Rates and Coverage

Comparing Health Plans

The Cook County Pension Fund (CCPF) 2018 Health Benefits Plans and Rates Brochure shows two plan options administered by UnitedHealthcare: the Choice Plan and the Choice Plus Plan. Both plans offer the same network of hospitals and doctors, and referrals are not required to see specialists.

The Choice Plan has in-network benefits only, and the Choice Plus Plan has out-of-network benefits as well.

Plan Option: The Choice Plan

You can use any doctor, clinic, hospital, or healthcare facility in the national network, which saves you money. But you won’t have any coverage if you go out of the network.

Find_Your_DocFind Your Doctor

Find out if your doctor, clinic, or facility is in the network.

> Search the network: The Choice Plan

Scroll down page to view the Choice Plan Summary and Highlights

Plan Option: The Choice Plus Plan

With this plan, you can use any doctor, clinic, hospital, or healthcare facility you want. You save money when you use the national network. You also have coverage if you use out-of-network providers.

Find_Your_DocFind Your Doctor

Find out if your doctor, clinic or facility is in the network for the Choice Plus Plan.

> Search the network: The Choice Plus Plan

Scroll down page to view the Choice Plus Plan Summary and Highlights

2018 Pharmacy Coverage

Pharmacy coverage is automatically included with enrollment in any of CCPF’s medical plans. CCPF makes a prescription drug benefit available through CVS/Caremark. You must fill all prescriptions for maintenance medications with a 90-day supply at a CVS retail location or through the Caremark mail order service. All other medications may be filled at any retail drug store for a 30-day supply.

Non-Medicare Retirees | 1-888-752-7231
caremark.com

Prescription
Co-Pays

30-Day Supply at
Retail Pharmacy

90-Day Supply at CVS
or Caremark
Mail Order

Generic

$10

$20

Preferred brand

$35

$65

Non-preferred brand

$50

$100

 

Medicare-eligible Retirees | 1-877-878-1670  cookcountypensionfund.silverscript.com

Download and complete the Request for Medicare Prescription Drug Coverage Determination Form.

Prescription
Co-Pays

30-Day Supply at
Retail Pharmacy

90-Day Supply at CVS
or Caremark
Mail Order

90-Day Supply
at Non-CVS Pharmacy

Generic

$10

$20

$30

Preferred brand

$35

$65

$105

Non-preferred brand

$50

$100

$150    

 

The Choice Plan Summary and Highlights

Get more freedom and protection with a national network.

  • Save money by staying in our network. If you don’t use the network, you’ll have to pay for all of the costs.
  • There’s no need to choose a primary care provider (PCP) or get a referral to see a specialist. However, a PCP can be helpful in managing your care.
  • Your preventive care is covered 100% in the network. You don’t have to pay any out-of-pocket costs for preventive care as long as you use a network doctor.

+ More about saving with the network

How the Choice Plan Works
  • You'll usually pay a co-payment for doctor visits and prescriptions.
  • You are protected with an out-of-pocket limit. 

Note: You won’t need to worry about these costs for preventive care if you stay in the network.

For certain services, you may be required to have approval (called prior authorization) before those services can be covered by your plan.

Summary of Covered Services

This plan covers the following healthcare services and more, including:

  • Doctor office visits
  • Emergency services
  • Hospital care
  • Lab services
  • Mental health and substance use disorder services
  • Outpatient care services
  • Preventive care services
  • Rehabilitation services and devices
  • Wellness services

This may not be a complete list of the services covered under this plan. See your health plan documents for coverage details.

The Choice Plus Plan Summary and Highlights

You can receive care and services from anyone in or out of network, but you save money when you use the network.

  • There’s coverage if you need to go out of the network. Choose what’s best for you. Just remember out-of-network providers will likely charge you more.
  • There’s no need to choose a primary care provider (PCP) or get a referral to see a specialist. However, a PCP can be helpful in managing your care.
  • Your preventive care is covered 100% in the network. You don’t have to pay any out-of-pocket costs for preventive care as long as you use a network doctor.

+ More about saving with the network

How the Choice Plus Plan Works
  • You’ll usually have to pay a deductible before your plan will start to pay.
  • If you pay the deductible, you'll likely have co-insurance, where you share a percentage of the cost with your plan.
  • You are protected with an out-of-pocket limit. 

Note: You don’t need to worry about these costs for preventive care if you stay in the network.

For certain services, you may be required to have approval (called prior authorization) before those services can be covered by your plan.

Summary of Covered Services

This plan covers the following healthcare services and more, including:

  • Doctor office visits
  • Emergency services
  • Hospital care
  • Lab services
  • Mental health and substance use disorder services
  • Outpatient care services
  • Preventive care services
  • Rehabilitation services and devices
  • Wellness services

This may not be a complete list of the services covered under this plan. See your health plan documents for coverage details.