1. Delete this slide before distribution
Welcome to Chapter 3 – Medical Plan Options
Please remember:
All Chapters provided in the 2016 Employee Presentation are intended to be part of a module series
There are 6 chapters
Follow along with and compile these into your own presentation (see below) in the order they are presented
Text items in red are variable. Please modify them as necessary in order to fit your customers’ needs
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2. UnitedHealthcare Preventive
BENEFITS
UnitedHealthcare Preventive
With the UnitedHealthcare Preventive plan, you can use any doctor, clinic, hospital or health care facility in our national network.
Save money by staying in our network. If you use a doctor who is not in the Options PPO network, the cost of your office visit and any screenings will not be paid by the plan.
There’s no need to choose a primary care Physician (PCP).
Preventive care is covered 100% in our Options PPO network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
UnitedHealthcare Preventive plan is not designed for non- routine care.
What you need to know about UnitedHealthcare Preventive
This plan does not cover
hospital care or non-preventive
physician services. In addition,
costs for other services,
such as x-rays, blood tests,
emergency department visits
or any other services to treat
medical conditions are not
covered. If you currently have,
or expect to incur, significant
health care expenses, you
should enroll in a more
comprehensive health care plan.
With the UnitedHealthcare Preventive plan, you can use any doctor, clinic, hospital or health care facility in our national Options PPO network.
You can save money by staying in our network. If you end up getting out-of-network care, you’ll have to pay for all of the costs.
You don’t need to choose a primary care provider (PCP)
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
It is important to note:
This plan This plan does not cover hospital care or non-preventive physician services. In addition, costs for other services, such as x-rays, blood tests, emergency department visits or any other services to treat medical conditions are not covered. If you currently have, or expect to incur, significant health care expenses, you should enroll in a more comprehensive health care plan.
If you sign up for UnitedHealthcare Preventive, you will NOT be eligible for a subsidy – financial assistance from the government to help pay for health coverage.
For COVERAGE DETAILS, see your official health plan documents.

3. Network preventive care is covered 100%
UnitedHealthcare Preventive
One physical checkup every year
One OB/GYN checkup every year (Pap Smear)
One screening for breast cancer every year (mammogram)
Birth control pills or other forms of birth control
Shots for measles and other childhood diseases (Immunizations)
One colonoscopy every five years (colorectal cancer screening test)
Other preventive tests required by the Affordable Care Act
We want to help you feel your best, so preventive care is always 100% covered in our network. This includes immunizations and preventive health screenings that may help catch potential health problems early. Yearly
health checkups and screenings, like those paid for by UnitedHealthcare Preventive, can help you stay healthy and may even lessen your chance of getting sick. Be sure to review your plan to ensure you understand what preventive services are included in your benefit plan.
To see a list of preventive care guideline recommendations, visit
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

4. Searching our network before you enroll.
Network Search
NETWORK-UnitedHealthcare Preventive
Searching our network before you enroll. 1
Select the Options PPO network at myuhc.com® You can search by name, location and specialty. 2
It’s very important on the UnitedHealthcaer Preventive plan that you visit a network provider because if you use a doctor that is not in the network, the cost of your visit will not be paid by the plan.
Before you enroll, you can easily find a network doctor.
Go to .com and select the Options PPO network.
You can search by name, location and specialty.
Consider looking for the blue Tier 1 symbol which identifies doctors that have met the UnitedHealthcare Premium Program quality and cost efficiency standards.
If you need help, give us a call our customer care team is happy to help you find a health care provider in your area.
Find a doctor
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

5. Save on your prescription medications
Prescription Savings Program
Save on your prescription medications
Use your discount card at more than 62,000 pharmacies nationwide
Savings average over 36%, with potential savings up to 75%*
Find estimated pricing information and location of participating pharmacies at
Unlimited use at participating pharmacies
Use for everyone in the household, every medication is eligible for savings
The Best Price Advantage…
The Best Price Advantage means if a drug is ever “on sale,” or if the pharmacy price is less than the discounted price, you will pay the lower of the two prices on retail prescription purchases.
Network of more than 62,000 pharmacies nationwide
Savings average over 36%, with potential savings up to 75%. (Savings will vary depending on the medication, dosage and participating pharmacy used.)
Website available for members to see estimated pricing information and location of participating pharmacies
Unlimited use at participating pharmacies, can be used for everyone in the household, every medication is eligible for savings
Just go online and print out the ID card. When you fill a prescription, present the card to your pharmacist who will apply the discount. You’ll save money right away! And the Best Price Advantage means if a drug is ever “on sale,” or if the pharmacy price is less than the discounted price, you will pay the lower of the two prices.
Go online to print off a discount card
Present your card at participating pharmacy
Discount is applied
You pay discounted price
*Based on 2013 ScriptSave data
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

6. Choice Plan Paying for network care
BENEFITS
Choice Plan
With the Choice plan, you can use any doctor, clinic, hospital or health care facility in our national network.
Save money by staying in our network. If you go out-of-network, you’ll have to pay for all of the costs.
There’s no need to choose a primary care Physician (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
For COVERAGE DETAILS, see your official health plan documents.
Paying for network care
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
With the Choice plan, you can use any doctor, clinic, hospital or health care facility in our national network.
You can save money by staying in our network. If you end up getting out-of-network care, you’ll have to pay for all of the costs.
You don’t need to choose a primary care provider (PCP) or get referrals to see a specialist. But we would suggest considering having a PCP; they can be helpful in managing your care.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <$XX>
And the out-of-pocket limit is <$XXXX>.

7. Core Essential Plan Paying for network care
BENEFITS
Core Essential Plan
Paying for network care
With the Core Essential plan, you can use any doctor, clinic, hospital or health care facility in the Core Essential network.
Save money by staying in our network. If you go out-of-network, you’ll have to pay for all of the costs.
There’s no need to choose a primary care Physician (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
For COVERAGE DETAILS, see your official health plan documents.
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
With the Core Essential plan, you can use any doctor, clinic, hospital or health care facility in the Core Essential network.
You can save money by staying in our network. If you end up getting out-of-network care, you’ll have to pay for all of the costs.
You don’t need to choose a primary care provider (PCP) or get referrals to see a specialist. But we would suggest considering having a PCP; they can be helpful in managing your care.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <$XX>
And the out-of-pocket limit is <$XXXX>.

8. SignatureValue® Plan Paying for network care
BENEFITS
SignatureValue® Plan
Paying for network care
The SignatureValue® plan gives you a PCP so you can get the quality of care you deserve and the protection you need from major health care costs.
Select your personal PCP from the plan network. Each enrolled person must select a PCP.
You need to get referrals to see a specialist.
There’s no coverage if you go out-of-network. You will be responsible for the entire cost of the service.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
For COVERAGE DETAILS, see your official health plan documents.
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
The SignatureValue® plan gives you a PCP so you can get the quality of care you deserve and the protection you need from major health care costs.
Select your personal PCP from the plan network. Each enrolled person must select a PCP.
You need to get referrals to see a specialist.
There’s no coverage if you go out-of-network. You will be responsible for the entire cost of the service.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <$XX>
And the out-of-pocket limit is <$XXXX>.

9. Navigate® Plan Paying for network care
BENEFITS
Navigate® Plan
Paying for network care
This is plan that requires you to select a PCP who can help guide you through the health care system so you can get the right care at the right time.
You need to select your personal PCP from the plan network.
Referrals are not required to see a specialist. But you will get the highest level of coverage if you get one.
There’s no coverage if you go out-of-network. You will be responsible for the entire cost of the service.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
For COVERAGE DETAILS, see your official health plan documents.
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
This is plan that requires you to select a PCP who can help guide you through the health care system so you can get the right care at the right time.
You need to select your personal PCP from the plan network.
Referrals are not required to see a specialist.
But you will get the highest level of coverage if you get one.
There’s no coverage if you go out-of-network.
You will be responsible for the entire cost of the service.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <$XX>
And the out-of-pocket limit is <$XXXX>.

10. Navigate® Balanced Plan
BENEFITS
Navigate® Balanced Plan
Paying for network care
This is plan that requires you to select a PCP who can help guide you through the health care system so you can get the right care at the right time.
You need to select your personal PCP from the plan network.
Referrals are not required to see a specialist. But you will get the highest level of coverage if you get one.
There’s no coverage if you go out-of-network. You will be responsible for the entire cost of the service.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
For COVERAGE DETAILS, see your official health plan documents.
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
The Navigate Balanced plan requires you to select a PCP who can help guide you through the health care system so you can get the right care at the right time.
You need to select your personal PCP from the plan network.
Referrals are not required to see a specialist.
But you will get the highest level of coverage if you get one.
There’s no coverage if you go out-of-network.
You will be responsible for the entire cost of the service.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <$XX>
And the out-of-pocket limit is <$XXXX>.

11. <ACO Provider Group Logo>
BENEFITS
<Navigate Plan [in partnership with <ACO Provider Group>]>
With this health plan, you can get higher quality care and pay less by using Tier 1 network providers. This plan requires you to select a primary care Physician (PCP) from the network who will help guide you through the health care system.
You need to select your personal PCP [from <ACO provider group>’s network] [from the plan network].
Online referrals are needed from your PCP to see network specialists.
Save money by staying in our network. If you go out-of-network, you’ll have to pay for all of the costs.
Preventive care is covered 100% in our network.
For COVERAGE DETAILS, see your official health plan documents. [
<ACO Provider Group Logo>
UnitedHealthcare has partnered with <ACO provider group> who is a Tier 1 Provider Group. <ACO provider group> is one of the most trusted names in health care and consistently earns high marks for patient satisfaction.]
We want to help you get the most value.
With this health plan, you can get higher quality care and pay less by using Tier 1 network providers. This plan requires you to select a primary care provider (PCP) from the network who will help guide you through the health care system.
[UnitedHealthcare has partnered with <ACO provider group> who is a Tier 1 Provider Group. These health care providers and facilities work together to help you get the most out of your plan by providing quality, efficient care. <ACO provider group> is one of the most trusted names in health care and consistently earns high marks for patient satisfaction.]
You need to select your personal PCP [from <ACO provider group>’s network] [from the plan network]. Your PCP will be your first point of contact to see that you receive the highest quality of care at the right time. Each enrolled person must select a PCP.
Online referrals are needed from your PCP to see network specialists. Your PCP must submit all referrals online. Without an online referral, you’ll have to pay for all of the costs. You don’t need referrals for everything. For a complete list of providers that need referrals, see your plan documents.
Save money by staying in our network. Out-of-network means that a provider does not have a contract with us. If you get out-of-network care, you’ll have to pay for all of the costs.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
*Preventive care is covered 100% so you won’t need to worry about these costs and payments.

12. <Navigate Plan [in partnership with <ACO Provider Group>]>
BENEFITS
<Navigate Plan [in partnership with <ACO Provider Group>]>
Paying for care
CO-PAYMENT*
TIER 1 PROVIDER
IN THE NETWORK
OUT OF NETWORK
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
Understand your costs when getting care.
You’ll pay less when you use our Tier 1 providers. These are doctors who are recognized for meeting high quality standards and cost efficiency benchmarks. So, you you’ll get quality care at the best price.

13. Here’s how to choose your PCP.
BENEFITS
Here’s how to choose your PCP.
Your PCP:
Must be a general practice, family practice, pediatrician or internal medicine physician
Can be selected for the entire family or each covered dependent can select their own
Must submit all referrals online
When you sign up, have this information ready.
First name, last name and address
Physician ID number (you will find this number when you do a PCP search online)
You will need to choose a PCP in from a Tier 1 Provider Group when you enroll. If you don’t select one, or if the one you chose isn’t in the network, one will be assigned to you. Your PCP:
Must be a general practice, family practice, pediatrician or internal medicine physician
Can be selected for the entire family or each covered dependent can select their own
Must submit all referrals online
When you sign up, have this information ready.
First name, last name and address
Physician ID number (you will find this number when you do a PCP search online)
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

14. Pay less using <ACO Provider Group>.
BENEFITS
Pay less using <ACO Provider Group>.
Advantages of using <ACO provider group>:
Online test results and scheduling
Registered nurse phone line
One-stop multi-specialty care
More predictable costs
Fewer out-of-pocket expenses
Out-of-area emergency coverage
Extra Urgent Care access
Higher quality care
Better health care experience
[Find Premium® Tier 1 physicians.
These are doctors in 27 different medical specialties who are recognized for meeting national standards for quality and local market benchmarks for cost efficiency.
<ACO provider group> is known as an Accountable Care Organization (ACO). An ACO is a group of health care providers, including primary care providers (PCPs), specialists, hospitals and other facilities who work together as a team to manage your health and help lower your costs.
Other advantages of using<ACO provider group> include:
Online test results and scheduling
Registered nurse phone line
One-stop multi-specialty care
More predictable costs
Fewer out-of-pocket expenses
Out-of-area emergency coverage
Extra Urgent Care access
Higher quality care
Better health care experience
Look for the Tier 1 symbol when doing a network search.
These are doctors in 27 different medical specialties who are recognized for meeting national standards for quality and local market benchmarks for cost efficiency.
Look for the Tier 1 symbol when doing a NETWORK search.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

15. Choice Plus Plan Paying for network care
BENEFITS
Choice Plus Plan
Paying for network care
With the Choice Plus plan, you can use any doctor, clinic, hospital or health care facility, but you save money when you use the national network.
There’s coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more.
There’s no need to choose a primary care Physician (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
With the Choice Plus plan, you can use any doctor, clinic, hospital or health care facility, but you save money when you use the national network.
You have some coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more. Out-of-network providers can even bill you for amounts higher than what your plan will cover.
You don’t need to choose a primary care provider (PCP) or get referrals to see a specialist. But we would suggest considering having a PCP; they can be helpful in managing your care.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <XX%>
And the out-of-pocket limit is <$XXXX>.
If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.

16. UnitedHealthcare Tiered Benefits Plan
Paying for network care
With the UnitedHealthcare Tiered Benefits plan, you can use any doctor, clinic, hospital or health care facility, but you save money when you use the Choice Plus national network.
Reduced out-of-pocket costs when using UnitedHealth Premium® physicians
There’s no need to choose a primary care Physician (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
CO-INSURANCE*
Tier 1
<$XX>
PCP
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
OUT-OF-POCKET LIMIT
With the Tiered Benefits plan, the UnitedHealth Premium program takes the guesswork out of your doctor search. You’ll save money when you visit physicians who have received the UnitedHealth Premium Tier One designation for quality and cost efficiency. Look for the Tier 1 symbol when you are searching for a physician on myUHC.com or the Health4Me app.
The program currently evaluates doctors in more than 25 specialties continues to add new specialties to enhance your plan. You’ll have predictable co-payments or other costs when you see your doctor, so there are no surprises. PLUS, you will have coverage for services outside of the network, though usually at a higher out-of-pocket cost.
Here are the plan highlights:
-Predictable co-payments and lower costs for network care;
-Coverage for out-of-network care;
-See any network doctor, including specialists, without referrals;
-No requirement to choose a primary care physician;
-100 percent preventive care coverage in our network;
-No need to submit claims for network care.
-Care management if you require hospital stay or surgery, though certain services may need prior-authorization.
If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.

17. Options PPO Plan Paying for network care
BENEFITS
Options PPO Plan
Paying for network care
With the Options PPO plan, you can receive care and services from anyone in or out of our network, but you save money when you use the national network.
There’s coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more.
There’s no need to choose a primary care Physician (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
With the Options PPO plan, you can receive care and services from anyone in or out of our network, but you save money when you use the national network.
You have some coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more. Out-of-network providers can even bill you for amounts higher than what your plan will cover.
You don’t need to choose a primary care provider (PCP) or get referrals to see a specialist. But we would suggest considering having a PCP; they can be helpful in managing your care.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <XX%>
And the out-of-pocket limit is <$XXXX>.
If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.

18. Non-Differential Options PPO Plan
BENEFITS
Non-Differential Options PPO Plan
With the Non-Differential Options PPO plan, you can use any doctor, clinic, hospital or health care facility in the country.
You’ll have the same level of coverage for any health care provider or facility you use. If you can, use doctors and hospitals in the network. They can help keep your costs low.
There’s no need to choose a primary care provider (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
Paying for network care
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
With the Non-Differential Options PPO plan, you can use any doctor, clinic, hospital or health care facility in the country.
You’ll have the same level of coverage for any health care provider or facility you use. If you can, use doctors and hospitals in the network. They can help keep your costs low.
You don’t need to choose a primary care provider (PCP) or get referrals to see a specialist. But we would suggest considering having a PCP; they can be helpful in managing your care.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <XX%>
And the out-of-pocket limit is <$XXXX>.
If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.

19. Core Plan Paying for network care
BENEFITS
Core Plan
Paying for network care
With the Core plan, you have quality network care nearby. If you travel, you’ll get access to a national network to help lower your costs.
There’s coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more.
There’s no need to choose a primary care provider (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network.
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
With the Core plan, you have quality network care nearby. If you travel, you’ll get access to a national network to help lower your costs.
You have some coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more. Out-of-network providers can even bill you for amounts higher than what your plan will cover.
You don’t need to choose a primary care provider (PCP) or get referrals to see a specialist. But we would suggest considering having a PCP; they can be helpful in managing your care.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <XX%>
And the out-of-pocket limit is <$XXXX>.
If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.
*Preventive care is covered 100% so you won’t need to worry about these costs and payments.

20. Navigate Plus Plan Navigate Plus Plan Paying for network care
BENEFITS
Navigate Plus Plan
Paying for network care
This health plan requires you to select a PCP who can help guide you through the health care system so you can get the right care at the right time.
You need to select your personal PCP from the plan network.
There’s coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more.
Referrals are not required to see a specialist. But you will get the highest level of coverage if you get one.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
This Navigate Plus plan requires you to select a PCP who can help guide you through the health care system so you can get the right care at the right time.
You need to select your personal PCP from the plan network.
You have some coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more. Out-of-network providers can even bill you for amounts higher than what your plan will cover.
Referrals are not required to see a specialist.
But you will get the highest level of coverage if you get one.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <XX%>
And the out-of-pocket limit is <$XXXX>.
If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.

21. Catalyst® Plan Catalyst® Plan Paying for network care
BENEFITS
Catalyst® Plan
With the Catalyst plan, you can save money when you use the national network and take advantage of your pre-deductible allowance.
You get a pre-deductible allowance. It will help you pay for certain services before your deductible.
[There’s coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more.]
There’s no need to choose a primary care provider (PCP) or get referrals to see a specialist. Consider a PCP; they can be helpful in managing your care.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
Paying for network care
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
With the Catalyst plan, you can save money when you use the national network and take advantage of your pre-deductible allowance.
You get a pre-deductible allowance. It will help you pay for certain services before your deductible.
[You have some coverage if you need to go out-of-network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more. Out-of-network providers can even bill you for amounts higher than what your plan will cover.]
You don’t need to choose a primary care provider (PCP) or get referrals to see a specialist. But we would suggest considering having a PCP; they can be helpful in managing your care.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <XX%>
And the out-of-pocket limit is <$XXXX>.
If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.

22. Catalyst® Plan: Pre-deductible Allowance – two payments
BENEFITS
Catalyst® Plan
Your employer gives you a pre-deductible allowance. This allowance is money that your employer sets aside for you to help pay for covered services.
You can save money. The allowance can pay for certain covered services before you have to pay a deductible.
You’ll receive two separate allowances for the year. One allowance can be used for doctor visits and the other can be used for emergency care.
Qualified expenses:
Qualified expenses:
Doctor office visits
Emergency care
Note: Cannot be used for pharmacy expenses, such as prescriptions
With many plans, you have to pay a deductible before your plan will pay for covered services. This plan is different. Your employer gives you a pre-deductible allowance. This allowance is money that your employer sets aside for you to help pay for covered services.
You can save money.
The allowance can pay for certain covered services before you have to pay a deductible.
You’ll receive two separate allowances for the year.
One allowance can be used for doctor visits and the other can be used for emergency care.
Please note, the pre-deductible allowance can’t be used for pharmacy expenses, such as prescriptions.

23. Catalyst® Plan Qualified expenses: Qualified expenses:
Catalyst® Plan: Pre-deductible Allowance – one payment, doctor + emergency care
BENEFITS
Catalyst® Plan
Your employer gives you a pre-deductible allowance. This allowance is money that your employer sets aside for you to help pay for covered services.
You can save money. The allowance can pay for certain covered services before you have to pay a deductible.
You’ll receive one allowance for the year. You can use this money for doctor visits and emergency care.
Qualified expenses:
Qualified expenses:
Doctor office visits
Emergency care
Note: Cannot be used for pharmacy expenses, such as prescriptions
With many plans, you have to pay a deductible before your plan will pay for covered services. This plan is different. Your employer gives you a pre-deductible allowance. This allowance is money that your employer sets aside for you to help pay for covered services.
You can save money.
The allowance can pay for certain covered services before you have to pay a deductible.
You’ll receive one allowance for the year.
You can use this money for doctor visits and emergency care.
Please note, the pre-deductible allowance can’t be used for pharmacy expenses, such as prescriptions.

24. Catalyst® Plan Qualified expenses: Qualified expenses:
Catalyst® Plan: Pre-deductible Allowance – one payment, all types of care
BENEFITS
Catalyst® Plan
Your employer gives you a pre-deductible allowance. This allowance is money that your employer sets aside for you to help pay for covered services.
You can save money. The allowance can pay for certain covered services before you have to pay a deductible.
You’ll receive one allowance for the year. You can use this money for all types of care.
Qualified expenses:
Qualified expenses:
Doctor office visits
Emergency care
Surgery
Lab and X-ray services
Note: Cannot be used for pharmacy expenses, such as prescriptions
With many plans, you have to pay a deductible before your plan will pay for covered services. This plan is different. Your employer gives you a pre-deductible allowance. This allowance is money that your employer sets aside for you to help pay for covered services.
You can save money.
The allowance can pay for certain covered services before you have to pay a deductible.
You’ll receive one allowance for the year.
You can use this money for all types of care. This includes doctor visits, emergency care, surgery, as well as lab and X-ray services.
Please note, the pre-deductible allowance can’t be used for pharmacy expenses, such as prescriptions.

25. Catalyst® Plan: Pre-deductible allowance Step 1
BENEFITS
Catalyst® Plan
Paying for network care with a pre-deductible allowance
Your deductible: You will pay a co-payment for covered services and then your pre-deductible allowance pays until it’s gone. Then, you’ll have to pay until you reach your deductible.
STEP 1
STEP 1
Ok, here’s how paying for network care works with a pre-deductible allowance.
You will pay a co-payment for covered services and then your pre-deductible allowance pays until it’s gone.
Then, you’ll have to pay for services until you reach the deductible.
Your deductible
Your allowance pays first
You pay +

26. Catalyst® Plan: Pre-deductible allowance Step 2
BENEFITS
Catalyst® Plan
Paying for network care with a pre-deductible allowance
Your co-insurance: After you reach the deductible, you share the costs with the plan.
STEP 2
STEP 1
STEP 2
After you reach the deductible, you share the costs with the plan.
Your deductible
Your co-insurance
Your allowance pays first
You pay
Your plan pays %
You pay % + +

27. Catalyst® Plan: Pre-deductible allowance Step 3
BENEFITS
Catalyst® Plan
Paying for network care with a pre-deductible allowance
Your out-of-pocket limit: When you reach the limit, you are done paying. The plan pays 100% of covered services for the rest of the plan year.
STEP 3
STEP 1
STEP 2
STEP 3
When you reach the out-of-pocket limit, you are done paying. The plan pays 100 percent of covered services for the rest of the plan year.
Your deductible
Your co-insurance
Your out-of-pocket limit
Your allowance pays first
You pay
Your plan pays %
You pay %
You are
done paying + +

28. Select Plan Paying for network care
BENEFITS
Select Plan
Paying for network care
The Select Plan requires you to choose a primary care provider (PCP) who can help manage your care.
You need to select your personal PCP from the plan network.
There’s no need get referrals to see a specialist.
There’s no coverage if you go out-of-network. You will be responsible for the entire cost of the service.
Preventive care is covered 100% in our network. Preventive care is covered 100% so you won’t need to worry about these costs and payments
For COVERAGE DETAILS, see your official health plan documents.
CO-PAYMENT*
PCP
<$XX>
Specialist
DEDUCTIBLE*
[Self
<$XXXX>
[Family
CO-INSURANCE*
<XX%>
OUT-OF-POCKET LIMIT
The Select Plan requires you to choose a primary care provider (PCP) who can help manage your care.
You need to select your personal PCP from the plan network.
You don’t need to get referrals to see a specialist.
There’s no coverage if you go out-of-network. If you end up getting out-of-network care, you will be responsible for the entire cost of the service.
Preventive care is covered 100 percent in our network, so you won’t need to worry about these costs and payments.
To get more COVERAGE DETAILS, you can look through your official health plan documents.
When it comes to paying for network care, here are some of the basic costs:
The co-payment for a PCP visit is <$XX> and specialist visit is <$XX>.
The deductible for a single plan is <$XXXX> and a family plan is <$XXXX>.
After you reach the deductible, your co-insurance is <$XX>
And the out-of-pocket limit is <$XXXX>.

29. Your costs 1 Plan Costs Plan PCP <$XX> SPECIALIST <$XX>
BENEFITS
Your costs
CO-PAYMENT
DEDUCTIBLE
CO-INSURANCE
OUT-OF-POCKET LIMIT
Plan
PCP <$XX>
SPECIALIST <$XX>
SELF <$XX>
FAMILY <$XX>
<$XX>
Presenter Note: Select the table with the appropriate number of plans. Update options with offered plan names and edit text as needed. Insert this slide after CDH plan information if included.
This table summarizes the costs associated with your plan
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

30. Your costs by plan 2 Plan Costs Plan 1 Plan 2 PCP <$XX>
BENEFITS
Your costs by plan
CO-PAYMENT
DEDUCTIBLE
CO-INSURANCE
OUT-OF-POCKET LIMIT
Plan 1
PCP <$XX>
SPECIALIST <$XX>
SELF <$XX>
FAMILY <$XX>
<$XX>
Plan 2
Presenter Note: Select the table with the appropriate number of plans. Update options with offered plan names and edit text as needed. Insert this slide after CDH plan information if included.
This table allows you to see the costs for each of your plan options side-by-side
Now let’s address your pharmacy coverage.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

31. Your costs by plan 3 Plan Costs Plan 1 Plan 2 Plan 3 PCP <$XX>
BENEFITS
Your costs by plan
CO-PAYMENT
DEDUCTIBLE
CO-INSURANCE
OUT-OF-POCKET LIMIT
Plan 1
PCP <$XX>
SPECIALIST <$XX>
SELF <$XX>
FAMILY <$XX>
<$XX>
Plan 2
Plan 3
Presenter Note: Select the table with the appropriate number of plans. Update options with offered plan names and edit text as needed. Insert this slide after CDH plan information if included.
This table allows you to see the costs for each of your plan options side-by-side
Now let’s address your pharmacy coverage.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

32. Your costs by plan 4 Plan Costs Plan 1 Plan 2 Plan 3 Plan 4
BENEFITS
Your costs by plan
CO-PAYMENT
DEDUCTIBLE
CO-INSURANCE
OUT-OF-POCKET LIMIT
Plan 1
PCP <$XX>
SPECIALIST <$XX>
SELF <$XX>
FAMILY <$XX>
<$XX>
Plan 2
Plan 3
Plan 4
Presenter Note: Select the table with the appropriate number of plans. Update options with offered plan names and edit text as needed. Insert this slide after CDH plan information if included.
This table allows you to see the costs for each of your plan options side-by-side
Now let’s address your pharmacy coverage.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

33. Your costs by plan 5 Plan Costs Plan 1 Plan 2 Plan 3 Plan 4 Plan 5
BENEFITS
Your costs by plan
CO-PAYMENT
DEDUCTIBLE
CO-INSURANCE
OUT-OF-POCKET LIMIT
Plan 1
PCP <$XX>
SPECIALIST <$XX>
SELF <$XX>
FAMILY <$XX>
<$XX>
Plan 2
Plan 3
Plan 4
Plan 5
Presenter Note: Select the table with the appropriate number of plans. Update options with offered plan names and edit text as needed. Insert this slide after CDH plan information if included.
This table allows you to see the costs for each of your plan options side-by-side
Now let’s address your pharmacy coverage.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

34. Delete this slide before distribution
This ends Chapter 3- Medical Plans
Please open Chapter 4- CDH Plans
Copy and paste slides from Chapter 4 to your Master
Click on the first slide and then press shift while you click on the last slide
Right click on the first slide and select copy
Go to your Master (Chapter 1)
Click below the thumbnail of the last slide in that section
Right click there and select Copy—Use Source Formatting
Delete any slides from Chapter 4 that do not apply to your customer’s needs
Delete this slide before distribution
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

35. Delete this slide before distribution
This ends Chapter 3 – Medical Plan Options
Please open Chapter 3a – Tiered Medical Plan Options
Copy and paste slides from Chapter 3 into your Master
Click on the first slide and then press shift while you click on the last slide
Right click on the first slide and select copy
Go to your Master (Chapter 1)
Click below the thumbnail of the last slide in that section
Right click there and select Copy—Use Source Formatting
Whichever slides from Chapter 3 that do not apply to your customer’s needs, delete
Delete this slide before distribution
INSTRUCTIONS—DELETE BEFORE FINALIZING