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Point of Service Plans

Choice, My Choice & Choice Plus

Choice
Choice offers two benefit levels. A member may stay in-network and receive medical services from participating providers or go out-of-network and receive services from non-participating providers.

• In-Network or In-Plan means you receive services from your selected Primary Care Physician (PCP) and from participating specialists. Visit Find a Doctor to search for participating PCPs and specialists.
•  Out-of-Network or Out-of-Plan means you receive services from a non-participating provider. Read the
  provider notice and claim notice for information about the financial impact of receiving medical services from a non-participating provider.

My Choice
My Choice is a two-tier POS Plan that allows you to seek care from participating as well as non-participating providers. You receive a higher level of coverage if you use participating providers. Benefits are limited to the My Choice Fee Schedule.

• Tier 1 means you receive services from participating PCPs and specialists.
• Tier 2 means you receive services from non-participating providers.

Use the My Choice Fee Schedule Worksheet to determine your financial responsibility for out-of-plan claims.
 
Choice Plus
Choice Plus offers three benefit levels.

• Level 1 means you recieve services from your PCP and participating specialty providers.
• Level 2 means you receive services from a non-participating specialist within Unity's provider network based on your PCP's location. These specialists are listed in Find a Doctor.
• Level 3 means you receive services from providers who are not part of Unity's provider network.

Prior Authorization
All three POS plans require prior authorization for some medical procedures. This means that your physician must obtain approval from Unity before the procedure will be authorized for coverage. If you use a non-participating provider, it is your responsibility to arrange for prior authorization. View the list of procedures requiring prior authorization. See the POS section of the Member Guide for more detailed information.

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