2016/17 Cologuard - Colorectal
Cancer Screening Test: Effective
1/1/16, UK HealthCare has added Cologuard to our Preventive
Services List to be covered at 100%. Cologuard is
intended for the qualitative detection of colorectal
neoplastia associated DNA markers for the presence of occult
hemoglobin in human stool. A positive result may
indicate the presence of colorectal cancer (CRC or advanced
adenoma (AA) and should be followed by diagnostic
colonoscopy. Cologuard is indicated to screen adults
of either sex, 50 years or older, who are at typical average
risk for CRC. Cologuard is not a replacement for
diagnostic colonoscopy or surveillance colonoscopy in high
risk individuals. Please talk with your health care
providers to see if you would be a candidate for this test.
09-21-15 2015/16 Flu Shots: Please check back soon for more updated clinic information. Note - UK-HMO members must obtain their flu shots at their UK-Primary Care Providers office for them to be covered by the plan.
2014/15 Flu Shots:
UK-HMO members should check with their Primary Care
Providers' office to obtain your flu shots in their office.
Most clinics are providing these flu shots by scheduling a
nurses appointment. Note - UK-HMO members must
obtain their flu shots at their UK-PCP office for them to be
covered by the plan.
4/28/14 2014/15 Benefit Changes: There are just a few changes to the UK-HMO benefits for the 2014-15 plan year. We have added Music Therapy to all of the UK Health Plans. Music Therapy visit limits will be included with the other therapies in the 45 therapy visit limit count per plan year. Music Therapy will have a $15 co-pay per visit. The co-payment for the High Cost Outpatient Diagnostic Testing (MRI, MRA, CT, SPECT and PET scans) will increase from $50 to $75; and the co-payment for a Hospital Observation Stay has increased from $75 to $100.
4/19/13 Benefit Changes: You will be excited to know that there are no co-pay or benefit changes for UK-HMO for the new plan year. Premiums stayed the same as well.
4-19-13 New TPA: The University of Kentucky has chosen a new Third Party Administrator (TPA), Anthem. Anthem will replace Humana as our TPA effective 7-1-13. This should mean a larger network of providers for services that we don't provide at UK where we utilize the Anthem network. We are looking forward to our new relationship with Anthem.
04-19-13 UK 2013-2014 Open Enrollment: Open Enrollment starts on Monday April 22, 2013 through May 10, 2013. Please check out an open house during this period. The UK-HMO plan information for the new year is to the right on this page.
7-25-12 Elimination of Assist America: Effective 7-1-12, Assist America will no longer be available for UK-HMO members. UK-HMO was able to provide Assist America to the UK-HMO members as part of the UK-HMO Reinsurance Agreement with our reinsurance. When we renegotiated the reinsurance contract this year, the company proposed a 71% increase in our rates. Due to the substantial increase we were forced to switch our contract to another reputable reinsurance carrier which unfortunately does not offer Assist America with their program. Therefore Assist America will no longer be a benefit we will be able to offer our members as of July 1, 2012.
4-23-12 UK-HMO LSA 2012-2013 Plan Changes: The only changes on the UK-HMO plan for the 2012-2013 Plan Year beginning July 1, 2012 are the following co-payment changes:
*Outpatient surgery $75
*Inpatient hospital $200
*Emergency department $100
*Allergy injections $10
*Durable medical equipment 20% co-insurance (up to
$500 maximum per plan year), then 100%
04-23-12 UK 2012-2013 Open Enrollment: Open Enrollment Dates are from April 23rd, 2012 through May 11th, 2012. Please see information to the right on this page.
12-01-11 NEW Urgent Care Centers join the UK-HMO network: The Urgent Care Centers in Berea, Frankfort, and Georgetown have joined the UK-HMO participating network effective 12-1-11. For addresses and center times, click on the link to the left announcing these centers.
09-21-11 UK Clinic Flu Shot Schedules: To see the schedule of when and where each primary care clinic is giving flu shots, please click here.
06-27-11 Autism Coverage: The University of Kentucky added an expanded benefit after open enrollment for Autism Spectrum Disorders. This will follow Kentucky Bill KRS 304.17a-142. Even though Respite Care is not provided for in the bill, UK decided to continue to provide a respite benefit of $375 per month for members with an autism spectrum disorder diagnosis as long as they are not participating in ABA therapy. For more information, please click on the "LSA Addendum to COC for Expanded Autism Benefit - 7-1-11" to the left on this page.
06-27-11 Cardiac or Pulmonary Rehab Co-pay Reimbursement: Effective 7-1-11, the $15 co-payment for Cardiac and Pulmonary Rehabilitation has been reinstated. It also is now included in the therapy benefit limits of 45 visits per plan year combined. However, as an incentive, UK-HMO has decided that for any members who complede at least 24 visits of Cardiac Rehab or 24 visits of Pulmonary Rehab, we will reimburse the member 50% of their co-pays for these visits. Please complete the "Cardiac or Pulmonary Rehab Co-Pay Reimbursement Form" to the left on this page to obtain this reimbursement.
06-27-11 Patient Satisfaction Survey: This is your chance!: Each year, UK-HMO hires an outside agency to perform a member satisfaction survey. These letters will be going out in the near future. The Myers Group (TMG) will be performing this for us this year. If you are one of the chosen members to receive this survey, please taken the time to complete this and let your voice be heard. We do take these survey results seriously and share them with UK Leadership to determine if there are areas that need to be addressed.
04-13-11 UK Open Enrollment: UK Open Enrollment begins on Monday, April 25th and will continue through Friday, May 13th, 2011. This is the one time of the year that you can make any changes to your insurance plans for any reason. Please be sure to make any changes during this three week period of time. No changes are allowed until next year unless you have a qualifying event that allows you to change something (i.e. birth of a child, death, marriage, divorce, etc.)
10-25-10 Flu Shot Update: UK has received a shipment of flu vaccine. Please check with your PCP to see if your clinic can give your flu shots. KY Clinic South will be holding flu shot clinics in their lobby on Monday through Thursday of this week (10-25-10 through 10-28-10) from 2-4 p.m. for any adults.
10-19-10 Flu Shots: UK is currently awaiting a shipment of flu vaccine from the manufacturer which is scheduled to arrive the end of October. If your provider's office is out, please check back late October to get your flu shots. UK-HMO members cannot get reimbursed for obtaining flu shots outside UK.
9-1-10 St. Joseph Hospital Notice: Effective immediately, St. Joseph Hospital will no longer bill UK-HMO for UK-HMO member's services. If you access the St. Joseph Hospitals for services such as Emergency Room, the bill will now be sent directly to you. It will be your responsibility to obtain an itemized bill from St. Joseph and forward that bill to Humana for consideration of coverage. You would forward the claim to Humana Claims, P.O. Box 14601, Lexington, KY 40512-4601. If the service is deemed to be a true emergency, the claim will be paid. If not, the claim will remain your responsibility to pay to St. Joseph Hospital. If your claim is denied as non-emergent, your appeal rights will be provided to you on the denial notice. You can find a list of covered diagnosis codes on the UK-HMO website entitled "UK-HMO ER Covered Diagnosis Code List".
It is important to remember that when you are utilizing an Emergency Room within the Lexington Service Area counties, UK Chandler or UK Samaritan Hospitals are the two participating facilities to utilize.
07-06-10 UK-HMO LSA ER Reminder: As your UK-HMO LSA plan rules state, the UK Chandler Hospital and UK Samaritan Hospital are the hospitals of choice for emergent care. If you are seen in an out of network facility, your claims will only be covered by UK-HMO for true emergency medical conditions [see the UK-HMO Certificate of Coverage (COC) for emergency medical condition definition].
7-1-10 The UK-HMO Regional Service Area's Name Change: 7-1-10 The UK-HMO RSA plan's name changed to UK Regional Health Plan (UK RHP). This plan is no longer part of the UK-HMO and is now managed by the UK Benefits Office. For information contact (859) 257-9519, option 3; option 1 or choose www.uky.edu/HR/benefits.
7-6-10 Trover Solutions: Trover Solutions works with UK-HMO to review medical services provided and/or paid claims that may have been the result of an accident or injury. It is important to UK-HMO that if you receive one of these letters, that you call Trover back, regardless of how or where this injury or illness occurred. Trover Solutions needs to obtain detailed information to determine if another party is responsible for the medical treatment provided. Your response is an important part of your health plan’s cost management program. Making sure UK-HMO is not held responsible for claim payments that should be paid by other parties is one way we attempt to keep down your insurance premiums.10-1-09 New Urgent Treatment Locations - UTC Georgetown and UTC Hamburg locations have been added to the list of participating Urgent Treatment Centers within the LSA counties.
10-1-09 Emergency Rooms in LSA Counties - It is important to remember that when you are utilizing an Emergency Room within the Lexington Service Area counties, UK Chandler ER or the UK Samaritan ER are the two participating facilities.
10-1-09 Acupuncture Providers in Lexington - We now have two UK-HMO participating acupuncture providers in Lexington. These are Connie Jennings, M.D. at Kentucky Clinic South on Greatstone Point (859) 257-9800 and Elizabeth A. Armstrong, M.D. with Lexington Medical Acupuncture at 380 S. Mill Street (859) 281-0100.
10-8-09 MRI of Breast - These services are temporarily unavailable at UK. MRI of Breast will be covered at Central Baptist Hospital and St. Joseph Hospital but authorization must be obtained prior to receiving services. This needs to be obtained by your UK provider.
10-14-09 Seasonal Flu Shots - Due to increased demand for seasonal flu shots - there is a temporary shortage of the vaccine. UK expects their next shipment in November. Please check with your PCP in November to obtain your seasonal flu shot if you have not already obtained this.
11-20-09 New UK Podiatrist - Heather Whitesel joined the UK HealthCare team as a Podiatric Surgeon. For appointments with her regarding bone related foot problems please call (859) 323-5533. For appointments regarding any other foot related problems, call (859) 323-8082.