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MEDICAL & PRESCRIPTION DRUG

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MEDICAL & PRESCRIPTION

Coverage to Build a Foundation of Good Health

At Olympic Steel, we understand the importance of good health as the foundation for a productive life at home and at work. That is why we offer medical and prescription coverage, administered by UnitedHealthcare (UHC), to fit your needs and budget.

Keep in mind that you may use any provider or facility.  However, if you choose a network provider, your UHC benefits will be paid at the highest level. In addition, if you use a Tier 1 Designated provider your office visit out of pocket amount will be reduced.  Remember that you will pay more for care if you choose an out-of-network provider.

Use Your Coverage Wisely – Urgent Care vs Emergency Room

Everyone wants to save time and money and sometimes it takes a little legwork to do both.  One way is to be aware of the appropriate usage of the Emergency Room versus using an Urgent Care center.

Urgent Care is for minor illness and injuries such as sprains and cuts, colds and the flu. The Emergency Room is for true emergencies such as broken bones, chest pains, and excessive bleeding…any condition that may be life-threatening or that will cause permanent damage without immediate and a higher level of care.

On average, the cost of the Emergency Room is five to eight times higher than the cost of Urgent Care and the average wait time is several hours instead of minutes.  Why pay more and wait more for the same outcome?

How it Works

UnitedHealthcare PPO Plan

The UHC medical plan is a Preferred Provider Organization (PPO) which means UHC has contracted with a network of healthcare providers, including facilities, to provide better pricing for those who seek care within the network.  UHC has further enhanced their PPO network by identifying certain providers as Designated Tier 1 providers.  Tier 1 providers have demonstrated that they provide both quality and cost-effective care for their patients.  Since managing healthcare dollars is everyone’s responsibility, there is a lower copay for you when you seek care from a Tier 1 provider.  See the plan summary for more details.

In-Network Medical Plan FAQs:

  • When you use network and Tier 1 providers you will pay less for your care;
  • Copays:
    • Office visits, ER, Urgent Care and Generic prescription drug all have flat copays and are not subject to the Plan deductible;
    • Copays do not count toward your deductible
    • Copays do accumulate toward your annual out-of-pocket maximum
  • The annual deductible will apply to services such as Inpatient hospital stays, Outpatient services and some diagnostic testing
  • Once the deductible is met, the Plan’s will begin to pay benefits at 80% (network)
  • Your coinsurance amount after the deductible is 20%; once your annual out of pocket maximum is met the Plan will pay covered services at 100% for the rest of the plan year (network).

Preferred Lab Network (PLN)

Just like there are Tier 1 doctors and specialists in the UHC network, there are also Preferred Lab Networks (PLN).  When you use a PLN there is no cost to you for diagnostic lab work, testing and x-rays.  Participating labs include LabCorp, Quest Diagnostics and AmeriPath to name a few.  To find the locations of these labs and those of other preferred labs, go to www.myuhc.com and look for the  icon.

Prescription Coverage through UHC/OptumRx

If you enroll in the medical plan, you are automatically enrolled in prescription drug coverage.  The pharmacy benefits manager is OptumRx, UHC’s pharmacy partner.  To find out which drugs are covered, refer to the National Drug List found to the right side of this window or contact a customer service representative at 1-833-760-7890.

Some medications may require prior authorization from OptumRx before your prescription will be filled.  Your doctor should contact OptumRx to initiate a prior authorization request.

Visit MyUHC.com if you have questions regarding your medical or prescription coverage.

PPO Plan

Plan Features In-Network Out-of-Network
Deductible $1,000 /individual
$3,000/family
$2,000/individual
$6,000/family
Coinsurance 20% 40%
Out-of-Pocket Maximum $5,000/individual
$10,000/family
$5,500/individual
$11,000/family
Primary Care Copay $25 40% after deductible
Designated Primary Care Copay  $10 N/A
Specialist Copay $45 40% after deductible
Designated Specialist Copay $25 N/A
Diagnostic Lab 20% after deductible 40% after deductible
Diagnostic Lab at Preferred Lab  $0 N/A
Virtual Visits $0 Not Covered
Urgent Care $50 40% after deductible
Emergency Room $200 40% after deductible
Prescription Drug $10 Generic
25% Brand Preferred
50% Brand Non-Preferred
$10 Generic
25% Brand Preferred
50% Brand Non-Preferred

Please refer to the benefits summary for more information.

Physician office visit copays, ER and urgent care copays, and prescriptions do not count toward your deductible, but do accumulate toward your out-of-pocket maximum. The annual deductible is included in the out-of-pocket maximum.