2020-2021 UT System Health Benefit Option
PERSONALIZED SUPPORT AND SERVICES. SAVINGS ON DEDUCTIBLES AND PREMIUMS. ACCESS TO CARE.
An Option With Extra Advantages UT CONNECT. It’s a health benefit option for 2020-2021 coverage, available to UT System employees and non-Medicareeligible retirees living or working in Dallas, Tarrant, Collin, Denton, Parker or Rockwall counties.
UT CONNECT offers opportunities to save on copays, deductibles and premiums (from about $300 to $600 per year for dependent coverage) while providing for simple access to exceptional medical care.
CONNECTIONS DESIGNED TO MAKE HEALTHCARE WORK BETTER FOR YOU Navigating healthcare can be tricky, no matter what type of medical coverage you have. With UT CONNECT, you’ll have a service designed to take the guesswork out of getting the care you need, when you need it. Healthcare Coverage That Goes Beyond the Basics It covers the same benefits as UT SELECT, and it is administered by Blue Cross and Blue Shield of Texas. You’ll also receive the extra advantages of Southwestern Health Resources, the network UT Southwestern Medical Center and Texas Health Resources created to improve the quality of healthcare. It’s at the core of UT CONNECT. For you and your family, this means a medical benefit dedicated to making healthcare work for you and your family.
This coverage gives you access to nationally recognized experts in medicine — doctors, caregivers and hospitals that are part of: • UT Southwestern Medical Center • Texas Health Resources
Increased Access to Care UT CONNECT provides next-level service to members including more physicians in our network than last year. In November 2020, Texas Health Resources urgent care facilities with a reduced copay will be open. Personalized Service If you need help with going to a specialist, want to find ways to save even more on your out-of-pocket costs or anything else related to your healthcare coverage, you’ll have someone dedicated to helping you find answers. It’s a service only available through UT CONNECT. You’ll have experts working for you — this includes nurses who are connected to UT Southwestern medical directors. In addition to your regular doctors, you can call on the CONNECT Team for support.
Keep Money in Your Pocket With Savings on Dependent Coverage, Deductibles and Copays to See Doctors With UT CONNECT. To participate in UT CONNECT, simply choose it as your medical benefit option. If you’re already a member and don’t change your healthcare benefits, your UT CONNECT coverage will continue for 2020-2021.
Benefits Highlights & Out-of-Pocket Costs
UT CONNECT
UT SELECT
Monthly Plan Premium for Employee Only
$0
$0
Monthly Plan Premium for Employee + Spouse
$243.37
$270.41
Monthly Plan Premium for Employee + Child(ren)
$254.53
$282.81
Monthly Plan Premium for Employee + Family
$479.26
$532.51
Annual Deductible/Individual
$250
$350
Annual Deductible/Family
$750
$1,050
$0
$30 (unless for preventive care)
$15 (unless for preventive care)
$30 (unless for preventive care)
Copay for Specialist Office Visit
$25
$35
Copay for Inpatient Hospital Care at UT Southwestern Medical Center and Texas Health Resources Hospital Locations
$0
Copay for Annual Primary Care Physician (PCP) Office Visit (Annually)* Copay for PCP Office Visits (After the First Visit)
Copay for Outpatient Facility (Plus Coinsurance)
$50
$100
$2,150/$6,450
$2,150/$6,450
Copay at Texas Health Resources Urgent Care Facilities**
$30
$35
Copay at Non-Texas Health Resources Urgent Care Facilities
$35
$35
Prescription Drug Coverage — New 90-Day Retail Option & Same Deductible and Copays
Yes
Yes
Urgent Care Emergency Care
Yes
Yes
Yes
Coinsurance Maximum Individual/Family
Out of Area Coverage MDLIVE (24/7 Virtual Doctor Visits) Doc Finder To find doctors, urgent care centers, hospitals or other healthcare providers in the UT CONNECT network, call 1-888-372-3398 or go online to BCBSTX.COM/UTCONNECT.
$100 per day
($500 maximum)
* $0 PCP copay for preventive care for UT CONNECT and UT SELECT. ** THR urgent care facilities will be open in November 2020. Copay for non-THR urgent care facilities is the same for both plans ($35).
Care Where and When You Need It More than 10,000 doctors in North Texas are part of the UT CONNECT network. This includes: • Primary care physicians (PCPs) to help with a range of healthcare needs. • Some of the most highly regarded specialists in the United States, at the forefront of orthopedics, cardiology, neuroscience, cancer and other specialized care. • For pediatricians you have many choices, including doctors your child may already be seeing. • Also, you’ll never need to contact your PCP before seeing a gynecologist.
New for 2020-2021 Coverage • Members have access to the Ovia Health App providing maternity and family support through your entire parenthood journey. • There is an increase in the annual maximum for physical therapy and occupational therapy visits to 30 per condition. (Speech therapy continues to be 60 visits per year.) • The Affordable Care Act out-of-pocket limit (combining medical and prescription drug costs) is increasing to $8,150 per individual and $16,300 per family. These limits on total out-of-pocket expenses provide an extra level of financial protection for you and your family.
Top-Ranked Hospitals You’ll be connected to nationally recognized hospitals, including: • UT Southwestern Medical Center, including Clements University Hospital and Zale Lipshy University Hospital. • Texas Health Resources locations, such as Texas Health Presbyterian Dallas, Texas Health Arlington Memorial, Texas Health Harris Methodist and many others. • Children’s Health, Cook Children’s and all pediatric hospitals in North Texas.
When you need it, you’ll have access to outstanding medical care.
Urgent and Emergency Care No worries about getting medical attention, even on weekends or when traveling — you’re covered with UT CONNECT: • Urgent care providers in-network, located in all 50 states, including 150+ urgent care centers in North Texas. • Emergency care anywhere in the world.
Ready to learn more about UT CONNECT? Call us at 888-399-8889 or go to UT-Connect.com.
The UT CONNECT Network provides access to physicians, caregivers, outpatient facilities and hospitals in the network in North Texas, as well as urgent care centers throughout the United States. When you’re in North Texas, there’s no coverage for out-of-network care, except for true emergencies and other special situations.
Keep Money in Your Pocket With Savings on Dependent Coverage, Deductibles and Copays to See Doctors With UT CONNECT. New for 2020-2021 Coverage • Members have access to the Ovia Health App providing maternity and family support through your entire parenthood journey. • There is an increase in the annual maximum for physical therapy and occupational therapy visits to 30 per condition. (Speech therapy continues to be 60 visits per year.) • The Affordable Care Act out-of-pocket limit (combining medical and prescription drug costs) is increasing to $8,150 per individual and $16,300 per family. These limits on total out-of-pocket expenses provide an extra level of financial protection for you and your family. Benefits Highlights & Out-of-Pocket Costs
UT CONNECT
UT SELECT
$0
$0
Monthly Plan Premium for Employee + Spouse
$243.37
$270.41
Monthly Plan Premium for Employee + Child(ren)
$254.53
$282.81
Monthly Plan Premium for Employee + Family
$479.26
$532.51
Annual Deductible/Individual
$250
$350
Annual Deductible/Family
$750
$1,050
$0
$30 (unless for
$15 (unless for preventive care)
$30 (unless for
Copay for Specialist Office Visit
$25
$35
Copay for Inpatient Hospital Care at UT Southwestern Medical Center and Texas Health Resources Hospital Locations
$0
Monthly Plan Premium for Employee Only
Copay for First Primary Care Physician (PCP) Office Visit (Annually)* Copay for PCP Office Visits (After the First Visit)
Copay for Outpatient Facility (Plus Coinsurance)
preventive care) preventive care)
$100 per day
($500 maximum)
$50
$100
$2,150/$6,450
$2,150/$6,450
Copay at Texas Health Resources Urgent Care Facilities**
$30
$35
Copay at Non-Texas Health Resources Urgent Care Facilities
$35
$35
Prescription Drug Coverage — New 90-Day Retail Option & Same Deductible and Copays
Yes
Yes
Urgent Care Emergency Care
Yes
Yes
Yes
Coinsurance Maximum Individual/Family
Out of Area Coverage MDLIVE (24/7 Virtual Doctor Visits)
* $0 PCP copay for preventive care for UT CONNECT and UT SELECT. ** THR urgent care facilities will be open in November 2020. Copay for non-THR urgent care facilities is the same for both plans ($35).
Ready to learn more about UT CONNECT? Call us at 888-399-8889 or go to UT-Connect.com.
MDLIVE
24/7 VIRTUAL VISITS WITH DOCTORS — AT YOUR SERVICE, ANYWHERE Getting sick over the weekend or after normal business hours used to mean a lengthy, costly trip to an emergency room or hospital. Not any more — with UT CONNECT, you’ll be able to have a virtual visit with a doctor through MDLIVE. It’s provided by Blue Cross and Blue Shield of Texas, and available as part of your medical coverage. With MDLIVE, the doctor is in 24/7/365. And there is no additional cost to you to use this service. You don’t have to leave the comfort of your home. Virtual visits allow you to consult with a doctor for nonemergency situations by phone, mobile app or online video — anytime, anywhere. Speak to a doctor or schedule a time that works best for you. Virtual visits with doctors can treat a variety of health conditions, such as: • Allergies • Asthma • Cold/flu • Nausea • Ear problems (age 12+) • Fever (age 3+) • Pink eye • Rash • Sinus infections
Speak with a licensed counselor, therapist or psychiatrist for support, available by appointment. You can choose who you want to work with for issues including: • Anxiety • Depression • Relationship problems • Trauma and loss • And more
For information, please contact the CONNECT Team by going to UT-Connect.com or calling 888-399-8889.
UT CONNECT: 2020-2021 Health Benefit Frequently Asked Questions 1) Does UT CONNECT provide comprehensive coverage for medical care? Yes. UT CONNECT covers the same core benefits as UT SELECT. UT CONNECT is a plan option for UT System employees and non-Medicare-eligible retirees living or working in Dallas, Tarrant, Collin, Denton, Parker or Rockwall counties. UT CONNECT is designed to meet the demands of your busy life. With UT CONNECT, you get personalized service, cost savings and a quality physician network of more than 10,000 healthcare providers ready to care for you when you need it. The plan is administered by Blue Cross and Blue Shield of Texas (BCBSTX); delivering value to you and your family. Selecting a primary care provider is required, but we make the selection process easy. Simply call the CONNECT Team for assistance at 1-888-399-8889 or go to the Doctors and Hospitals page to find your primary care physician. 2) What are the changes for 2020-2021? For 2020-2021, we are excited to offer UT CONNECT members extended urgent care coverage through Texas Health Resources with new THR facilities coming in November 2020. And, the copay is lower this year: $30 from $35. 3) Can I call and/or email the CONNECT Team for help? Yes. Members are encouraged to email CONNECTteam@southwesternhealth.org or call 1-888-399-8889. The CONNECT Team can assist with referrals, answer benefit questions and provide personalized service. In addition, Nurses are available to support health care needs and coordination of care. The CONNECT Team of nurses and navigators have access to UT Southwestern Medical Directors to provide guidance on healthcare issues. The CONNECT Team number and email address are on the back of the UT CONNECT member ID cards. 5) Where can I find a list of in-network doctors, hospitals, and urgent are centers? For a comprehensive list of in-network providers, please see the Doctors and Hospitals page. UT CONNECT includes all UT Southwestern and Texas Health Resources hospitals, plus Children’s, Cook Children’s and other pediatric hospitals in the Dallas Fort Worth area. 6) Which urgent care centers are part of the UT CONNECT network? There are more than 150 urgent care facilities in North Texas. If you need to find facilities or locations, check the Doctors and Hospitals page or call the CONNECT Team at 888-399-8889.
Starting in November, new Texas Health Resources urgent care sites will open and be available to members at a lower co-pay than other in-network urgent care facilities. 7) Are urgent care centers available outside of North Texas? Yes. If you need to find an urgent care facility in other parts of Texas (or any part of the United States), in-network providers are available. To find an urgent care center in our national network outside of Texas, contact the CONNECT Team at 888-399-8889.
8) Does UT CONNECT offer telemedicine, or virtual visits? If so, what is the cost? Yes, through MDLIVE® you can reach a doctor 24 hours day, seven days a week, from anywhere in the United States. There’s no copay or extra charge to use it. MDLIVE may be accessed online, by phone or downloading the app. Visit the UT CONNECT MDLIVE page for more information. 9) Will I need to pay a copay each time my primary care physician refers me to a specialist? When you enroll in UT CONNECT, your first PCP visit has a $0 copay. This first “free” visit is a great opportunity to talk with your PCP about specialty care you currently receive or anticipate needing in the future to expedite the referral process.