United Healthcare of Texas Saver 80 Plan Information
Calendar-Year Deductible You pay: $500, $1,000, $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 Not Covered
Primary Care Physician/Specialist Referrals Required No
Prescription Drugs
Preferred price card Not Covered
Annual Maximum Not Applicable
Wellness/Preventive Care Benefits (No waiting period)
Doctor Office visit Not Covered
X-ray and Lab Not Covered
Child immunizations (0-18) Not Covered
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: $500 copay if not admitted, then 20% after deductible
Emergency Room Fees-Injury You pay:$500 copay if not admitted, then 20% after deductible
Other Covered Outpatient Expenses You pay: 20% after deductible
Spine and Back Disorders Not Covered
Mental and Nervous Disorders (including substance abuse) Not Covered
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:
