Opportunity member profile...
"My family doesn't go to the doctor often, so paying a slightly higher copay isn't a problemn, but we want complete coverage for emergencies and routine care. We're looking for modest benefits at a modest cost."

Opportunity plan

Preferred Care's Opportunity plan is offered to individuals primarily through employers. This plan offers higher copays and modest premiums. The coverage is slightly less than our top-of-the-line Community plan, but still offers a wide range of benefits, including routine and emergency care.

Our Opportunity plan offers the following important features:

The Opportunity health plan offers low premiums and somewhat higher copays

(typically $0-$20).


An extensive network of providers

With all Preferred Care plans, you have access to an extensive network of physicians as well as area hospitals—all dedicated to providing you and any covered family members with quality health care.

Your own primary care physician (PCP)

We recognize the important relationship between you and your physician. So when you join our Opportunity Plan, you select your own primary care physician (PCP) from one of the many qualified internists, general practitioners, family practitioners, and pediatricians in our network. Women may select an obstetrician/ gynecologist in addition to a PCP.

Extensive coverage at home

You're covered for a full range of services, including:

• Office visits to your primary care physician (PCP)
• No copays for well-child visits—checkups and physicals—to age 19
• No or low copays for sick-child visits during regular office hours (depending on plan)
• Specialist visits (may require a referral from your PCP)
• Maternity care
• Surgical and other medical procedures
• Inpatient and outpatient hospital services
• Lab work and X-rays
• Prescription drugs–many employers choose to offer prescription benefits with their plans
• Medically necessary spinal chiropractic services
• Diabetic equipment, drugs, and supplies

We also offer our health plan members a convenient and affordable alternative to the emergency room through our Urgent Care benefit. So whether you're around the block or around the world, you're covered 24 hours a day, 365 days a year, for medical emergencies or urgent care.

An emphasis on preventive care

Preferred Care focuses on your health. That's why our health plans provide coverage for preventive care and routine checkups and tests, including:

• Routine physicals and gynecological exams
• Childhood immunizations and vaccinations
• Well-baby and well-child visits
• Prenatal and postnatal care
• Mammogram and Pap screens
• Routine vision exams (under most plans) and medical eye exams

Coverage for serious illness

• Hospitalization
• Surgical fees
• Operating room fees
• Semi-private hospital rooms

Emergency and urgent care

• Around the world coverage, no referral needed
• Urgent care in and out of the service area

Eye care at participating providers

• 20% discount and $60 allowance for lenses, frames, glasses or daily wear contact lenses (if your employer has purchased eyewear benefits)
• No eyewear coverage? 20% discount still applies!
• Eye exam every year (under most plans)

Maternity care benefits

• Pre-and post-natal care
• Delivery room
• Physician fees

HealthDollarssm
Preferred Care is committed to helping you and your family lead a healthier life. When you enroll in one of Preferred Care's health plans, you are eligible for $50 in HealthDollars to spend during the year on health, wellness, and fitness programs.

In addition, our health and wellness programs offer a wide array of opportunities to help keep you healthy and well. Visit the Health and Wellness and Calendar pages of this site to learn more about what is available.

Ready to join?

See the personnel, human resources, or benefits officer at your company, where benefit summaries and enrollment kits of plans offered by your employer are available.

Most companies conduct an open enrollment during the fall. New employees enroll according to your company's new hire policy.

To have an information kit sent to you, call us at: (585) 325-3113 or (800) 950-3224.

TTY users may call (585) 325-2629 or (800) 252-2452.

Disclaimer:
This summary of benefits is only an overview of plan provisions. While every effort has been made to ensure that this summary accurately reflects the provisions of each plan, it is the plan contract that governs the operations of individual plans and payment of all benefits. Please check with your company's plan administrator for a more detailed plan description.

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Last updated: December 20, 2006