Consider if: You live outside Central Kentucky but don’t need care outside the state.
This plan offers high-quality care for those who live outside Central Kentucky. Members who live in outlying counties can choose physicians from the Anthem network and benefit from the same coverage as the HMO plan.
That means no deductibles and no co-payments for preventive care. Members of the RHP plan incur slightly higher monthly premiums.
Service coverage and costs
All employee health insurance plans provide one annual preventive care visit with your primary care provider at $0 co-pay within specified networks.
For other common visits, this is what you’ll pay with UK-RHP.
Coverage highlights
RHP health plan | Maximums | UK HealthCare and Anthem |
---|---|---|
Lifetime Maximum Benefit | Unlimited | |
Out-of-Pocket Amount | Annual deductible | $0/member; $0/family |
Medical out-of-pocket maximum | $4,000/member; $8,000/family | |
Prescription out-of-pocket maximum | $5,000/member; $10,000/family |
Employee monthly rates
Coverage level | Total monthly cost* | UK pays | You pay |
---|---|---|---|
Employee only | $691 | $614 | $77 |
Employee + children | $1,032 | $823 | $209 |
Employee + spouse | $1,374 | $1,015 | $359 |
Employee + family | $1,719 | $1,203 | $516 |
Coverage level | Total monthly cost* | UK pays | You pay |
---|---|---|---|
Employee only | $848 | $736 | $112 |
Employee + children | $1,265 | $986 | $279 |
Employee + spouse | $1,669 | $1,216 | $453 |
Employee + family | $2,093 | $1,442 | $651 |
* Regular part-time and temporary employees (less than 0.75 FTE or work less than an average of 30 hours per week in a 12-month measurement period), who are not eligible for the UK credit toward the costs of coverage, pay this rate.
Coverage for common services
RHP health plan | Service | UK HealthCare and Anthem |
---|---|---|
Preventive Care (Coverage under preventive care category depends on age, symptoms, and diagnosis) | Routine Pap smears, mammograms, PSA, screening colonoscopy, and sigmoidoscopy | $0 |
Routine child care and immunizations (through age 18) | $0 | |
Routine adult physical exam (19 years and above, one per plan year) | $0 | |
Physician Services | Primary care office visits (excludes certain diagnostic lab and X-ray) | $10 co-pay per visit |
Specialist office visits (excludes certain diagnostic lab and X-ray) | $30 co-pay per visit | |
Lab tests, X-rays and diagnostic tests | $0 | |
Allergy injections | $10 co-pay | |
Inpatient services | $0 | |
Outpatient surgery and diagnostics | $0 | |
Physician visits to emergency room | $0 | |
Hospital Services | Inpatient care (semi-private room and board, nursing care, ICU) | $200 co-payment per admission |
Hospital observation stay | $100 co-payment | |
Organ transplants | $0 | |
Outpatient nonsurgical care | $0 | |
Outpatient tests, lab, X-ray and other diagnostic tests | $0 | |
Ancillary services | $0 | |
Outpatient surgery | $75 co-payment | |
Outpatient diagnostic testing (high costs - MRI, MRA, CT and PET scans) | $75 co-payment | |
Emergent/Urgent Services | Emergency room | $100 co-payment plus 20% co-insurance (waived if admitted) |
Urgent treatment center | $25 co-payment | |
UK Children's Twilight Clinic | $15 co-payment | |
Ambulance | $75 co-payment | |
Other Medical Services | Skilled nursing facility (up to 30 per plan year) and hospice services | $0 |
Home health care (up to 60 visits per plan year) | 20% co-insurance | |
Durable medical equipment, orthotics, and prosthetics | 20% co-insurance up to $500 member cost per year | |
Hearing aids | 20% co-insurance for children under 18 | |
Speech, music, physical, occupational, manipulative, hydrotherapy, acupuncture, pulmonary rehab, and cardiac rehab therapy (limited to 45 visits per plan year, combined) | $15 co-payment per visit for all therapies | |
Mental Health and Substance Abuse | Inpatient mental health or substance abuse | $200 co-pay per admission |
RHP plan members must live in the 110 outlying counties of Kentucky.