If you have trouble accessing the UMR portal, call the portal support team for assistance: 1-866-922-8266.
Highlights of Your Medical Plan Options
You have three medical plan options, each of which is administered by UMR:
Health Savings Plan
Classic Plan
Premier Plan.
All three medical plans:
Offer a nationwide network of providers and facilities. The Health Savings Plan and Premier Plan offer coverage for out-of-network benefits.
Cover preventive care in-network at no cost to you. This includes well-baby visits; routine physical exams, immunizations, mammograms, colorectal cancer screenings, Pap smears, nutritional counseling; and certain preventive care drugs. Some preventive care is subject to yearly limitations.
Include prescription drug coverage through MedImpact, which has a nationwide network of pharmacies, including most national drug store chains and many independent pharmacies.
Health plan with a Health Savings Account (HSA)—a tax-advantaged account with contributions made by the university and optional contributions made by you
Before you meet the annual deductible: You pay for all medical expenses (except preventive care), including prescription drugs, yourself or with money from your HSA
After you meet the annual deductible: You and the university share the cost of care
After you meet the medical annual out-of-pocket maximum: Plan pays 100% of all covered expenses for the rest of the Plan Year
You can see out-of-network providers but you will pay more for care
You pay copays for doctor and specialist office visits, certain other expenses and prescription drugs; all other expenses apply to the deductible—you pay the expense in full until you meet the deductible
After you meet the annual deductible: You and the university share the cost of care through copays and coinsurance
After you meet the medical annual out-of-pocket maximum: Plan pays 100% of all covered expenses for the rest of the Plan Year
Benefits are not paid for services received from non-network providers, except in emergencies
Pay the least out-of-pocket of all the medical options when you receive care from in-network providers
You pay copays for doctor and specialist office visits, certain other expenses and prescription drugs; all other expenses apply to the deductible—you pay the expense in full until you meet the deductible
After you meet the annual deductible: You and the university share the cost of care through copays and coinsurance
After you meet the medical annual out-of-pocket maximum: Plan pays 100% of all eligible expenses for the rest of the Plan Year
You can see an out-of-network providers but you will pay more for care
Transparency in Coverage
The Transparency in Coverage Rules require certain group health plans to disclose on a public website information regarding in-network provider rates and historical out-of-network allowed amounts and billed charges for covered items and services.
UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files (MFRs) on behalf of the University of Arkansas System.
Hit Ctrl + F (Command + F for a Macbook) on your keyboard to bring up a search bar.
Type in "Arkansas" and the associated MRFs will appear.
Files will be updated monthly in accordance with the requirements.
Medical Coverage Summary
The charts below compare the in-network coverage for all three medical plan options. The listed amounts are what you pay. See Out-of-Network Coverage, below, for coverage when you do not see a UMR network provider.
Annual Deductibles
Health Savings Plan
Classic Plan
Premier Plan
Individual
$3,300
$1,350
$800
Family
$6,000
$2,700
$1,600
Annual Out-of-Pocket Maximums
Health Savings Plan
Classic Plan
Premier Plan
Individual
$6,750
$5,250
$3,200
Family
$13,300
$10,500
$6,400
Medical Services
The below table shows an overview of how certain services are covered in-network. If there is a discrepancy between the website content and the official Plan Documents, the official Plan Documents will govern.
Health Savings Plan
Classic Plan
Premier Plan
Coinsurance
10% after deductible
25% after deductible
20% after deductible
PCP Visit
10% after deductible
$35 copay
$25 copay
Specialist Visit
10% after deductible
$55 copay
$45 copay
Preventive Care
$0
$0
$0
Diagnostic Lab In Office
10% after deductible
25% after deductible
20% after deductible
Urgent Care
10% after deductible
$55 copay
$50 copay
Emergency Room
10% after deductible
25% after deductible is met and $350 copay (waived if admitted)
20% after deductible is met and $350 copay (waived if admitted)
Ambulance
10% after deductible
$100 copay (waived if admitted)
$100 copay (waived if admitted)
Advanced Imaging*
10% after deductible
25% after deductible is met and $150 copay
20% after deductible is met and $100 copay
Outpatient Surgery
10% after deductible
25% after deductible is met and $160 copay
20% after deductible is met and $80 copay
Inpatient Services**
10% after deductible
25% after deductible, and $300 copay
20% after deductible, and $300 copay
Infertility Treatment and Services***
25% after deductible
20% after deductible
10% after deductible
Speech, Occupational and Physical Therapy (30-visit combined maximum)
10% after deductible
25% after deductible, and $55 evaluation copay
25% after deductible, and $45 evaluation copay
Routine Vision Exam
10% after deductible
$35 copay
$25 copay
Hearing Exam
10% after deductible
PCP: $35 copay
Specialist: $55 copay
PCP: $25 copay
Specialist: $45 copay
Hearing Aids (benefit is per ear every three years)
10% after deductible, up to Maximum Benefit of $3,000
$3,000 allowance
$3,000 allowance
*Prior authorization required. **Includes semi-private room and board, intensive care room and board, ancillary charges and maternity inpatient charges. ***$20,000 medical services/$10,000 prescription drug lifetime maximums.
Insulin Pumps
When you purchase an insulin pump, it will be covered under the medical plan—not under prescription drug coverage. Continuous glucose monitors will only be covered under the pharmacy benefit. The preferred brands for continuous glucose monitors are FreeStyle Libre and Dexcom G6.
Diabetes supplies will continue to be covered under both the medical and pharmacy benefit.
Telehealth Visits are Covered!
Telehealth visits (phone or video) with in-network providers are covered by the Plan at the same cost sharing amount as an in-person visit.
Find an In-Network Provider
To find an in-network provider, start by visiting umr.com.
From the home page, click Search for a provider.
Click Change Location to add your address or zip code. You can then search for a provider by name, specialty, location, service, cost, and more.
For step-by-step directions, check out the find a provider instructions. If you have any questions, please call UMR at 888-438-6105.
Out-of-Network Coverage
The Health Savings Plan and Premier Plan offer coverage for out-of-network providers, but your out-of-pocket expenses will be higher than for in-network care. The Classic Plan offers only in-network coverage (except in case of emergency).
Annual Deductibles
Health Savings Plan
Classic Plan
Premier Plan
Individual
$3,300
Emergency coverage only
$2,000
Family
$6,000
Emergency coverage only
$4,000
Coinsurance
50%
Emergency coverage only
50%
Annual Out-of-Pocket Maximums
Health Savings Plan
Classic Plan
Premier Plan
Individual
$9,800
Emergency coverage only
$9,000
Family
$19,800
Emergency coverage only
$18,000
In-network deductibles and maximums do not count toward your out-of-network deductibles and maximums, and vice versa.
Benefit payments for covered services received out of network will be based on the Maximum Allowable Payment, as determined by UMR. Charges in excess of the Maximum Allowable Payment do not count toward meeting the annual deductible or meeting the limitation on your coinsurance maximum. Out-of-network providers may bill you for amounts in excess of the Maximum Allowable Payment.
UMR Programs
Work with a Health Coach
Program coaches help you create health care goals and adhere to your diabetes and healthy heart treatment plan. If you are identified as high-risk, you may be invited to work with a health coach to bring these and other health conditions under control. You can also self-enroll by calling UMR Care Management at 866-575-2540.
Disease Management
UMR—the medical plan administrator—offers disease management programs to help you and your family members deal with chronic conditions. If you or a covered family member has a chronic condition, like diabetes or hypertension, speak with a UMR representative about your options at 866-575-2540.
Maternity Management
Navigating infertility treatment can be overwhelming, but if you are enrolled in university medical coverage, you can contact the UMR Maternity Management Program for assistance. Speak with a dedicated nurse, who can guide you through pre-approvals and inform you of your options. Call 844-604-6244 to get started.
Explanation of Benefits (EOBs)
An explanation of benefits (EOB) is not a bill. It simply tells you everything you might want to know about how your recent medical service was covered by your benefits plan. You’ll receive a bill from your provider for any amount you may owe.
Your EOB shows:
What providers charge for their services
The network discount applied
How much your plan has paid
How much the patient owes, if anything
You will also see individual/family deductible and out-of-pocket amounts applied to your account.
When you enroll in a university medical plan, UMR sends you an ID card. If you need a replacement ID card, you can order one on the UMR website.
To view or print a copy of your ID card, log in to your UMR account. Or download the UMR app from the App Store or Google Play to access your card when you’re away from home.
If you have trouble accessing the UMR portal, call the portal support team for assistance: 1-866-922-8266.
