Unicare of Illinois HSA Compatible 2000 5200 Plan 2 Plan Information
Plan Name: HSA Compatible 2000 5200 Plan 2
Plan Type: High Deductible HSA-Qualified
Health Savings Account: Compatibility with tax deferred savings accounts
Physician Choice: You choose specialist(s)
Annual Out-of-Pocket Maximum: Single party: $5000 or Family: $10,000 (includes annual deductible)
Annual Deductible: Single party: $2600 or Family: $5200
Office Visits: UniCare pays 80%
Professional Services: UniCare pays 80%
Hospital Inpatient: UniCare pays 80%
Hospital Outpatient: UniCare pays 80%
Inpatient Medical Emergency: UniCare pays 80%
Preventive Care for Babies and Children (through age 6): UniCare pays 80%
Preventive Care for Adults: UniCare pays 80%
Drug Benefits: After the annual deductible is met, UniCare pays 100% except for the following member copay: Generic: $10 copay. Brand Formulary: $30 copay. Brand Non-Formulary: $50 copay.
Other Unicare of Illinois health insurance plans:
