UT Connect Medical Plan Coverage

This will provide responses and clarification to questions raised regarding the new UT Connect Medical Plan during the Benefit Presentations held throughout the campus.

UT Connect is a new medical plan option in addition to the UT Select Plan. Employees may choose either the UT Connect or UT Select Plan effective September 1, 2018.

Question 1

Which urgent care providers are available in the Southwestern Health Resources Network (SWHR [Southwestern Health Resources Network] ), also known as “The UT Connect Network”?

Response

The list of urgent care providers is available through the Blue Cross Blue Shield website.

Question 2

Will there be more health care providers added to the UT Connect Network at a later date?

Response

The provider lists will continue to change and get updated periodically. You can review the lists of providers as needed through the Blue Cross Blue Shield website. If you need help finding a physician, hospital or other health care providers, please contact the Blue Cross Blue Shield customer service at 1.888.372.3398.

Question 3

What does NA [Not Applicable] mean noted on the Benefit Plan Design Comparison under the UT Connect Coinsurance Maximum?

Response

The coinsurance maximum amount is the total amount that an individual or family is obliged to pay before a health plan begins paying 100% of covered medical expenses per plan year. This does not include the medical and prescription deductible and copayments.

With UT CONNECT plan, the individual member does not stop paying coinsurance at $2,150. Therefore, a coinsurance maximum is not applicable (NA [Not Applicable] ). The member would continue to pay coinsurance, copays, office visit costs, etc., until they hit the Affordable Care Act (ACA [Affordable Care Act] ) maximum amount of $7,350.

With UT SELECT, if a person has services and expenses throughout the year that applies to coinsurance, the maximum coinsurance for the year is $2,150. After that, if the individual member incurs additional services and expenses requiring coinsurance, the member does not pay the coinsurance. The insurance plan will pay 100% for services requiring coinsurance when the member has met the maximum coinsurance for the year. If the member continues to have additional services (office visits, copay, RX [Prescription] costs), members pay those charges (but not coinsurance), until they hit the ACA [Affordable Care Act] maximum amount of $7,350.

Question 4

Will the UT Connect Plan waive the $100 copay for MRI [Magnetic Resonance Imaging] /CT [Computed Tomography] Scans if the member calls the Benefits Value Advisor prior to service?

Response

No, the UT Connect plan does not provide the same level of coverage as the UT Select Plan. The member will pay the $100 copay for the MRI [Magnetic Resonance Imaging] /CT [Computed Tomography] Scan and 20% of the allowable charges.

 

 

The online FAQ provides answers to most common questions. For more information regarding benefits available through the UT Connect Plan, visit the UT System Office of Employee Benefits and the Blue Cross Blue Shield websites. You may also contact the Blue Cross Blue Shield customer service at 1.888.372.3398 to speak to a representative.

 

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