter 3b- Gated Medical Plans• Please open Chapter 4- CDH Plans• Copy and paste slides from Chapter 4 to

your Master1. Click on the first slide and then press shift

while you click on the last slide2. Right click on the first slide and select copy3. Go to your Master (Chapter 1)4. Click below the thumbnail of the last slide in

that section5. Right click there and select Copy—Use Source

Formatting

• Delete any slides from Chapter 4 that do not apply to your customer’s needs

Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.20



Documents

Welcome to Chapter 3b – Gated Medical Plan Options Please remember: All Chapters provided in the 2016 Employee Presentation are intended to be part of