Search
 
Announcements
Bullying
2014-2015 School Year
- MCS Board of Trustees Adopts

  2014-2015 Calendar 

6th Grade Immunization

 
Examples of Excellence
District Calendar of Events
Parents
- To view a teacher's e-mail address, double click on the Faculty and Staff tab.

- The STI InformationNow & Online Payment links can be found under the Parents tab.


 
Collaborative Learning Inc.

Building Common Core Capacity 
Curriculum Maps
clihome.com

 

Unified Group Services

Muncie Community Schools


1/1/2010 – 12/31/2010

Schedule of Medical Benefits

  In-Network Out-of-Network
Deductible per Covered Person, per Calendar Year $1,700 $2,000
Deductible per Family Unit, per Calendar Year $3,400 $4,000
Coinsurance 100% - unless otherwise noted 100% - subject to Usual & Customary (U & C) – unless otherwise noted
Lifetime Maximum Benefit per Covered Person while Covered Under this Plan $1,000,000
Hospital Services
Inpatient Hospital After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Hospital Outpatient Facility or Ambulatory Surgical Facility After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Hospital Diagnostic X-ray & Lab After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Extended Care Facility, Skilled Nursing Facility, Rehabilitation Facility After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Emergency Room (when Emergency) After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Emergency Room for Non-Emergency Services After Deductible, 100% (facility charge related to the non-emergency ER visit is limited to a $100 Maximum Benefit)
Precertification Requirements
This Plan requires all Non-Emergency Inpatient Admissions, Outpatient Surgeries, Non-Emergency surgical procedures and Outpatient Chemotherapy and Radiation Therapy to be precertified by calling Med-Cert at (800) 356-7126 prior to admission or treatment. It is recommended to call within 2 business days following an Emergency Admission or Surgery. Failure to precertify an inpatient admission or outpatient surgery results in a $250 penalty
Physician Services
Physician inpatient visits, inpatient or outpatient surgical, anesthesia, radiology, pathology or ER Physician After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Physician Office Services Primary Care Physician or Specialist After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
  In-Network Out-of-Network
Other Medical Services
Ambulance After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Maternity Services
(Employee/Spouse only)
After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Durable Medical Equipment After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Prosthetic, Orthotic, Orthopedic Devices After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Hospice Services
(6 month life expectancy)
After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Home Health Care After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Physical, Occupational or Speech Therapy After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Other Therapy Services
(chemotherapy, radiation, dialysis etc.)
After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Chiropractic Care (maintenance care is not covered) After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
TMJ/Jaw Joint Services After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Organ & Tissue Transplants After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Preventative Care (Adult or Child)
Exams, Labs, Immunizations & Other Routine Services as recommended by the current CDC guidelines related to age & frequency
No Deductible, 100% No Deductible, 100% paid by Plan subject to U & C
$1,500 Calendar Year Maximum per Covered Person
Preventative Colonoscopy and Sigmoidoscopyper the most current CDC guidelines regarding age & frequency No Deductible, 100% No Deductible, 100% paid by Plan subject to U & C
Mental Health and Substance Abuse Services
Mental Health Inpatient Services After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
  In-Network Out-of-Network
Mental Health Outpatient Services After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Substance Abuse Inpatient Services After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Substance Abuse Outpatient Services After Deductible, 100% paid by Plan After Deductible, 100% paid by Plan subject to U & C
Perscription Drugs
Please Note: Prescription Drug Copayments do not apply to the Deductible
Prescription Drug Copayments at a Participating Pharmacy for a 31-day supply, or 90-days (if maintenance medication) 0% Generic Copayment, 100%
10% Formulary Brand Copayment, 100%
20% Non-Formulary Brand Copayment, 100%
Prescription Drug Copayments through the Mail Order Pharmacy for a 90-day supply 0% Generic Copayment, 100%
10% Formulary Brand Copayment, 100%
20% Non-Formulary Brand Copayment, 100%

This Schedule of Medical Benefits is a summary of the plan benefits. For more complete information related to any requirements or limitations, please see sections Covered Services, Prescription Drug Benefits and Services Not Covered.

Copyright (c) 2014 Muncie Community Schools   |  Privacy Statement  |  Terms Of Use