|Medical and Prescription Drug Plan Benefit Information
|Kaiser Permanente HMO $15
|SIMNSA HMO (Cross border plan)
|VEBA Direct HMO $20
|UnitedHealthcare HMO Network 3
|UnitedHealthcare HMO Alliance $20/$30
|UnitedHealthcare HMO Harmony $10
|KindBody Fertility and Menopause Services
|Summary Plan Description
Kaiser Permanente: www.kp.org
UnitedHealthcare provider search:
Prescription Drugs (UnitedHealthcare plans only): www.expressscripts.com
Misc. Benefit Information
Acupuncture and chiropractic benefits for Kaiser and UnitedHealthcare members
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.
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:
Schedule a phone or video appointment to connect to a doctor at your convenience. No cost share for Kaiser virtual care.
Get started here.
Visit with a doctor 24/7 — whenever, wherever via phone and video appointments. Cost share varies with plan type.
Get started here.
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.
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.