Medical, Prescription Drug and Acupuncture/Chiropractic Plans

Please select your employee group from the list below.

*Please reach out to Benefits Coordinator, Lorena Carpenter, for updated forms.

Medical and Prescription Drug Plan Benefit Information    
Kaiser Permanente HMO $15 Medical/Rx
SIMNSA HMO (Cross border plan) Medical/Rx
UnitedHealthcare HMO Network 1 (Plan D) Medical Rx
UnitedHealthcare HMO Network 3            Medical Rx
UnitedHealthcare HMO Alliance $20/$30 Medical Rx
UnitedHealthcare HMO Harmony $10      Medical Rx

UnitedHealthcare HMO Network Comparison
Provider Medical Group for San Diego County

Websites
MyVEBA: www.vebaonline.com/myveba/
Kaiser Permanente:  www.kp.org
SIMNSA:  www.simnsa.com
UnitedHealthcare:  www.myuhc.com
UnitedHealthcare provider search:  www.welcometouhc.com/csveba
Prescription Drugs (UnitedHealthcare plans only):  www.expressscripts.com

Misc. Benefit Information
Acupuncture and chiropractic benefits for Kaiser and UnitedHealthcare members 
SIMNSA eligibility
Virtual Office Visit - Kaiser
Virtual Office Visit - UnitedHealthcare


Additional Benefit - Prescription Plans 

SaveOnSP - For Express Scripts Participants Only (UHC HMO and UMR PPO)

The SaveOnSP program through Express Scripts is designed to reduce or eliminate out-of-pocket costs on select specialty medications. Enrollment in the program is voluntary; however, if you choose not to participate, you will be responsible for the full copay on certain medications which will lead to additional costs . The copay will not count towards your deductible or out-of-pocket maximum. The specialty drug list is subject to change and members will be notified if their specialty medication applies to this program.

For further information, please contact SaveOnSP at 800-683-1074.


Step Therapy - For Express Scripts Participants Only (UHC HMO and UMR PPO)

Step Therapy simply means making sure you get safe and proven-effective medications at the lowest possible cost to you and your plan sponsor. A panel of independent licensed medical experts work with Express Scripts to recommend medications for the step therapy program. If taking a medication on the step therapy program, you are required to try a first-line medicine before a second- line medicine is covered.

First-line medications are the first step and are typically generic and lower-cost brand-name medications. In most cases, they provide the same health benefit as more expensive medications, but at a lower cost.

Second-line medications are the second and third steps and are typically brand-name medications. They are best suited for the few patients who don’t respond to first-line medications. They’re also the most expensive options.

*Please reach out to Benefits Coordinator, Lorena Carpenter, for updated forms.

Medical and Prescription Drug Plan Benefit Information             
Kaiser Permanente HMO $10 Medical/Rx
SIMNSA HMO (Cross border plan) Medical/Rx
UnitedHealthcare HMO Network 1 (Plan A) Medical Rx
UnitedHealthcare HMO Network 3  Medical Rx
UnitedHealthcare HMO Alliance $20/$30 Medical Rx
UnitedHealthcare HMO Harmony $10   Medical Rx
UMR PPO       Medical In-Network Medical Out-of-Network Rx

UnitedHealthcare HMO Network Comparison
Provider Medical Group for San Diego County

Websites
MyVEBA: www.vebaonline.com/myveba/
Kaiser Permanente:  www.kp.org
SIMNSA:  www.simnsa.com
UMR PPO: www.umr.com 
UnitedHealthcare:  www.myuhc.com
UnitedHealthcare provider search:  www.welcometouhc.com/csveba
Prescription Drugs (UnitedHealthcare plans only):  www.expressscripts.com

Misc. Benefit Information
Acupuncture and chiropractic benefits for Kaiser and UnitedHealthcare members 
SIMNSA eligibility
Virtual Office Visit - Kaiser
Virtual Office Visit - UMR PPO Plan
Virtual Office Visit - UnitedHealthCare


Additional Benefit - Prescription Plans

SaveOnSP - For Express Scripts Participants Only (UHC HMO and UMR PPO)

The SaveOnSP program through Express Scripts is designed to reduce or eliminate out-of-pocket costs on select specialty medications. Enrollment in the program is voluntary; however, if you choose not to participate, you will be responsible for the full copay on certain medications which will lead to additional costs . The copay will not count towards your deductible or out-of-pocket maximum. The specialty drug list is subject to change and members will be notified if their specialty medication applies to this program.

For further information, please contact SaveOnSP at 800-683-1074.


Step Therapy - For Express Scripts Participants Only (UHC HMO and UMR PPO)

Step Therapy simply means making sure you get safe and proven-effective medications at the lowest possible cost to you and your plan sponsor. A panel of independent licensed medical experts work with Express Scripts to recommend medications for the step therapy program. If taking a medication on the step therapy program, you are required to try a first-line medicine before a second- line medicine is covered.

First-line medications are the first step and are typically generic and lower-cost brand-name medications. In most cases, they provide the same health benefit as more expensive medications, but at a lower cost.

Second-line medications are the second and third steps and are typically brand-name medications. They are best suited for the few patients who don’t respond to first-line medications. They’re also the most expensive options.

Medical and Prescription Drug Plan Benefit Information    
Kaiser Permanente HMO $15 Medical/Rx
SIMNSA HMO (Cross border plan) Medical/Rx
UnitedHealthcare HMO Network 1 (Plan D) Medical Rx
UnitedHealthcare HMO Network 3         !NEW in 2022!     Medical Rx
UnitedHealthcare HMO Alliance $20/$30 Medical Rx
UnitedHealthcare HMO Alliance with $1,200 HRA Medical Rx
UnitedHealthcare HMO Harmony $10     !NEW in 2022! Medical Rx

UnitedHealthcare HMO Network Comparison
Provider Medical Group for San Diego County

Websites
MyVEBA: www.vebaonline.com/myveba/
Kaiser Permanente:  www.kp.org
SIMNSA:  www.simnsa.com
UnitedHealthcare:  www.myuhc.com
UnitedHealthcare provider search:  www.welcometouhc.com/csveba
Prescription Drugs (UnitedHealthcare plans only):  www.expressscripts.com

Misc. Benefit Information
Acupuncture and chiropractic benefits for Kaiser and UnitedHealthcare members 
SIMNSA eligibility
Virtual Office Visit - Kaiser
Virtual Office Visit - UnitedHealthcare


Additional Benefit - Prescription Plans 

SaveOnSP - For Express Scripts Participants Only (UHC HMO and UMR PPO)

The SaveOnSP program through Express Scripts is designed to reduce or eliminate out-of-pocket costs on select specialty medications. Enrollment in the program is voluntary; however, if you choose not to participate, you will be responsible for the full copay on certain medications which will lead to additional costs . The copay will not count towards your deductible or out-of-pocket maximum. The specialty drug list is subject to change and members will be notified if their specialty medication applies to this program.

For further information, please contact SaveOnSP at 800-683-1074.


Step Therapy - For Express Scripts Participants Only (UHC HMO and UMR PPO)

Step Therapy simply means making sure you get safe and proven-effective medications at the lowest possible cost to you and your plan sponsor. A panel of independent licensed medical experts work with Express Scripts to recommend medications for the step therapy program. If taking a medication on the step therapy program, you are required to try a first-line medicine before a second- line medicine is covered.

First-line medications are the first step and are typically generic and lower-cost brand-name medications. In most cases, they provide the same health benefit as more expensive medications, but at a lower cost.

Second-line medications are the second and third steps and are typically brand-name medications. They are best suited for the few patients who don’t respond to first-line medications. They’re also the most expensive options.

Medical and Prescription Drug Plan Benefit Information             
Kaiser Permanente HMO $10 Medical/Rx
SIMNSA HMO (Cross border plan) Medical/Rx
UnitedHealthcare HMO Network 1 (Plan A) Medical Rx
UnitedHealthcare HMO Network 3          !NEW in 2022! Medical Rx
UnitedHealthcare HMO Alliance $20/$30 Medical Rx
UnitedHealthcare HMO Alliance with $1,200 HRA Medical Rx
UnitedHealthcare HMO Harmony $10     !NEW in 2022! Medical Rx
UMR PPO       Medical In-Network Medical Out-of-Network

Rx

UnitedHealthcare HMO Network Comparison
Provider Medical Group for San Diego County

Websites
MyVEBA: www.vebaonline.com/myveba/
Kaiser Permanente:  www.kp.org
SIMNSA:  www.simnsa.com
UMR PPO: www.umr.com 
UnitedHealthcare:  www.myuhc.com
UnitedHealthcare provider search:  www.welcometouhc.com/csveba
Prescription Drugs (UnitedHealthcare plans only):  www.expressscripts.com

Misc. Benefit Information
Acupuncture and chiropractic benefits for Kaiser and UnitedHealthcare members 
SIMNSA eligibility
Virtual Office Visit - Kaiser
Virtual Office Visit - UMR PPO Plan
Virtual Office Visit - UnitedHealthCare


Additional Benefit - Prescription Plans

SaveOnSP - For Express Scripts Participants Only (UHC HMO and UMR PPO)

The SaveOnSP program through Express Scripts is designed to reduce or eliminate out-of-pocket costs on select specialty medications. Enrollment in the program is voluntary; however, if you choose not to participate, you will be responsible for the full copay on certain medications which will lead to additional costs . The copay will not count towards your deductible or out-of-pocket maximum. The specialty drug list is subject to change and members will be notified if their specialty medication applies to this program.

For further information, please contact SaveOnSP at 800-683-1074.


Step Therapy - For Express Scripts Participants Only (UHC HMO and UMR PPO)

Step Therapy simply means making sure you get safe and proven-effective medications at the lowest possible cost to you and your plan sponsor. A panel of independent licensed medical experts work with Express Scripts to recommend medications for the step therapy program. If taking a medication on the step therapy program, you are required to try a first-line medicine before a second- line medicine is covered.

First-line medications are the first step and are typically generic and lower-cost brand-name medications. In most cases, they provide the same health benefit as more expensive medications, but at a lower cost.

Second-line medications are the second and third steps and are typically brand-name medications. They are best suited for the few patients who don’t respond to first-line medications. They’re also the most expensive options.

Time to see and talk to a doctor from the comfort of your own home. Get details on how you can connect by clicking on the logos below or calling the health care provider:

Kaiser

Kaiser Members:

Schedule a phone or video appointment to connect to a doctor at your convenience. No cost share for Kaiser virtual care. 

Get started here.

 

United Healthcare

UHC Members

Visit with a doctor 24/7 — whenever, wherever via phone and video appointments.  Cost share varies with plan type. 

Get started here.

 

UMR

UMR Members

Talk to a doctor day or night with Teladoc.  Your costs will vary depending upon your specific plan's coverage.

Download the app for easy access or visit teladoc.com.

 

SIMNSA

SIMNSA Members

Free videoconferencing and telephone conferencing with SIMNSA doctors and specialists are available to you. Members have to call SIMNSA in order to schedule an appointment.

Call 800-424-4652.