2012 RI Hospital UNAP Health Insurance Fact Sheet

The RI Hospital UNAP is very committed to making sure that our members have the best, most affordable health plan. Our new contract guarantees that there will be NO increase for four years in the percentage that we pay towards the total cost of our health insurance. To control the cost of our health insurance, we negotiated a new "preferred network" within Lifespan for some health care services.  This means you MAY have a co-pay for using certain non-Lifespan facilities. The following is a list of those services that go into effect January 1, 2012. 

IMPORTANT – If you believe you have been wrongly charged a co-pay, first call UNAP at 401-831-3647 and then call the BCBSRI Customer Service at (401) 459-5000 or 1-800-639-2227 immediately so that your rights can and will be protected.

Co-pays
Non-Lifespan hospital admission: $350 
Non-Lifespan outpatient hospital services and ambulatory surgery centers:  $250
Non-Lifespan Labs:  $25
Non-Lifespan Durable Medical Equipment:  $25

Exceptions to co-pays
There are NO co-pays if you use a Lifespan facility
There are NO co-pays if the service is not available at a Lifespan facility.
There are NO co-pays for an emergency hospitalization.
There are NO co-pays for colonoscopies.
There are NO co-pays if the service cannot be provided by a Lifespan facility within a medically-necessary timeframe.
There are NO co-pays for lab work that is drawn and processed by physician's staff as part of an office visit.
There are NO co-pays for Ob-GYN services. (** Note: The Union and the Hospital are not in agreement on this issue. If you receive a bill for a co-pay for hospital-based Ob-GYN services, please notify the Union.)
There are NO co-pays for employees (and dependents who live with them) who live more than 50 miles from a Lifespan facility.
There are NO co-pays for dependent students who live more than 50 miles from a Lifespan facility. (Contact the Union if your dependent student receives a bill for a co pay.)

No changes

There are NO co-pays for services provided through a home care service.
There are NO co-pays for oncology treatments/infusion. (** Note: The Union and the Hospital are not in agreement on this issue. If you receive a bill for a co-pay for hospital-based Ob-GYN services, please notify the Union.)
ER visit remains at $50 whether or not it is a Lifespan hospital.  The co-pay is waived if the patient is admitted.
Physician office visit:  $15 whether or not your physician is a Lifespan physician.  There is no co-pay for physician visits for preventative services.

Prescription co-pays

Tier 1   Retail $7; Mail order* $10.50
Tier 2   Retail $25; Mail order* $25
Tier 3   Retail $40; Mail order* $60
Specialty drugs  Retail $50; mail order not available

 * Mail order is a 3 month supply

Click on the links below for additional healthplan-related information

Lifespan Health Plan Booklet (141 pages)
BCBS Formulary Changes
BCBS Preferred Drug List -April - Sept 2012
Lifespan Laboratories

Click on the ZIP CODE LIST to determine if you live within a 50 mile radius