HMO United HealthCare
Phone toll free at 1-877-366-0011. Customer Service hours are 8:00 am - 5:00 pm EST, Monday through Friday.
- 2009 Member Handbook
- Member Home Page
- Benefit Changes for 2009
Physician Office Visit: $20 copay PCP; $25 copay specialist
Maternity: Increase to $20 copay PCP; $25 copay specialist
Chiropractic Care: Increase to $20 copay per visit
Emergency Room Use: Increase to $75 copay per visit (This applies only if not admitted to the hospital.)
Prescription Drug Copay: Increase to $25/preferred brand; $50/non-preferred brand
Diabetic Supplies (strips, lancets, syringes): Coinsurance waived when using In-Network Provider
Diabetic Prescription Drug (oral and insulin): Copay waived for generic and preferred brand when using In-Network Provider; $50/non-preferred brand - View a comparison of PPO, POS, HMO plans for 2009
- View a comparison of PPO, POS, HMO premiums for 2009
- Group Insurance Enrollment Form
- Primary Care Physician (PCP) Card must also be submitted if you are enrolling in HMO United HealthCare. Claims incurred without having a PCP will not be paid.
- Member Home Page
- 2008 Member Handbook
- HMO Plan Highlights for 2008
Primary Care Physician (PCP) coordinates health care services; each family member may choose a different physician. To change your PCP contact the customer service office.
Annual Medical Deductible: None
Annual Medical Out-of-Pocket Maximum: None
Physician Office Visit: $15 copay PCP; $20 copay specialist
Lab & X-Ray: 100% benefit
Prescription Drug Copay: $5/generic; $20/preferred brand; $40/non-preferred brand
Annual Pharmacy Copay Maximum: None - Frequently Asked Questions
- Provider Search (select State of Tennessee in the drop-down box) Subscribers to the HMO plan must select a Primary Care Physician (PCP). Claims incurred without having a PCP will not be paid.
- Member Health Programs (prevention & disease management initiatives)
- Prescription Benefit
Prescriptions may be filled for a single course of treatment up to a 34-day supply by participating pharmacies OR receive a 100-day supply of medication for one copayment from either the home delivery program or a retail pharmacy that participates in the home delivery pharmacy retail network. You will need a written prescription from your doctor for a 100-day supply of medication, with three refills, if appropriate. Phone 1-877-366-0011 to verify participating pharmacies. - Mail at Retail Pharmacies
A 100-day supply of medication may be obtained for one copayment in Hamilton County at Bi-Lo, CVS, KMart, Publix, Rite-Aid, Sam's Club, Target, Walmart; in Catoosa County, GA at Bi-Lo, CVS, KMart, Rite-Aid, Walmart, Walgreens. You will need a written prescription from your doctor for a 100-day supply of medication, with three refills, if appropriate. If you utilize a retail pharmacy that does not participate in the home delivery network, you will only be able to obtain up to a 34-day supply of your medication for one copayment. Phone 1-877-366-0011 to verify participating pharmacies. - Vision Care
Routine vision care limited to one visit/year. Eye exams must be obtained from a Spectera Vision provider. Phone 1-800-638-3120 for a participating provider or view the provider directory, using your Social Security number as the subscriber's identification number. You must use an approved provider to receive benefits for an eye exam and ID card must be presented. Exams performed by an optometrist will be covered for $15 copay. - Chiropractic Care
Chiropractic Care will be covered for $15 copay; maintenance visits not covered when no additional progress is apparent or expected to occur. Phone 1-800-873-4575 for more information about chiropractic care. - Your Health Network Newsletter for July 2008
- View a comparison of PPO, POS, HMO plans for 2008
- View a comparison of PPO, POS, HMO premiums for 2008
- Group Insurance Enrollment Form
- Primary Care Physician (PCP) Card must also be submitted if you are enrolling in HMO United HealthCare. Claims incurred without having a PCP will not be paid.
