There are 3 options on a TriTerm Medical Plan you can purchase:

• Plan 80 Max, It is structured based on 80/20 coinsurance sharing of expense after deductible is met.  All main services have copays. Click on button Details. Plan can be customized here. Highlights of this category of plans are:

1. Deductibles: Choice of $2,500, $5,000, $7,500, $10,000, and $12,500.
2. Coinsurance out-of-pocket Maximum: $2,000 after selected deductible is met.
3. Doctor Office Visits: You pay a 20% after deductible is met.
4. Prescription Drugs: You pay 20% after deductible is met. Use Member ID card for lower price available. $5,000 outpatient Rx covered expense per term maximum.
5. Preventive care: After six months on the plan, you have access to the doctor of wellness checks, a $200 benefit per person, per term.
6. Lifetime maximum: $ 2 million over 3 terms.
7. Plan coverage: 3 terms equal to 1 days less than 3 years.

• Copay Select Max. It is structured based on 70/30 coinsurance sharing of expense after deductible is met. All main services have copays. Click on button Details. Plan can be customized here. Highlights of this category of plans are:
1. Deductibles: Choice $2,500, $5,000, $7,500, $10,000, and $12,500.
2. Coinsurance out-of-pocket Maximum: $4,500 after selected deductible is met.
3. Doctor Office Visits: You pay a $50 copay for the first 4 doctor visits, per term of 12 months without affecting deductible.
4. Prescription Drugs: Tier 1 – $25 copay, Tier 2 – $55 copay, Tier 3 – $75 copay, and Tier 4 – 50% coinsurance. Deductible $500 per term. $5,000 outpatient Rx covered expense per term maximum.
5. Preventive care: After six months on the plan, you have access to the doctor of wellness checks, a $200 benefit per person, per term.
6. Lifetime maximum: $ 2 million over 3 terms.
7. Plan coverage: 3 terms equal to 1 days less than 3 years.
• Plan 100 Max. It is structured based on 100/0 coinsurance sharing of expense after deductible is met. All main services have copays. Click on button Details. Plan can be customized here.  Highlights of this category of plans are:
1. Deductibles: Choice of $5,000, $7,500, $10,000, and $12,500.
2. Coinsurance out of-pocket Maximum: $0 after selected deductible is met.
3. Doctor Office Visits: You pay a $50 copay for the first 4 doctor visits, per term of 12 months without affecting  deductible.
4. Prescription Drugs: Tier 1 – $25 copay, Tier 2 – $55 copay, Tier 3 – $75 copay, and Tier 4 – 50% coinsurance. Deductible $500 per term. $5,000 outpatient Rx covered expense per term maximum.
5. Preventive care: After six months on the plan, you have access to the doctor of wellness checks, a $200 benefit per person, per term.
6. Lifetime maximum: $ 2 million over 3 terms.
7. Plan coverage: 3 terms equal to 1 days less than 3 years.

Age

• The primary applicant (and spouse, if applicable) must be between 19 and 63 years of age when the policy/certificate is issued, and coverage ends at age 65. Eligibility is for this plan is based on accurate answers to questions in the application during underwriting process.
• Dependents must be younger than 26 at the time of application, but can remain on the plan until the policy/certificate ends.
• If the primary insured dies, a covered spouse or the youngest covered dependent child, if unmarried, can become the primary.
• Applications are not accepted for anyone age 64 or older. If the primary insured reached age 65, the plan terminates for all members. If the spouse reaches age 65, the plan terminates for spouse only.
• In general, it is recommended that the younger spouse be designated as the primary insured on the application.
• If the primary insured moves to a different state, the policy/certificate will end. A move within the same state to a different Zip Code may result in premium change.

Optimal height and weight

• Height and weight of the applicant and each member of the family above age 19 will be one of the factors in determining eligibility for this plan. See chart of Height and Weight here. 
• Best rates are offered for optimal height and weight of the applicant. However, when Height and Weight falls above or below the optimal range, rate-up is applied. See the notes in this chart.

Unacceptable medical conditions

Some medical conditions present increased risk. Below are some examples of conditions that would likely result in a TriTerm Medical plan application being declined.  Familiarize yourself with these medical conditions here. This list is an example only. 

Exclusions and Limitations

These plans have a number of exclusions and limitations.   View these sample exclusions and limitations here.

Quotes for all TriTerm Medical plans are available here.   Enter basic information of Zip Code, Date of Birth, Male/Female, and Yes/No for Tobacco use. If you adding your family members, click on ‘Add Spouse, and Add Child, and then click on View Plans. You are presented with quotation of all three categories of available plans with their prices:

• Plan 80 Max, and
• Copay Select Max,
• Plan 100 Max.

You have four choices to sort these plans by selecting from the dropdown under Sort. When you select to sort plans ‘High to Low Premium’, the first three plans are showing minimum deductible for the standard coinsurance percentages corresponding to the three categories of plans.

A typical chart showing premiums for different ages is placed here.

Pricing of prescription medications is structured in each of the three categories of plans, either on copay basis, or on discount pricing using Member ID Card.  All prescription medications are categorized in Tier levels 1 to 4, Tier 1 being low cost generics, and Tier 2 are combination of generics and brand names, and Tier 3 and 4 are brand name.

Tier level of the medication may be looked up  here  from the formulary associated with the plan.   A download copy is also available here.

Choose local pharmacy that is on network of UnitedHealthcare for preferred services and prices. Search for pharmacy here.  

Be familiar with:

• The power of adding Supplemental Medical Plans to this main medical plan.
• An example of showing effect of adding supplemental medical plan to Short Term Medical or ACA plan.
• Medical Ancillaries to add to this main medical plan to enhance health related coverages available.
• The power of using in-network healthcare providers and pharmacies.
• Optimum pick of the TriTerm plan
• Reduction of risk of financial responsibility.  
• UnitedHealthcare Choice providers network.