UPHS_Enrollment_Guide_FINAL

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Print this Guide Human Resources/ Benefits Locations Making Changes During the Year Contact Information Search this Document > Carewise Health Programs Medical PENNCare PPO Keystone POS and Aetna QPOS Behavioral Health Prescription Drug Vision Dental Flexible Spending Accounts (FSAs) Life Insurance AD&D Coverage Disability Legal Notices Welcome What’s New Cost for Coverage Plan Highlights Welcome > Medical > Keystone POS and Aetna QPOS Keystone POS and Aetna QPOS Below is a summary of the POS plans. For a more detailed list of coverage, click here. Point-of-Service Plan (Keystone POS and Aetna QPOS) PENNCare Network Carrier Network Out-of-Network/Self- (Keystone or Aetna) Referred How to Access Care Select a UPHS Primary Care provider Select a carrier network Primary Care provider Go to any qualified provider Referrals Needed Yes Yes No Annual Deductible and Coinsurance None None $300/person $600/family Outpatient Office Visit Hospital Inpatient For all plans, Pavilion is covered for an additional fee. Annual Out-of-Pocket Limit $10 Primary Care or specialist visit Covered at 100% N/A $15 Primary Care or $20 specialist visit Covered at 100% after $120 copayment per admission Keystone only $1,500/person $3,000/family Plan pays 70% UCR after deductible Deductibles and coinsurance apply Covered at 70% after deductible $2,500/person $5,000/family More Information Review the POS Chart Contact Provider • Keystone POS at 215-241-2273 or 800-227-3114 • Aetna QPOS at 888-287-4296
Print this Guide Human Resources/ Benefits Locations Making Changes During the Year Contact Information Search this Document > Welcome What’s New Cost for Coverage Plan Highlights Carewise Health Programs Medical Behavioral Health Prescription Drug Vision Dental Flexible Spending Accounts (FSAs) Life Insurance AD&D Coverage Disability Legal Notices Welcome > Medical > Behavioral Health Behavioral Health Coverage The University of Pennsylvania Health System Mental Health and Chemical Dependency Benefits have changed in response to the Mental Health Parity and Addiction Equity Act of 2008. To learn more about Parity and how it may affect your coverage, please click here. Behavioral health coverage for all of the medical plans is provided by PENN Behavioral Health. They can be reached by at 888-321-4433. More Information Review the Behavioral Health Chart. Contact Provider PENN Behavioral Health at 888-321-4433
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UPHS_Enrollment_Guide_FINAL

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