Unicare of Illinois HSA Compatible Variable Contribution Plan Plan Information
Plan Name: HSA Compatible Variable Contribution Plan
Plan Type: H.S.A-Compatible Variable Contribution
Health Savings Account: Compatibility with tax deferred savings accounts
Physician Choice: Yes
Annual Out-of-Pocket Maximum: Single party: $5000 per member or, Family: $10,000 per family (includes annual deductible, and pharmacy co-pays)
Annual Deductible: Single party: $2850 per member, or Family: $5650 per family
Office Visits: UniCare pays 100%
Professional Services: UniCare pays 100%
Hospital Inpatient: UniCare pays 100%
Hospital Outpatient: UniCare pays 100%
Inpatient Medical Emergency: UniCare pays 100%
Preventive Care for Babies and Children (through age 6): UniCare pays 100%
Preventive Care for Adults: UniCare pays 100%
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. Self-administered injectible Drugs: UniCare pays 80%.
Other Unicare of Illinois health insurance plans:
