Unicare of Michigan MI FIT 5000 Plan Information

Plan Name: MI FIT 5000

Plan Type: PPO

Physician Choice: Yes

Annual Out-of-Pocket Maximum: $3000 plus deductible per member, $6000 plus deductible per family

Annual Deductible: $5000 per member, two-member family maximum

Office Visits: You pay a $30 copay, unlimited visits, deductible waived

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 100%, deductible waived

Preventive Care for Adults: UniCare pays 100% with deductible waived

Drug Benefits: Generic drugs: You pay a $10 copay. Brand name drugs: You pay a $30 copay for formulary drugs or $50 for nonformulary drugs, plus a separate $500 deductible per member, per year. Self Injectable Drugs: You pay 20% (deductible applies to brand name).

Other Unicare of Michigan health insurance plans:

• UniCare Solaura HIA Plus Plan 3
• UniCare High Deductible Health Plan 4 100
• UniCare Saver 2000
• UniCare Solaura HSA Plan 2a
• UniCare Solaura HIA Plan 2
• UniCare High Deductible Health Plan 2 80
• MI FIT 3000
• UniCare Solaura HSA Plan 1a
• UniCare Solaura HIA Plus Plan 1
• UniCare Solaura HIA Plan 1
• UniCare High-Deductible Health Plan 3 100
• MI FIT 2000
• UniCare Solaura HIA Plus Plan 2
• MI FIT 1500
• MI FIT 1000
• UniCare High-Deductible Health Plan 1 80
• MI FIT 500