Health Plans
Caremark Prescription
The Commission’s prescription drug program provides prescription drug benefits for:
- Diabetic supplies
- Insulin
- Most medications which by federal or state law may not be dispensed without a prescription
- Needles and syringes
Outpatient prescription drug benefits will be available to a subscriber with a written prescription from a health care provider.
To find out more about the services provided under the Caremark Prescription Drug Plan, click here to visit their website.
Delta Dental Plans
M-NCPPC lets you choose between two dental plans from Delta Dental, The Delta Dental PPO plan and the DeltaCare HMO plan. No matter which plan you choose, you will have access to reliable dentist networks and affordable preventive care.
The Delta Dental PPO plan offers you the convenience of visiting any licensed dentist, nationwide and also a special cost-saving “safety net”. Covered services are paid based on a percentage. For example, fillings are covered at 80%, you pay the remaining 20%. As a cost-saving “safety net”, the PPO program gives you access to two (2) dentist networks at once. Your out-of-pocket expense are lowest when you visit a dentist in the Delta Dental PPO network. Nationwide, 55% of all dentists are in the Delta Dental PPO network. In addition, if you visit a dentist in the Delta Premier network, Delta Dental limits the dentist’s total collectable charge. Nationwide, 79% of all dentists can be found in the Delta Dental Premier network. Only with a non-participating dentist is there no contracted fee limit of any kind.
Under the DeltaCare HMO plan, you have your choice of skilled primary dentists from the DeltaCareUSA network. You select a primary care dentist, who will coordinate any referrals to a specialist. You pay a preset copayment (dollar amount) for covered services provided by your DeltaCare USA dentist. The copayment schedule can be found in your DeltaCare USA Summary. There are no annual deductibles or maximums.
To find out more about the services provided visit the DeltaDental website.
EyeMed Vision Plan
EyeMed is a national network of 78,000 vision care providers with many choices including independent providers and major retail chains, such as LensCrafters, Sears Optical, JC Penney Optical, Pearle Vision, America’s Best and MyEyeDr. The plan is designed to encourage members to maintain their vision through regular eye examinations and to help with vision care expenses for required glasses or contact lenses.
EyeMed covers routine eye exams, frames, and lenses or contact lenses. Members may use network or non-network opticians, optometrists and ophthalmologists. Three options are available on a plan year basis, all requiring a $10 in-network co-pay. The plan year begins January 1st.
- Low Option – An eye exam every plan year and frames, lenses or contact lenses every two plan years.
- Moderate Option – An eye exam and lenses or contact lenses every plan year and frames every two plan years.
- High Option – An eye exam, frames and lenses or contact lenses every plan year. ***Under the High Option Plan the following lens enhancements are covered in full; you pay $0.00: Standard anti-reflective coating, standard progressive lenses, tints (solid/gradient) and photochromic/transition lenses). You can use your frame allowance and contact lens allowance in the same benefit year (January 1 – December 31).
To find out more about the services provided, go to visit EyeMed.
Kaiser Permanente
Kaiser Permanente is a one-stop model Health Maintenance Organization (HMO) where most services are provided at one location – office visits, urgent care, x-rays, diagnostic tests, pharmacy and a vision center for eyeglasses and contact lenses. This plan offers the lowest premium.
Prescription drug coverage is included in the Kaiser Permanente Plan. You cannot enroll in the Caremark Prescription Drug Plan.
United Healthcare Point-of-Service (POS)
The United Healthcare (UHC) POS plan gives you the freedom to see any Physician or other health care professional from a network of providers or if you choose to seek care outside of the network. You will receive the highest level of benefits when you seek care from a network provider as most services are covered in full or subject to a co-payment. Visits to a specialist are covered subject to the office visit co-payment as long as the specialist is a participating provider in the network. In addition, you do not have to worry about any claim forms or bills if you seek care from a network provider. Unlike an HMO or EPO, there are out-of-network benefits. You do not need to select a Primary Care Physician (PCP) or get a referral from your PCP to see a specialist.
For more information, please view the UHC pre-enrollment website.
United Healthcare Exclusive Provider Organization
The United Healthcare (UHC) Exclusive Provider Organization (EPO) plan operates just like a Health Maintenance Organization (HMO) in that you may only select doctor’s in a designated network (UHC network). You may need to select a Primary Care Physician (PCP) who manages your healthcare needs; however, unlike an HMO, you do not need to get a referral from your PCP to see a specialist. Visits to a an in-network specialist are covered however, services rendered by a specialist that is not in the UHC network are not covered. There are no out-of-network benefits in an EPO, except for medical emergencies. For more information, please view the UHC M-NCPPC website. Â
