Coverage Plans
Classic Plan
The Classic Plan is similar to a managed care plan, however, you are not required to obtain referrals from your Primary Care Physician (PCP).
Like most medical plans, there are deductibles, co-payment, co-insurance and maximum out-of-pocket amounts.
Under the Classic Plan you select a doctor from the UA QualChoice Network prior to seeking services. You file no claim forms and only pay a $25.00 co-payment at the time of your physician visit.
Covered Services under Classic Plan
- Preventive Care Services (physical exams, well baby/child visit, immunizations, and routine gynecological visits, mammograms, prostate screening and other “wellness services”)
- Physician Services (office visits, surgical services, inpatient medical care, diagnostic testing)
- Outpatient Services (surgical services, ER visits, urgent care, ambulance, home health, hospice, etc.)
- Routine Vision Exam
- Inpatient Services (room & board, ICU/CCU)
- Maternity Services (physician, hospital)
Note: Some services may require Pre-authorization. Please refer to the Summary Plan Description Booklet.
Point of Service (POS)
The Point of Service Plan provides the choice to utilize the in-network and out-of-network benefits. Under the POS Plan you select a doctor from the UA QualChoice Network prior to seeking services, but you also have the option to choose any doctor for services with reduced benefits.
You file no claim forms and pay only $25 co-payment at the time of your physician visit, if that visit is to your PCP.
Covered Services under POS Plan
- Preventive Care Services (physical exams, well baby/child visit, immunizations, and routine gynecological visits, mammograms, prostate screening and other “wellness services”)
- Physician Services (office visits, surgical services, inpatient medical care, diagnostic testing)
- Outpatient Services (surgical services, ER visits, urgent care, ambulance, home health, hospice, etc.)
- Inpatient Services (room & board, ICU/CCU)
- Maternity Services (physician, hospital)
- Routine Vision Exam
- TMJ ($10,000 Lifetime Maximum)
Note: Some services may require Pre-authorization. Please refer to the Summary Plan Description Booklet.
Point of Service Alternate Plan
This plan is only available for out of state employees and retirees. Also available to active employees whose work assignment is out of state. Please contact Department of Human Resources for further information.