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Delete this slide before distribution All Chapters provided in the 2016 Employee Presentation are intended to be part of a module series There are 6 chapters.

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Presentation on theme: "Delete this slide before distribution All Chapters provided in the 2016 Employee Presentation are intended to be part of a module series There are 6 chapters."— Presentation transcript:

1 Delete this slide before distribution 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 Please pick and choose from the slides provided to create a custom presentation that is right for you and your customers. Welcome to Chapter 3b – Gated Medical Plan Options Please remember:

2 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Navigate ® Plan BENEFITS This is plan that requires you to select a PCP. Your PCP will guide you through the health care system so you can get the right care at the right time. Pay less by using Tier 1 providers. They have been recognized for providing value. You need to select your personal PCP from the network. Each enrolled person must select a PCP. Save money by staying in our network. If you don’t use the network, you’ll have to pay for all of the costs. You need to get online referrals from your PCP to see a network specialist. If you see a network specialist without a referral, you will be responsible for the full cost of the service. Preventive care is covered 100% in our network. For COVERAGE DETAILS, see your official health plan documents. If you go out-of-network or see a specialist without a referrals, you will not be covered. You will have to pay the full cost of services. For COVERAGE DETAILS, see your official health plan documents. Your PCP will help you get the right care and save. Find your PCP at welcometouhc.com/navigateadvanced

3 NAVIGATE ADVANCED Your PCP: Must be located in a town or city near where you (the subscriber) lives 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 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) Choosing your PCP One PCP can be selected for the entire family or each covered person can select their own. If you don’t select a PCP when you enroll, one will be assigned for you. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. How can a PCP help you? Your PCP will get to know you and your health history. They can help you prevent and catch health issues before they become more serious. If you need special care, they can refer you to the right specialist. Find your PCP at welcometouhc.com/navigateadvanced

4 NAVIGATE ADVANCED Pay less using our Tier 1 providers. Where you go for care can make a big difference in cost. You’ll pay a lower [co-pay] [and] [co-insurance] when you use these Tier 1 providers. UnitedHealth Premium® Tier 1 providers have been recognized for providing value. [Tier 1 hospitals can charge less for the same services compared to other hospitals. Tier 1 hospitals are any hospitals that aren’t labeled Tier 2.] Free-standing facilities and centers are medical facilities in the network that are not connected to hospitals or another medical facility. They usually charge less. They may include radiology centers, surgery centers, and more. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Look for Premium Tier 1 network care first. To help you save money, we make it easy for you to find Premium Tier 1 providers. They have been recognized for providing value. Look for the Tier 1 symbol when doing a NETWORK search.

5 NAVIGATE You don’t need a referral for everything. Online referrals are required to see most specialists. But you may not need to receive one to see the following providers as long as they are in the network: Obstetricians/gynecologists (OB/GYNs) Behavioral health or substance use disorder clinicians Convenience care clinics Urgent care clinics Emergency care at an emergency room For a COMPLETE LIST of providers and services that need referrals, see your plan documents. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Your PCP must submit all referrals online. A paper referral will not be considered a valid referral. You can check all of your referrals online at myuhc.com.

6 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Navigate ® Plan, cont’d BENEFITS CO-PAYMENT*IN THE NETWORKOUT OF NETWORK PCP Specialist DEDUCTIBLE* [Self [Family CO-INSURANCE* OUT-OF-POCKET LIMIT [Self [Family Paying for care *Preventive care is covered 100 percent so you won’t need to worry about these costs and payments.

7 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Catalyst® Plan: Pre-deductible Allowance – two payments BENEFITS Navigate® Plus Plan This is plan that requires you to select a PCP. Your PCP will 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 network. Each enrolled person must select a PCP. There’s coverage if you need to go out of the network. Choose what’s best for you. You get the highest coverage when your PCP submits an online referral for you to see a network specialist. But, referrals are not required. Preventive care is covered 100% in our network. Look for network care first. To help you save money, we make it easy for you to find your PCP and other network providers. Find your PCP at welcometouhc.com/navigateplus 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.

8 NAVIGATE PLUS Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Your PCP: Must be located in a town or city near where you (the subscriber) lives 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 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) Choosing your PCP One PCP can be selected for the entire family or each covered person can select their own. If you don’t select a PCP when you enroll, one will be assigned for you. How can a PCP help you? Your PCP will get to know you and your health history. They can help you prevent and catch health issues before they become more serious. If you need special care, they can refer you to the right specialist. Find your PCP at welcometouhc.com/navigateplus

9 NAVIGATE PLUS Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. You don’t need a referral for everything. Referrals aren’t required in this plan but they are encouraged. If you need a referral, it must be submitted online by your PCP to be accepted. Referrals may not be needed to see the following providers as long as they are in the network: Obstetricians/gynecologists (OB/GYNs) Behavioral health or substance use disorder clinicians Convenience care clinics Urgent care clinics Emergency care at an emergency room For a COMPLETE LIST of providers and services that need referrals, see your plan documents. Your PCP must submit all referrals online. A paper referral will not be considered a valid referral. You can check all of your referrals online at myuhc.com.

10 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Catalyst® Plan: Pre-deductible Allowance – two payments BENEFITS Navigate Plus Plan, cont’d CO-PAYMENT*IN THE NETWORKOUT OF NETWORK PCP Specialist DEDUCTIBLE* [Self [Family CO-INSURANCE* OUT-OF-POCKET LIMIT [Self [Family Paying for care *Preventive care is covered 100 percent so you won’t need to worry about these costs and payments.

11 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Charter ® Plan BENEFITS This is plan that requires you to select a PCP. Your PCP will guide you through the health care system so you can get the right care at the right time. Pay less by using Tier 1 providers. They have been recognized for providing value. You need to select your personal PCP from the network. Each enrolled person must select a PCP. Save money by staying in our network. If you don’t use the network, you’ll have to pay for all of the costs. You need to get online referrals from your PCP to see a network specialist. If you see a network specialist without a referral, you will be responsible for the full cost of the service. Preventive care is covered 100% in our network. For COVERAGE DETAILS, see your official health plan documents. Your PCP will help you get the right care and save. Find your PCP at welcometouhc.com/charteradvanced

12 CHARTER ADVANCED Your PCP: Must be located in a town or city near where you (the subscriber) lives 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 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) Choosing your PCP One PCP can be selected for the entire family or each covered person can select their own. If you don’t select a PCP when you enroll, one will be assigned for you. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. How can a PCP help you? Your PCP will get to know you and your health history. They can help you prevent and catch health issues before they become more serious. If you need special care, they can refer you to the right specialist. Find your PCP at welcometouhc.com/charteradvanced

13 CHARTER ADVANCED Pay less using our Tier 1 providers. Where you go for care can make a big difference in cost. You’ll pay a lower [co-pay] [and] [co-insurance] when you use these Tier 1 providers. UnitedHealth Premium® Tier 1 providers have been recognized for providing value. [Tier 1 hospitals can charge less for the same services compared to other hospitals. Tier 1 hospitals are any hospitals that aren’t labeled Tier 2.] Free-standing facilities and centers are medical facilities in the network that are not connected to hospitals or another medical facility. They usually charge less. They may include radiology centers, surgery centers, and more. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Look for Premium Tier 1 network care first. To help you save money, we make it easy for you to find Premium Tier 1 providers. They have been recognized for providing value. Look for the Tier 1 symbol when doing a NETWORK search.

14 CHARTER You don’t need a referral for everything. Online referrals are required to see most specialists. But you may not need to receive one to see the following providers as long as they are in the network: Obstetricians/gynecologists (OB/GYNs) Behavioral health or substance use disorder clinicians Convenience care clinics Urgent care clinics Emergency care at an emergency room For a COMPLETE LIST of providers and services that need referrals, see your plan documents. Your PCP must submit all referrals online. A paper referral will not be considered a valid referral. You can check all of your referrals online at myuhc.com.

15 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Charter ® Plan, cont’d BENEFITS CO-PAYMENT*IN THE NETWORKOUT OF NETWORK PCP Specialist DEDUCTIBLE* [Self [Family CO-INSURANCE* OUT-OF-POCKET LIMIT [Self [Family Paying for care *Preventive care is covered 100 percent so you won’t need to worry about these costs and payments.

16 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. BENEFITS Charter® Plus Plan This is plan that requires you to select a PCP. Your PCP will 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 network. Each enrolled person must select a PCP. There’s coverage if you need to go out of the network. Choose what’s best for you. You get the highest coverage when your PCP submits an online referral for you to see a network specialist. But, referrals are not required. Preventive care is covered 100% in our network. Look for network care first. To help you save money, we make it easy for you to find your PCP and other network providers. Find your PCP at welcometouhc.com/charterplus 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 CHARTER PLUS Your PCP: Must be located in a town or city near where you (the subscriber) lives 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 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) Choosing your PCP One PCP can be selected for the entire family or each covered person can select their own. If you don’t select a PCP when you enroll, one will be assigned for you. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. How can a PCP help you? Your PCP will get to know you and your health history. They can help you prevent and catch health issues before they become more serious. If you need special care, they can refer you to the right specialist. Find your PCP at welcometouhc.com/charterplus

18 CHARTER PLUS You don’t need a referral for everything. Referrals aren’t required in this plan but they are encouraged. If you need a referral, it must be submitted online by your PCP to be accepted. Referrals may not be needed to see the following providers as long as they are in the network: Obstetricians/gynecologists (OB/GYNs) Behavioral health or substance use disorder clinicians Convenience care clinics Urgent care clinics Emergency care at an emergency room For a COMPLETE LIST of providers and services that need referrals, see your plan documents. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Your PCP must submit all referrals online. A paper referral will not be considered a valid referral. You can check all of your referrals online at myuhc.com.

19 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. BENEFITS Charter Plus Plan, cont’d CO-PAYMENT*IN THE NETWORKOUT OF NETWORK PCP Specialist DEDUCTIBLE* [Self [Family CO-INSURANCE* OUT-OF-POCKET LIMIT [Self [Family Paying for care *Preventive care is covered 100 percent so you won’t need to worry about these costs and payments.

20 This ends Chapter 3b- Gated Medical Plans Please open Chapter 4- CDH Plans Copy and paste slides from Chapter 4 to your Master 1.Click on the first slide and then press shift while you click on the last slide 2.Right click on the first slide and select copy 3.Go to your Master (Chapter 1) 4.Click below the thumbnail of the last slide in that section 5.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 Copy and paste slides from Chapter 4 into your Master 1. Click on the first slide and then press shift while you click on the last slide 2. Right click on the first slide and select copy 3. Go to your Master (Chapter 1) 4. Click below the thumbnail of the last slide in that section 5. Right click there and select Copy—Use Source Formatting Whichever slides from Chapter 4 that do not apply to your customer’s needs, delete This ends Chapter 3b – Gated Medical Plans Please open Chapter 4 – CDH Plans


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