Medical Coverage

The IRS-mandated deductible will increase to $3,200 individual coverage (from $3,000).

Starting January 1, 2024, we’re replacing our current wellness program with the UMR Live Well Reward$ wellness program.

When you opt into UMR Live Well Reward$ and complete certain wellness activities, you’ll earn up to $500 in online rewards. Plus, you’ll automatically get a lower medical plan out-of-pocket limit when you opt in on the UMR website.

To access these great benefits, you must opt in by November 6.

If you, or a covered family member, has a chronic condition like asthma, diabetes, or hypertension, UMR offers disease management resources. 

The Centers for Disease Control and Prevention (CDC) recommend a yearly flu vaccination for everyone 6 months of age and over as the first and most important step in protecting against the flu.

People should begin getting vaccinated soon after flu vaccine becomes available, if possible, by October, to ensure that as many people as possible are protected before flu season begins. However, as long as flu viruses are circulating, it’s not too late to get vaccinated.

Find an on-the-go version on umr.com.

If you have suffered an injury as a result of an accident, you might not be responsible for all costs related to your medical treatment.

This is one call you don’t want to miss. UMR may be trying to contact you regarding the case management program available to help you manage or improve your health.

The amount you have to pay before your plan pays for specified services. Deductibles are usually an annual set amount. A deductible may apply to all services or just a portion of your benefits. It depends on your benefits plan.

A set percentage of costs that are covered by your plan after your deductible has been paid. Your plan pays a higher percentage. You pay a lower percentage.

A small set fee. It is paid each time you have an office visit, outpatient service or prescription refill. The fee is determined by your health plan. Copayments don’t vary with the cost of service.

The amount you pay out of your pocket for particular health care services during a particular period of time. An out-of-pocket maximum limits the amount you have to pay during a particular period of time.

Many families are covered by more than one health plan. The coordination of benefits (COB) process determines which plan pays first. It also determines if the second plan will pay any remaining charges not covered by the first plan. The process makes sure your doctor doesn’t get paid twice for the same service.

An EOB is simply the statement explaining your benefits activity. It includes the services provided, the amount billed and the amount paid, if any. You should review your EOBs carefully. Call the customer service number on your ID card or visit umr.com if you have any questions about your EOB.