The UIChoice plan is a comprehensive health care program that covers hospital, medical, surgical, outpatient, and other health care services such as physical therapy. Coverage is also provided for routine physicals, newborn care (including inoculations, scheduled visits, etc.), well-child checkups, treatment of mental health conditions, treatment of chemical dependency, and prescription drugs.
How an Individual Uses UIChoice
Health care under the UIChoice plan may be obtained from any provider you wish. However, how much you pay for care will depend on the benefit level of the provider you choose.
UIChoice has three benefit levels. You do not need to pick a plan level. The level of the provider you choose for care automatically determines how much you pay. The lower the level, the lower the cost to you.
|Level of Provider||Participating Providers per Level|
|Level 1||Providers from the University of Iowa Hospitals and Clinics, UI QuickCare, Urgent Care Clinic, the Carver College of Medicine (CCOM), UI Community Medical Services Clinics (CMSC), UI Health Alliance Facilities and Primary Care Clinics, and Pediatric Associates of University of Iowa Stead Family Children's Hospital|
|Level 2||Providers from the Wellmark Blue Choice network. Locally, Level 2 includes Mercy Hospital in and around Iowa City who are not in Level 1|
|Level 3||Any providers outside of Levels 1 or 2, regardless of whether or not they participate in the Blue Cross Blue Shield network.|
Don't forget about UIeCare, the no-cost to you option for routine illnesses or mild injuries available 24/7, 365 days a year. With UIeCare, you can use your smartphone, tablet, or laptop to connect with a doctor or nurse practitioner via video-chat. Comparatively, like an in-person visit, a provider will evaluate your history and symptoms, perform an exam, recommend treatment when appropriate - including sending prescriptions to your local pharmacy - or refer you to a suitable in-person UIHC care option. UIeCare is a free benefit for UIChoice plan participants and their dependents.
Participating vs. Non-Participating Providers
In Iowa, participating providers will accept payment arrangements and file claims for you with Blue Cross and Blue Shield. Payment is made directly to these providers.
Non-participating providers do not have contracts with Blue Cross and Blue Shield. They do not agree to accept payment arrangements and are not responsible for filing claims for you. Non-participating providers may charge more for health care than participating providers. Payment is made to you and you are responsible for paying the provider. Non-participating providers can bill you for the difference between what Blue Cross and Blue Shield will pay for a service and what they charge (balance billing).
When you are out-of-state, participating Blue Cross and Blue Shield providers will result in lower out-of-pocket costs for you and the out of pocket maximum for Levels 1 and 2 will apply to these providers. If it is a state that allows balance billing, using a participating Blue Cross and Blue Shield provider should result in a lower balance bill.
In an emergency, if you cannot reasonably reach a participating provider, care received in an emergency room during the course of the emergency will be reimbursed as though the service was received from a participating provider.
- Wellmark/Blue Cross Patient Claim Form #C-2318978 (pdf)
- UIChoice Prescription Reimbursement Claim Forms (pdf)
- International Claim Form
- Wellmark/Blue Cross Patient form #C-4614 (Lodging Reimbursement Form for Transplant-Related Expenses) (pdf)
ABOUT OUR SITE: The information presented on our website describes only the highlights of the plans and does not constitute official plan documents. Additional terms and conditions apply. If there are any discrepancies between the information contained herein and the official plan documents, the plan documents will govern.