Medical Insurance

MEDICAL & PRESCRIPTION COVERAGE

United Healthcare's Definity HRA product is offered to all full-time County Employees. 

Below is an outline of the Medical Plan:

When you have medical expenses, you pay a specific amount of your initial covered expenses each year; this is called your deductible.  If you have family coverage, there is a maximum amount of deductible expenses that your family members pay during the year.  Your deductible and out-of-pocket maximum are the same if you are in-network, therefore, after you have met your annual deductible, you have also satisfied your out-of-pocket maximum IF all of your expenses are in-network.  After you have satisfied the in-network deductible and your in-network out-of-pocket maximum, then the plan pays 100% of eligible expenses for the remainder of the calendar year.  NOTE: The In-Network Plan and Out-of-Network Plan are separate plans.  For example, if you have satisfied your In-Network Single Deductible, and you go Out-of-Network, you must meet the entire $4,000 Single Out-of-Network Deductible.  Deductible and Out-of-Pocket Limits DO NOT coordinate between the Plans. 

HEALTH REIMBURSEMENT ACCOUNT ("HRA")

Clinton County provides a HRA to help offset your deductible expenses.  The HRA is administered by United Healthcare and Exante Bank.  Based on your coverage selection, Clinton County deposits money into your HRA for you to use. 

While you are meeting your deductible, unpaid Medical expenses will automatically roll over to your HRA.  Your medical providers, or you, will be reimbursed out of the HRA.  Keep in mind that this is a separate transaction from the Medical plan.  After the Medical claim is processed and an Explanation of Benefits (EOB) is sent to you and your medical providers, then reimbursement from your HRA will be processed.  This will result in an additional statement from UHC and also your medical providers.  You will receive a monthly statement from your Definity HRA detailing any payments made.  You should match these statements up with any invoices you receive from your medical providers. 

PRESCRIPTION DRUG COVERAGE

The prescription drug program is included in your Medical coverage and administered by Medco Pharmacy.  At the pharmacy, you will present your Consumer Accounts Card (HRA card) and also your United Healthcare ID card.  After you have exhausted your HRA, you will be responsible for expenses incurred until you satisfy your annual deductible.  After your deductible is met, the Prescription Drug plan will pay 100% of all eligible prescription drug expenses. 

You may also order your maintenance medications through Medco's Mail Order pharmacy and receive a 90 day supply at one time.  Be sure to allow 14 business days to receive your initial order or a refill. 

WWW.MYUHC.COM

You can access ALL of your Medical, Pharmacy, and HRA information online at http://www.myuhc.com/ 

Registration is simple and you can set up your online account by registering, or by entering the username and password you set up the first time you entered http://www.myuhc.com/ 

At http://www.myuhc.com/, you can:

• See if your deductible has been met;
• View claim transactions and EOBs;
• Print EOBs;
• Search for in-network providers;
• View HRA transactions and payments;
• Check Drug Eligibility and Pricing;
• Request ID cards;
• Much, much more . . .

QUESTIONS?

If you have questions about a specific medical claim, if you have coverage questions, or eligibility questions and do not wish to go online, call United Healthcare Customer Service at 866-314-9775.

To check your HRA balance, call the automated Customer Service line at 866-755-2648 and follow the prompts to receive your account balance.

CERTIFICATE OF COVERAGE 2007

A copy of the 2007 Medical Plan description included covered and non-covered services is located at the bottom of this page in PDF format.