United HealthCare EPO Central Florida Ideal Plans (Very much like their HMO which is no longer available) The Ideal Plan has an Open Access provider network where referrals are not necessary for participating specialty care.

Benefits Ideal Plan 1000I Ideal Plan 1000INRX Office Visits: Preventative Care Periodic Health Exams Well-child care Immunizations Well-woman exam Specialty Care         $15 per visit (Primary Care) $25 per visit ( Specialist ) $15 per visit $25 per visit Emergency Room & Ambulance $100 per visit $100 per trip $100 per visit $100 per trip Urgent Care $50 per visit $50 per visit Routine Eye Exam (One per 24 mo.) $25 per visit $25 per visit Allergy Testing & Treatment $20 per visit $20 per visit Inpatient Hospital - Non-Maternity $1,000 per admission $1,000 per admission Prof Fees for Surgical & Medical Services $25 per visit $25 per visit Outpatient Hospital Surgery/Diagnostic/Therapeutic Services CT Scans, MRI, Ultrasounds, Nuclear Medicine Other Outpatient Hospital Diagnostic/Therapeutic   $200 per procedure     $100 per procedure   $200 per visit     $100 per procedure Maternity Services Not Covered Not Covered Family Planning Not Covered Not Covered Outpatient Therapy Rehab - Speech, Occup.,Physical, & Pulmonary (20 visits/yr) $25 per visit $25 per visit Skilled Nursing Facility (60 days/yr) $100 per admission $100 per admission Prosthetics/ DME $100 per item $1,000 Maximum $100 per item $1,000 Maximum Spinal Treatment (12 visits/yr) $20 per visit $20 per visit Home Health Care (60 visits/yr) $25 per visit $25 per visit Prescription Drug Services $10 Generic $30 Brand Name - on preferred list $50 Brand Name - Not on list Not Covered Not Covered Not Covered   This is a Summary of Benefits. If there is a variation between this summary and the plan's Certificate of Coverage, the Certificate of Coverage Governs. There are Limitations and Exclusions for coverage under these plans, please refer to the application material for a disclosure of the plan details.