Choices are good, especially when they offer you the opportunity to save money.
Two years ago we introduced the MetroHealth Select EPO plan – it is now renamed the SkyCare EPO plan.
This plan requires that you receive your healthcare from one of the many SkyWay Network facilities and providers. There are many in Cuyahoga County and LakeHealth facilities are also included in the network. So, if you live or work in Lake County, this will be of interest to you.
Click HERE for a list of locations.
The design of this plan is suited for folks who need regular healthcare but would appreciate lower out-of-pocket costs. The chart below compares the SkyCare EPO to the MMO PPO plan. You can see the advantages: lower deductibles, lower out-of-pocket maximums, lower copays…you get the idea. This new plan also has lower premiums than the MMO PPO: for single coverage you save $324 a year and for family coverage you save $1,176 a year.
But remember, and this is VERY IMPORTANT, you must get health care from one of the SkyWay network providers. In addition to SkyWay pharmacies, there are four Discount Drug Mart locations that are in-network. There are no benefits, other than for emergency care, if you do not use a network doctor, lab, pharmacy, outpatient facility or hospital.
*Payment for specific non-emergency lab services are limited to 80% of the Maximum Allowable Cost
The SkyCare EPO Health Plan covers the same services as the PPO plans. A key distinction that is part of any exclusive provider organization health plan is that medical services are only available from network providers and hospitals. With this plan, medical services obtained from providers and hospitals that are not part of the SkyWay network are not covered.
Fees for services from SkyWay network providers are generally lower than those for the same services obtained from providers in the MMO network. Members enrolling in this plan will have lower deductibles, out-of-pocket maximums and copayments than the other plans. Additionally, this plan will pay 90% of medical expenses incurred after the deductible is satisfied. Members can obtain their prescriptions using pharmacies that are part of the SkyWay or CVS/Caremark networks. Members enrolled in this plan will have lower copayments if they use SkyWay network pharmacies.