EXPANDED UHC PowerPoint Template

Report
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
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Group.
UNITEDHEALTHCARE
VISION
Vision Care and Your Health
Facts:
• Vision disorders are the 2nd most prevalent
health problem1
• Eye exams may detect early warning signs
of serious health conditions2
-
diabetes
hypertension
high cholesterol
vascular disease
glaucoma
cataracts
1
Employee Benefit News, April 15, 2009
2 Health News Digest, December 2008
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In-Network Benefits At a Glance
Frequency
Benefits
Comprehensive Eye Exam
Every 12 months
$15 copay
A complete pair of eyeglass lenses*
Covered selection of contact lenses
(lens fitting included)* *after copay
Every 12 months
$30 copay
• Frame
Every 24 months
$130 allowance
• Single vision, lined bi-focal, lined
tri-focal or lined lenticular lenses
(Other lens options available at a
discounted rate)
• Standard scratch coating
Every 12 months
Covered in full
Covered in full
Covered in full
Lens Options
See benefit summary for details
Elective Contact Lenses
• Contact lenses that fall outside the
covered selection.
(Copay does not apply)
Every 12 months
Additional Materials
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$105 allowance
20% off
UNITEDHEALTHCARE
Critical Illness and
Accident Protection
What about Critical Illness?
Facts you should know:
• Every 34 seconds someone has a
heart attack1
• Men have a 44% chance of getting
cancer and women have a 38%
chance of getting cancer in a
lifetime2
• Nearly 20% of insured Americans
have problems paying their medical
bills3
1 Heart
and Stroke Statistical Update, American Heart Association 2010
American Cancer Society, Cancer Facts & Figures 2010
3 Center for Studying Health System Change 2008
2
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UnitedHealth Group.
Critical Illness -What’s Covered?*
Cancer
1
Cancer
Carcinoma in Situ*
Cardiovascular
2
Heart Attack
Heart Failure
Ruptured Aneurysm
Stroke
Coronary Artery Bypass*
Critical Illness – Other
3
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.
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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
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UnitedHealth Group.
Why Accident Insurance?
Facts you should know:
• Accidents are the 5th 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 paycheck4
1
National Vital Statistics Reports, January 2012
National Highway Traffic Safety Administration, 2008
3 National Highway Traffic Safety Administration , 2008
4 Careerbuilders, August 2011
2
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
Silver Plan
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
Initial Care
Hospital Care
$20,000
$20,000
Ground Ambulance
$200
Hospital Admission
$10,000
$4,000
Air Ambulance
$1,200
Hospital Inpatient Stay
(per day up to 365 days)
$160
Emergency Room
Treatment
$100
Hospital Intensive Care
Unit ICU Admission
$2,500
Hospital ICU Inpatient Stay
(per day up to 30 days)
$500
$800
$2,000
Accidental Death Common
Carrier
(while on public transportation)
Child benefit – 50% of
employee/spouse
$80,000
Waiver Premium
Yes
Physician Office
Urgent Care (per visit)
$40
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UnitedHealth Group.
What’s Covered?
Enhanced Plan
Enhanced Benefit Coverage (sample of benefits included)
Scheduled Benefit
Follow Up Care
Major Diagnostic Exam
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)
$160
$40
$140
$ 30
$500
$1,000
$ 80
Common Injuries (for complete list, see Summary of Benefits)
Abdominal/Thoracic (abdomen/chest) Surgery
•Surgery to repair
•Exploratory without repair
Blood/Plasma/Platelets
Burns
•2nd Degree (at least 36% of body surface)
•3rd Degree (9-34 sq. inches)
•3rd Degree (35 or more sq. inches)
Skin Graft – 25% of burn benefit
Coma
$1,000
$ 100
$280
$500
$8,000
$10,000
Concussion (once per 12 month period)
$140
Dental Emergency
Broken teeth repaired with crown(s)
Broken teeth resulting in extractions
$ 200
$80
Eye Surgery
$200
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Critical Illness and Accident
Additional Features
Wellness Benefit - $100 per year for Employee and
Spouse
•
•
•
•
•
•
•
•
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
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UnitedHealth Group.
Q&A
15
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