Each covered family member must meet an annual deductible of $500, up to a maximum of $1,000 for the whole family, before the plan starts sharing costs. Once your annual out-of-pocket costs for eligible expenses reach $2,000 per person, up to a maximum of $4,000 for the whole family, the plan covers eligible expenses at 100% for the remainder of the year.

After meeting your deductible but before reaching your annual out-of-pocket maximum, you will pay 10% of the total cost for most covered in-network services. To get the most out of your medical benefits, visit providers in the BlueCross BlueShield of Illinois (BCBSIL) PPO network. Find a network provider or a virtual care appointment on the BCBSIL website.

Get your care approved in advance

For some services to be covered, like outpatient surgery or inpatient mental health treatment, you must be approved in advance. This process, called pre-admission review, ensures that you receive medically appropriate care for your situation. Contact HealthCare Strategies at (800) 582-1535 to preauthorize your care.

Note: Pre-admission review is not required prior to receiving emergency treatment. You must still contact HealthCare Strategies within 24 hours to have your emergency care authorized.

Once you become eligible for Fund benefits, an HRA will be opened for you. You will receive a $10 contribution to your HRA each week you work in covered employment, which you can use to be reimbursed for eligible medical, prescription drug, dental, and vision expenses incurred by you or your covered dependents.

Elite Administration and Wex Health manage HRA accounts for the Fund. Elite Administration will send you an HRA debit card in the mail to use when you receive care or incur an HRA-eligible expense.

Want some HRA cash?

All you need to do is schedule an annual HealthReach physical and bring a Physician Fax Form to your appointment. Your doctor will submit the results to HealthCare Strategies. Then your HRA will be credited $125. If covered by Fund benefits, your spouse also receives the $125 HRA credit for an annual physical.

Note: You cannot receive HRA credits and a UIC Wellness reward in the same 12-month period.

You and your spouse can each receive a $250 Visa gift card each year via UIC Wellness by completing a health screening. The screening includes a physician assessment, blood panel, urinalysis, cancer screening, and lung function test. Contact UIC Wellness at (312) 996-7420 for more information.

Note: You cannot receive a gift card from UIC Wellness and a $125 HRA credit in the same 12-month period.

The No Surprises Act protects you against balance billing if you are treated by an out-of-network provider at an in-network hospital or emergency room. Balance billing happens when an out-of-network provider charges you the difference between the total cost of your care and what your health plan agreed to pay.

Sometimes in-network emergency rooms and hospitals employ out-of-network doctors. In these cases, you might receive emergency care from an out-of-network provider without realizing it. The No Suprises Act ensures that you do not receive a hefty bill when receiving care under circumstances beyond your control.

If you believe that you have been wrongly billed, contact the Employee Benefits Security Administration (EBSA) at (866) 444-3272 or through the EBSA website.

When filling a prescription, remember to do two things: Visit a network pharmacy and get generic drugs when possible.

A retail pharmacy is a physical store like Walgreens or CVS. You can fill up to a 30-day supply of your prescriptions plus up to two refills at a retail pharmacy in the Sav-Rx network. Prescriptions filled at out-of-network pharmacies are not covered. Because major pharmacies like Walgreens and CVS participate in the Sav-Rx network, finding a convenient option near you should not be any trouble. For long-term prescriptions, the Sav-Rx mail-order pharmacy can provide you with a 90-day supply. Note: Wal-Mart and Sam’s Club do not participate in the Sav-Rx Program.

Using generic drugs whenever possible instead of brand-name drugs keeps your out-of-pocket costs down. Generic drugs are lower-cost chemical equivalents to brand-name drugs.

Filling a prescription by mail?

Contact the Sav-Rx mail-order pharmacy at (800) 228-3108 or visit the Sav-Rx website.

Get your prescriptions approved in advance

To have some prescriptions covered, your doctor must authorize your prescription with Sav-Rx before you fill it. Many prescriptions have lower-cost, more established alternatives available. In some cases you may be required to try the alternative medication first.

Keeping on top of dental and vision care is essential to your overall health. Your teeth and eyes can show early signs of broader health problems like diabetes or heart disease. Fortunately, you and your covered family members have comprehensive dental and vision coverage.

The dental plan is administered by Dental Network of America (DNOA). While you can choose to receive care from any dentist you would like, your care is covered at higher levels when visiting a dentist in the DNOA network. You will pay 20% of the total cost of your care for most in-network services after meeting your $25 deductible. The plan pays up to a maximum of $3,500 per person per calendar year. Note: Orthodontia is not covered.

The vision plan, administered by EyeMed, also allows you to receive care from any provider you choose. However, you will receive richer benefits when you visit providers in the EyeMed network, and the highest frame allowance applies when you use EyeMed Plus providers.