Unicare of Michigan UniCare Saver 2000 Plan Information

Plan Name: UniCare Saver 2000

Plan Type: PPO

Savings Account Compatibility: Not compatible

Physician Choice: Yes

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

Annual Deductible: $2000 per member, two-member family maximum

Office Visits: 2 office visits per member, per year, You pay a $30 copay. (deductible is waived)

Professional Services: UniCare pays 70%

Hospital Inpatient: UniCare pays 70%

Hospital Outpatient: UniCare pays 70%

Inpatient Medical Emergency: UniCare pays 70%

Preventive Care for Babies and Children (through age 6): UniCare pays 70%

Preventive Care for Adults: UniCare pays 70%

Drug Benefits: Generic: $10 copay, All Brand name drugs subject to a separate $200 deductible per member, per year, Brand Formulary $30 copay, Brand Nonformulary $50 copay, Self injectable You pay 30%. Max benefit of $500 per member, per year for all drugs combined.

Other Unicare of Michigan health insurance plans:

• UniCare Solaura HIA Plus Plan 3
• MI FIT 5000
• UniCare High Deductible Health Plan 4 100
• 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