Medical Benefits

Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.

Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit umr.com.

Core Narrow Network	In-Network	Out-of-Network
Deductible (Individual/Family)	$5,000 / $10,000	$10,000 / $20,000
Out-of-Pocket Max (Individual/Family)	$6,250 / $12,500	$20,000 / $40,000
Member Coinsurance	20%	50%
Physician Visits
Primary Care Visit	First 4 visits: $35 Copay After 4 visits: Deductible + 20% coinsurance	Deductible + 50%
Preventive Care	Fully Covered	Deductible + 50%
Specialist Visit	First 4 visits: $70 Copay After 4 visits: Deductible + 20% coinsurance	Deductible + 50%
Hospital Services
Physician Services	Deductible + 20%	Deductible + 50%
Inpatient Hospitalization	Deductible + 20%	Deductible + 50%
Outpatient Surgery	Deductible + 20%	Deductible + 50%
Basic Outpatient Diagnostics	Deductible + 20%	Deductible + 50%
Urgent Care	First 4 visits: $50 Copay After 4 visits: Deductible + 20% coinsurance	Deductible + 50%
Emergency Room	Deductible + 20%	Deductible + 20%
Retail Prescriptions
Tier 1/2/3/4	$10/$65/$125/$250	N/A
Mail Order Prescriptions
Tier 1/2/3/4	$25/$162.50/$312.50/$625	N/A

	Per Pay Period Cost (26)
Employee Only	$43.05
Employee + Spouse	$141.01
Employee + Child(ren)	$129.32
Family	$196.79

Downloads

Find a Provider

UMR On the Go – Mobile App

Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit umr.com.

Choice Plus Network	In-Network	Out-of-Network
Deductible (Individual/Family)	$5,000 / $10,000	$10,000 / $20,000
Out-of-Pocket Max (Individual/Family)	$6,250 / $12,500	$12,500 / $25,000
Member Coinsurance	20%	50%
Physician Visits
Primary Care Visit	First 4 visits: $35 Copay After 4 visits: Deductible + 20% coinsurance	Deductible + 50%
Preventive Care	Fully Covered	Deductible + 50%
Specialist Visit	First 4 visits: $70 Copay After 4 visits: Deductible + 20% coinsurance	Deductible + 50%
Hospital Services
Physician Services	Deductible + 20%	Deductible + 50%
Inpatient Hospitalization	Deductible + 20%	Deductible + 50%
Outpatient Surgery	Deductible + 20%	Deductible + 50%
Basic Outpatient Diagnostics	Deductible + 20%	Deductible + 50%
Urgent Care	First 4 visits: $50 Copay After 4 visits: Deductible + 20% coinsurance	Deductible + 50%
Emergency Room	Deductible + 20%	Deductible + 20%
Retail Prescriptions
Tier 1/2/3/4	$10/$65/$125/$250	N/A
Mail Order Prescriptions
Tier 1/2/3/4	$25/$162.50/$312.50/$625	N/A