United Healthcare of Kentucky Copay Select Plan Information
Benefit Highlights
Calendar-Year Deductible Choices You pay: $500, $1,000, $1,500, $2,500, or $5,000
Coinsurance After Deductible You pay: 20% to $2,000 We pay: 80% to $8,000, then 100%
Lifetime Maximum Benefit $3 million ($5 million available)
Initial Rate Guarantee 12 months
Preventive Care Benefits
Doctor Office Visit (Not subject to deductible) History and exam: $35 copay X-ray and Lab: 80%
Child Immunizations Vaccine: 80% (not subject to deductible)
Preventive Mammogram, Pap Smear, PSA Testing 80% (not subject to deductible)
Outpatient Expense Benefits
Doctor Office Visit- Illness & Injury $35 copay
Outpatient X-ray and Lab 80%
Outpatient Prescription Drugs Generic: $15 copay Brand $30 copay
Surgeon, Assistant Surgeon, and Facility Fees 80%
Hemodialysis, Radiation, Chemotherapy, and Organ Transplant Drugs 80%
CAT Scans, MRIs 80%
Emergency Room Fees Illness 80% and additional $100 copay if not admitted Injury: 80%
Other Covered Outpatient Expenses 80%
Inpatient Expense Benefits
Room and Board, Intensive Care Unit, Operating Room, Recovery Room, and Professional Fees of Doctors, Surgeons, and Nurses 80%
Other Covered Inpatient Services 80%
Other United Healthcare of Kentucky health insurance plans:
