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Does a group or a subscriber within a group have to take prescription drug coverage?

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Does a group or a subscriber within a group have to take prescription drug coverage?

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A client (group) does not have to offer drug coverage. However, if the client has both medical and drug coverage, UniCare requires that each subscriber within a group take both medical and drug coverage. UniCare does offer plan options that are medical only.

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Pharmacy coverage is not optional at the subscriber level. However, groups under 100 lives can elect not to have pharmacy coverage on PPO and Traditional Plans. Pharmacy coverage is optional for all plans (Traditional, PPO, HMO and POS) for groups with more than 100 lives.

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We offer multiple plan design options for our customers encompassing a variety of plan provisions. As a result, group contracts vary by customer. However, a plan administrator may opt to offer several different plans to provide choices for their members. If more than one option is available, members can select a benefits plan that includes or excludes prescription coverage. Once a member selects a plan, coverage is provided as a package.

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UNICARE’s Small Group plans include prescription drug coverage. [Back to top] Provider Network • Describe your provider networks. MEDICAL: UNICARE’s Platinum PPO network includes coverage throughout the country. UNICARE’s Platinum PPO network includes many of the leading physicians, hospitals and other health care providers in the nation. All network providers are carefully screened and must meet and maintain high standards of quality. This includes coverage both at home and when our members are traveling. Location specific information is available via the Provider Finder feature on our home page or by contacting your local UNICARE Representative. DENTAL: Broad Network Access – Our large dental provider network offers members wide access to care. We are able to maintain our network size because of our flexibility. We have broad access to networks in our large metropolitan areas. PHARMACY: UNICARE’S Pharmacy Network, the largest carrier owned PBM in the nation, administered through Well

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A client (group) does not have to offer drug coverage. However, if the client has both medical and drug coverage, UNICARE requires that each subscriber within a group take both medical and drug coverage. UNICARE does offer plan options that are medical only. [Back to top] Provider Network • Describe your provider networks. MEDICAL: UNICARE’s Platinum PPO2 network includes coverage throughout the country. UNICARE’s Platinum PPO network includes many of the leading physicians, hospitals and other health care providers in the nation. This includes coverage both at home and when our members are traveling. Location specific information is available via the Provider Finder feature on our home page or by contacting your local UNICARE Representative. DENTAL: Broad Network Access – Our large dental provider network offers members wide access to care. We are able to maintain our network size because of our flexibility. We have broad access to networks in our large metropolitan areas. PHARMACY: W

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