Thank you for watching this presentation about your health insurance benefits through Missouri Consolidated Health Care Plan. Hello, my name is Carol.

From this website, you can review benefit information and link to the health plans.

Today I'll explain the benefits of the Copay plan. Check with your employer to see if this plan is available to you. To review your prescription drug benefits through Express Scripts, Inc. please watch the pharmacy plan video.

The Copay plan through UMR uses the UnitedHealthcare Choice Plus provider network in all areas, except for the Northeast region which uses the First Health network. Links to view participating providers are available on this website.

If you use participating providers, there is no deductible and preventive services are covered at 100%.

The office visit copayment is $25 for your family physician and $35 for specialists.

The inpatient hospital copayment is $300 per admission.

Outpatient surgery has a $100 copayment. The urgent care copayment is $35 and the copayment for an emergency room visit is $100. These copayments apply for both network and non-network providers. If you are admitted to the hospital from the emergency room, then the ER copayment is waived and the inpatient copayment applies.

However, if you see a non- participating provider, for most benefits, the non-network benefits apply.

A $600 deductible applies to services received from a non-network provider. Then you pay a percentage of the charges, called coinsurance. You are responsible for 30% and the plan pays 70% of the UCR amount.

UCR is the usual, customary and reasonable amount allowed for that service. If you are charged above the UCR, the amount above the allowed cost is your responsibility.

Once the deductible and coinsurance equals the out of pocket maximum, the plan pays 100% of claims based on the UCR amount for the remainder of that year.

For more detailed benefit information, please refer to your member handbook. Don't forget that the pharmacy benefits are explained in a separate video.

If you have questions, please feel free to contact MCHCP at 800-487-0771.

Thank you for watching this presentation about the Copay Plan.