You have a choice between two medical plan options. Which option is right for you depends on you and your family’s specific health care needs. It’s important to consider all of the features and benefits of each plan when making a medical plan election. Below are some general guidelines, please carefully review both options in more detail below.
The HSA Plan
The HSA Plan is a high-deductible health plan that is paired with a tax-advantaged health savings account (HSA).
Key Highlights
- In-network and out-of-network coverage is available; however, your annual deductible and out-of-pocket expense is lower, and the benefits payable are higher when using an in-network provider.
- Preventive care services are covered at 100 percent when you see in-network providers.
- You pay the full cost of your health care services (except for preventive care) and prescription drug expenses—using either the funds in your HSA or other sources—until you meet your annual deductible.
- Once you satisfy the deductible, you and the plan share in the cost of your care—known as coinsurance—until you reach your out-of-pocket maximum for the year. The plan will then pay 100 percent of covered in-network expenses for the remainder of the calendar year.
- As a participant in the HSA Plan, HomeServices will also contribute to your HSA to help you pay for eligible health care expenses.
The Surest Copay Plan
With the Surest Copay Plan option, you can use any doctor, clinic, hospital or health care facility in the network. There is no coverage if you go out of the network, except in emergencies.
Key Highlights
- No deductible. No coinsurance. Ever
- Plan and cost information at your fingertips.
- Receive one bill.
- If your doctor’s already in-network, or you are flexible about where you get care and can easily stay in-network, then choosing the Surest Copay Plan may mean a lower cost for your care.
- This plan uses the same UnitedHealthcare network as the HSA Plan.
- In-network coverage only.
Exceptions to the “In-Network” Requirement
With the exception to emergency room care, you can only receive health care services from providers in the Surest Copay Plan network; otherwise, you will have to pay your bill in full.
Medical Plan Comparison
| HSA Plan | Surest Copay Plan | |||
|---|---|---|---|---|
| Employer HSA Contribution | Available | Not Available | ||
| Deductible, OOP Maximum, Coinsurance | In-Network | Out-of-Network | In-Network | Out-of-Network |
| Medical Deductible (Individual/All Other Tiers) | $2,000/$3,500 | $2,000/$3,500 | Not applicable | No coverage |
| Medical OOP Maximum (Individual/All Other Tiers) | $3,500/$7,350 | $3,500/$7,350 | $4,000/$8,000 | No coverage |
| Coinsurance (Paid Plan) | 80% | 60% | Not applicable | Not applicable |
| Physician Services | ||||
| Office Visit (Primary or Specialist) | 80% coverage after deductible | 60% coverage after deductible | $20 to $120 copay | No coverage |
| Preventive Care | 100% covered | 60% coverage (no deductible) | 100% covered | No coverage |
| Routine Diagnostic Test (X-ray, Lab, Ultrasound) | 80% coverage after deductible | 60% coverage after deductible | $0 copay | No coverage |
| Virtual Visits | ||||
| Primary or Urgent Care | 80% coverage after deductible (approximately $40) Must use the myuhc.com® or the UHC Health4Me app | $0 copay | No coverage | |
| Specialty | $0 to $70 copay | No coverage | ||
| Hospital Care | ||||
| Procedures (Inpatient and Outpatient) | 80% coverage after deductible | 60% coverage after deductible | $200 to $3,500 copay | No coverage |
| Outpatient Hospital Services | 80% coverage after deductible | 60% coverage after deductible | $150 to $1000 copay | No coverage |
| Inpatient Stay | 80% coverage after deductible | 60% coverage after deductible | $2,750 copay | No coverage |
| Emergency Care | 80% coverage after deductible | $750 copay | ||
| Urgent Care | 80% coverage after deductible | 60% coverage after deductible | $75 copay | No coverage |
| Urgent and Emergency Care | ||||
| Urgent Care Visit | 80% coverage after deductible | 60% coverage after deductible | $75 copay | No coverage |
| Emergency Room | 80% coverage after deductible | $750 copay | ||
| Emergency Transportation | 80% coverage after deductible | $375 copay | ||
2nd.MD
- Do I have the right diagnosis?
- Am I on the best treatment path and medication for my condition?
- Is a proposed surgery or medical procedure right for me?
2nd.MD provides medical certainty by helping medical plan participants get answers to these questions and more, by offering the following services:
- A conversation with a top-tier specialty physician within 3-5 days by video-chat or phone
- Condition-specific education
- Personalized support connects you to high-quality local in-network physicians, local wellness programs and support groups
- Live monthly webinars about timely and relevant topics led by expert specialists, viewable from the comfort of your home
Have a general question about a new diagnosis or an existing condition? Text a member of the clinical team through the 2nd.MD app!
For more information, visit the 2nd.MD website or call 866-269-3534.
2nd.MD Flyer
Progyny
For medical plan participants only.
Your journey to parenthood begins here!
Fertility treatments can be overwhelming. Progyny helps by connecting you to leading fertility specialists who provide the most advanced, effective fertility treatments, the first time — without barriers to treatment. Your personal Progyny fertility nurse stays connected with you every step of the way on your journey to support you in having the best chance of achieving a successful pregnancy with the course of treatment that is best for you.
Twin Health
For medical plan participants only.
Reversing type 2 diabetes is possible!
Twin Health is a benefit for employees and dependents over age 18 who are covered by one of the HomeServices medical plans. Twin Health works with individuals to reverse type 2 diabetes by healing the underlying cause, normalizing blood sugar, reducing medications, including injectables like insulin and increasing energy, improving mood, and decreasing symptoms.
For more information visit the Twin Health website.
Get Help From a UnitedHealthcare Advocate (HSA Medical Plan)
- Understanding your benefits and how they work
- Navigating health care claims and reimbursement
- Choosing the type and level of care you may need
- Guiding you to providers who offer high-quality care at the best value
An Advocate can clarify common points of confusion and help find ways for you to save money on health care services. If needed, they will transfer you to a registered nurse or specialist and stick with you until your needs are met.
To speak to an Advocate, call 866-747-1021. You can also contact an Advocate by email at myuhc.com® or from the UnitedHealthcare app.
Get Help From Surest Member Support (Surest Copay Plan)
- Understanding your benefits and how they work
- Navigating health care claims and reimbursement
- Choosing the type and level of care you may need
- Guiding you to providers who offer high-quality care at the best value
An Advocate can clarify common points of confusion and help find ways for you to save money on health care services. If needed, they will transfer you to a registered nurse or specialist and stick with you until your needs are met.
To speak to Surest member support, call 866-683-6440. You can also contact the support team by email at benefits.surest.com or from the Surest app.
Where to Go for Care
You never want to pay more than you have to for the things you need. The same is true for health care. The emergency room (ER) is the right place to go in a real emergency, but that is not always the level of care you need. For everything else, you’ll save time and money by exploring your options — including 24/7 Virtual Visits, where you can see and talk to a doctor online, anytime.
You have a variety of care options. Get to know them before you need care so you can make the right choice for your condition.
| Care Option | Description of Service |
|---|---|
| UnitedHealthcare Advocate | A health advocate can help you determine the best place to go for quality care at the lowest cost to you. |
| 24/7 Virtual Visits | See a doctor anytime online for common, minor illnesses like colds/flu, sinus problems, pink eye and more. No appointment is needed. |
| Convenience Care Clinic | Receive care for minor illnesses and injuries without an appointment. Clinics are found in many larger retail stores, drugstores and grocery stores. |
| Doctor’s Office | Your doctor can provide preventive and routine care, manage your medications, and refer you to a specialist, if necessary. |
| Urgent Care | An urgent care center can treat the same conditions as a convenience care clinic as well as more serious medical issues like sprains and strains, minor broken bones, and small cuts. |
| Emergency Room | Emergency rooms (ERs) are for people with serious or life-threatening conditions. If your health issue isn’t life threatening, consider other options. |
| Urgency Center or Freestanding ER | An urgency center is a freestanding emergency room, not an urgent care center. Urgency centers are not located in or attached to a hospital, but they can treat similar conditions as an ER. |
Contact your medical plan directly for help on deciding where to go for care.
*Average amounts charged by UnitedHealthcare Network Providers and not tied to a specific condition or treatment. Actual payments may vary depending upon benefit coverage and location. See your official plan documents for more details.
Virtual Visits phone and video chat with a doctor are not an insurance product, health care provider or a health plan. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual Visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if these services are available.
Transparency in Coverage
Under the Transparency in Coverage Rule, HomeServices of America is required to make machine-readable files publicly available, which provide detailed information on the cost of items and services covered under the HomeServices Medical Plans.
You may visit the link below to obtain the required information.
