The selected physician will provide or coordinate the provision of all medical and hospital services. Benefits provided under this plan include unlimited hospital coverage, including room and board, intensive care, general nursing, physician and surgeon services, laboratory tests, and medicines and supplies. Outpatient services covered include physician services, prescription drug benefits, chiropractic care, physician health assessments, preventive care, health education, home health care, hospice care physical therapy, outpatient surgery and durable medical equipment. Emergency medical services are covered worldwide. Special services covered include mental health services, chiropractic care and acute alcohol or substance abuse services.
All conditions are covered provided it is a covered benefit.
This plan is available to all eligible University employees residing within PacifiCare's service area in California. This plan allows members to choose one of three options each time the member requires health services. The options allow choice of physician, type of service and location. Option One, similar to the HMO plan described above, is that coverage which is provided and coordinated by the member's Primary Care Physician who is selected from PacifiCare's HMO Directory of Physicians. Option One provides the most extensive coverage, with the lowest out-of pocket expense.