Duke Basic (HMO)
Among your choices for health care plans in 2004 will be a new option, Duke Basic. Employees should carefully review plan provisions of Duke Basic and compare them to Duke's other plans prior to enrolling, as the new plan differs from the other health plans in several key ways, including:
- Lower monthly premiums - $19.88 per month for individual, $194.66 per month for family coverage
- Higher co-pays, deductibles and co-insurance than other plans, including:
- $20 primary care physician visit co-pay per visit
- $50 specialty care physician visit co-pay per visit
- $100 per person prescription deductible per year
- $100 contributed to a Health Care Reimbursement Account by Duke for each
participant.
The contribution will be deposited into a Health Care Reimbursement Account
within 45 to 60 days.
Is Duke Basic Right for You?
When comparing Duke Basic to the other Duke health plans, the monthly premiums for Duke Basic are lower, but the overall cost for coverage will depend on other factors such as co-pays, deductibles and co-insurance, which are higher than in the other plans.
When considering Duke Basic, it may be the best choice if:
- You typically only visit the doctor for preventive services such as annual physicals, ob/gyn exams, immunizations and well baby visits
or
- You are not currently covered by health insurance and you or your family members would benefit from a basic level of coverage
Pharmacy Benefits
As with Duke's other health plans, pharmacy benefits are provided for participants in Duke Basic. Co-payments for Duke Basic's pharmacy benefits are the same as the other health plans; however each participant in Duke Basic must satisfy a $100 prescription drug deductible before the plan begins to pay benefits toward the cost. In addition, mail order is mandatory for maintenance medications, which are medications that a doctor has prescribed for regular use such as heart pressure medication or birth control pills. Authorization may be required for some prescribed medications before they can be covered.
|
