Getting the most out of your benefits

Before any procedure, speak with your provider about submitting a pre-determination request. This allows you to know in advance what is covered and offers an estimate of your financial responsibility before you receive the service. 

UnitedHealthcare, Guardian and EyeMed also offer on-demand tools so you can compare facilities, doctors and procedures and make informed decisions about your healthcare. For major medical procedures, you could save hundreds of dollars. EyeMed additionally offers coupons and promotions on their Special Offers page. 

If you end up receiving out-of-network services, free billing support is available through Naviguard. Use the phone number on the back of your UHC insurance card to contact an advisor who can review your bill and discuss options that may be available to lower the expense.

When you find yourself needing emergency medical services, you don’t want to delay care by having to research your options in the moment. Before you are in a situation where care is needed, you can log in to your myuhc.com account to find an in-network urgent care clinic or hospital near you:

• Click on the Find Care & Costs tab.
• Select Medical Directory and then Places.
• You can choose to view a list of either clinics or hospitals.
• You can refine your results by location (such as those closest to your home or a sports field you frequent), see if facilities are in-network and view their contact information.

Remember, urgent care services are best for situations where you need immediate care but your condition is not life-threatening. Emergency rooms are best for life-threatening injury or illness or conditions that could cause permanent disability if not immediately treated.

Urgent care clinics are generally more cost-effective than emergency rooms. To review the emergency care coverage provided by your medical plan, log in to myuhc.com, click on the Coverage & Benefits tab and then select Emergency care.

In addition to primary care services, you also have access to virtual specialist services, including:

• Behavioral health specialists for needs such as depression, anxiety, stress or ADHD
• Dermatology
• Women’s health
• Back, joint and muscle care
• Gastroenterology
• Migraine care
• Sleep care
• Speech Therapy

Specialist services are subject to plan copays.

LCRA’s prescription drug plan categorizes drugs into three pricing tiers, with additional tiers for specialty drugs. You can search for a medication on myuhc.com or within the UnitedHealthcare app so you know exactly what you will pay before you arrive at the pharmacy. Consider having the UnitedHealthcare app available at the doctor’s office so you can have a more informed discussion about your medications and possible alternatives before leaving with the prescription.

Opting for generic medications or using OptumRX Home Delivery can help cut down on costs as well.

UHC’s specialty medication copay card and coupons program may lower your monthly copay and help you save on your out-of-pocket costs for certain specialty medications.

Preventive care is designed to help you stay healthy and may help catch health problems early. LCRA’s medical plans cover preventive care at no additional cost when you see an in-network provider.

Preventive medical care includes screening tests, vaccines and wellness visits. Regular visits with your primary care doctor give you the opportunity to discuss things like quitting tobacco, healthy eating or reaching a healthy weight.

LCRA’s dental and vision plans also cover preventative care, such as routine cleanings or annual eye exams, at little or no cost.

You have access to 2nd.MD, an LCRA benefit that provides a free second medical opinion – see how it works. This service is available to all regular and project employees working 20 or more hours per week, even if you don’t participate in one of LCRA’s group medical plans. Visit www.2nd.md/lcra to activate your membership and schedule a consultation.

Our wellness program, Empower, supports you in developing healthy habits throughout the year. All LCRA employees are eligible to participate. Employees on an LCRA medical plan are eligible to receive a $50 incentive for completing quarterly challenge quotas. Set up and manage your account.

Want help managing your weight? If you participate in an LCRA medical plan, you and your covered dependents over age 18 have access to the Real Appeal weight loss program. It’s a comprehensive weight loss benefit available at no cost to you.

UHC offers help with nicotine cessation as well as convenient ways to access licensed therapists for virtual mental health support and online therapy through Talkspace. Employees on LCRA’s United Healthcare medical plans also have free access to Self Care from AbleTo, an online platform which offers self-care techniques, coping tools, meditations and more.

LCRA offers three supplemental insurance plans through MetLife – accident insurance, critical illness insurance and hospital indemnity insurance. These voluntary benefits can help you offset medical expenses beyond what is covered by your primary insurance.

There are no pre-existing condition limitations, so these benefits can be a helpful safety net for those with a family history of chronic illnesses, those who participate in high-risk activities such as contact sports, or those who plan to have surgery within the plan year. When a claim is approved, you receive a cash payout made directly to you, not your doctor or health care provider, and you can spend the funds however best serves you.