Coverage and benefits
Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.
GMA Comprehensive (PPO)
GMA Premium (PPO)
The following preventive services are covered under your plan for a $0 copay when you visit your primary care provider:
- Annual Wellness Exam
- Annual Routine Physical
- Screenings for certain Cancers (Prostate, colorectal, breast cancer)
- Screening for diabetes
- Smoking and Tobacco Use Cessation
For more information about these preventive services, please call the Customer Service number on your member ID card.
Benefits and costs
|Benefits||GMA Comprehensive (PPO)||GMA Premium (PPO)|
|Annual medical deductible||None||None|
|Annual out-of-pocket maximum||$2,000||$1,500|
|Office and clinic visits||$5 copay||$5 copay|
|Hospital services (inpatient)||$0 copay||$0 copay|
|Hospital services (outpatient)||$0 copay||$0 copay|
|Prescription drug coverage||
Tier 1: $10 copay
Tier 1: $25 copay
Tier 1: $5 copay
Tier 1: $12 copay
Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the costsharing that applies to out-of-network services.