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

Today I'll explain the benefits of the PPO 2000. 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 PPO 2000 through UMR uses the United Healthcare Choice Plus provider network in all areas, except the Northeast region which uses the First Health Network. Links to view participating providers are available on this website.

The PPO 2000 does not require a primary care physician, but you need to see a participating provider for the best benefit.

The network deductible for an individual is $2,000 and for a family is $6,000. The coinsurance is 20%. This means that once your deductible is met, you are responsible for 20% of the remaining charges and the plans pays 80%. The copayment for office visits are $25 for a primary care physician and $35 for a specialist. Copayments do not apply to the deductibles or out of pocket maximums.

Refer to your Member Handbook for more detailed information on the benefits and what applies to the deductible and coinsurance.

If you choose to use a provider that is not in the network, you must meet a separate non-network deductible. There are no copayments for office visits; they are subject to the deductible and coinsurance, which is 40%. The non-network deductibles are $4,000 for an individual and $12,000 for a family.

Once the deductible and coinsurance equals the out of pocket maximum, the plan pays 100% of claims based on the usual, customary and reasonable (UCR) charges for the remainder of the year. Amount charged above the UCR charges do not apply to the maximum.

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 any questions, please feel free to contact MCHCP at 800-487-0771 or UMR at 1-888-200-1167.

Thank you for watching this presentation about the PPO 2000.