United Healthcare of Texas Plan 80 Plan Information
Calendar-Year Deductible You pay: $1,500, $2,500, $5,000, $7,500, $10,000
Coinsurance Choices You pay:20%
Coinsurance Out-Of-Pocket Maximum $3,000
Lifetime Maximum Benefit $3Million ($5Million plan enhancment available)
Initial Rate Guarantee 12 Months (24 Month plan enhancment available)
Physicians (Illness & Injury)
Office Visit- History and Exam You pay: 20% after deductible
Primary Care Physician/Specialist Referrals Required No
Prescription Drugs
Preferred price card You pay: 20% after deductible
Annual Maximum $3,000
Wellness/Preventive Care Benefits (No waiting period)
Doctor Office visit You pay: 20% after deductible
X-ray and Lab You pay: 20% after deductible
Child immunizations (0-18) You pay: 20% after deductible
Preventive Mammograms, Pap Smear, PSA screening You pay: 20% after deductible
Outpatient Expense Benefits
X-ray and Lab You pay: 20% after deductible
Facility/Hospital for Outpatient Surgery You pay: 20% after deductible
Surgeon, Assistant Surgeon, and Facility Fees You pay: 20% after deductible
Hemodialysis, Radiation, Chemotherapy, Organ Transplant Drugs, and CAT Scans, MRIs You pay: 20% after deductible
Emergency Room Fees-Illness You pay: $100 copay if not admitted, then 20% after deductible
Emergency Room Fees-Injury You pay: 20% after deductible
Other Covered Outpatient Expenses You pay: 20% after deductible
Spine and Back Disorders You pay: 20% after deductible (limited benefit)
Mental and Nervous Disorders (including substance abuse) You pay: 20% after deductible (limited benefit)
Inpatient Expense Benefits
Room and Board, Intensive Care Unit, Operating Room, Recovery Room, Prescription Drugs, Physician Visit, and Professional Fees of Doctors, Surgeons, Nurses You pay: 20% after deductible
Other Covered Inpatient Services You pay: 20% after deductible
Other United Healthcare of Texas health insurance plans:
