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Medical Health Plan
The ManateeChoice Health System is administered by independent contractors within Employee Health Benefits. Employees are able to have “people to people” communication with Manatee Service Center staff by phone, walk-in or by appointment. The staff is provided by a Third Party Health Administrator and supervised by the Employee Health Benefits Manager. The staff includes Customer Service Representatives, Registered Nurse Advocates, Clinical Pharmacist, Wellness Specialist Advocates and support staff; specializing in nutrition, exercise, lifestyle assistance and health education.
Participants have the choice to enroll in one of four Health Plans based upon completing specific Qualifying Events.
The “YourChoice” Health Plan Levels:
- ULTIMATE - Highest Level of Reimbursement (co-pay, no deductible, no co-insurance)
- BEST - Middle to Highest Level of Reimbursement (co-pay, deductible & co-insurance)
- BETTER - Middle Level of Reimbursement (deductible & co-insurance applies)
- BASIC - Lowest Level of Reimbursement (deductible & co-insurance applies)
The only difference among the four plans is the Level of Reimbursement (Refer to the Reimbursement Levels).
*The level is determined by the co-pay, deductible or co-insurance, and the maximum out of pocket expense not including the deductible.
All four plans have:
- Identical Prescription Benefits with identical cost sharing
- Identical Medical Benefits with different cost sharing
- Identical Lifestyle Assessment & Modification Program (LAMP) Benefits with identical cost sharing
- Choice to utilize the Manatee Health Network or Non-Manatee Health Network Providers with different cost sharing
- Choice to utilize or not to utilize “YourChoice” Medical Management Programs and Guidelines
- Choice to utilize the Member Advocacy Program
Click Here for Qualifying Event details
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