Our HMO, RHP and EPO plans will have one change to how some emergency room visits are covered. The change does not apply to an emergency room visit which results in a hospital admission.
- Beginning July 1, HMO plan members will pay $100, then 10% of the remaining cost of an emergency room visit.
- RHP and EPO plan members will pay $100, then 20% of the remaining cost.
- Our PPO plan, in which about 48% of our members are enrolled, for many years has already included a $100 co-pay, then 20% of the remaining cost, for emergency room visits not resulting in a hospital admission. That plan remains the same this year.
For all those plans, those costs are waived for any emergency room visit which results in admission to the hospital. Emergency visits that lead to a hospital admission are instead billed as inpatient hospital visits, which remain subject to a flat $200 co-pay on the HMO and RHP plans or a $300 co-pay on the EPO plan.
Costs for emergency room visits can vary widely, depending on many factors. But as one example, if an emergency room visit that doesn’t result in admission visit has a cost of $1,500, an HMO plan member will pay $100, then 10% of the remaining cost, or $140. The total out-of-pocket cost would be $240. On the PPO plan, the same emergency room visit would cost $380 out of pocket.
Each plan member should choose the care setting that is most appropriate for their health care needs. Several options are available for urgent care. Urgent care visits cost a flat $25 co-pay on the HMO and RHP plans and a $50 co-pay on the PPO and EPO plans.
UK HealthCare Urgent Care Clinics are available at the Turfland and Fountain Court locations. Learn more about UK HealthCare Urgent Care. We also offer the UK Health Plan Urgent Care Clinic for UK employees and their dependents over age 18 who are on a UK health insurance plan. This clinic is in the University Health Service Building on campus.
When you need primary care, you may be interested in the Team Blue Clinic. This clinic is dedicated solely to UK employees and their family members who are on a UK health insurance plan. The clinic, located at Kentucky Clinic South off Harrodsburg Road, offers routine primary care as well as same-day appointments when you’re sick. Learn more about Team Blue Clinic.
We hope this information supports your decision on which health insurance plan to choose. If you have any questions, please contact us at benefits@uky.edu.