UIChoice is a comprehensive health care program that covers hospital, medical, surgical, outpatient, and other health care services such as physical therapy. Coverage is determined by the provider you have chosen. Providers will be associated with one of three levels of coverage. You do not pick a specific level under this plan, the chosen provider will automatically determine at which level the claim is processed.
Level 1: In addition, UI Health Alliance Founding Members (MercyCare -Cedar Rapids, Genesis Health System, Wheaton-Franciscan HealthCare-Waterloo/Cedar Falls, and Mercy -Des Moines) are now part of Level 1 for primary care only. For a listing of primary care providers, see UI Benefits.
Level 2: Providers from the Wellmark Blue Choice network. Locally, Level 2 includes Mercy Hospital and most Iowa City community providers.
Level 3: Any provider that does not belong to level 1 or 2, including non-participating Blue Cross/Blue Shield providers.
To find participating BC/BS providers outside of Iowa, National Doctor and Hospital Finder will help you find BC/BS providers within the United States and BlueCard Worldwide will help you find International BC/BS providers.
When using non-Blue Cross/Blue Shield providers, you will owe 40% Co-insurance plus the difference between Wellmark's payment and the billed charge.
UI Employee Assistance Program is a free service that can be used to assist with behavioral health support. This program includes a confidential assessment and up to 4 visits by calling 319-335-2085. Counselors can assist patients with needs, help resolve the problem, or facilitate a referral to a provider based on the assessment.
All pharmacies in the Iowa City/Coralville/North Liberty area participate in the UIChoice plan. For plan participants living outside this area, check pharmacy locations. Certain drugs are limited per month, benefit period, or lifetime by drug-specific quantity limitations. The limitations are determined by Wellmark based on Medical necessity. For a list of drugs subjects and quantity limitations, check with your pharmacist, physician, or Wellmark.
Important features of UIChoice include:
- Open access to any provider, including out of state providers and non-Blue Cross/Blue Shield providers.
- Reduced co-payment for University of Iowa and UI Community Medical Service providers.
- UI Health Alliance Founding Members (MercyCare -Cedar Rapids, Genesis Health System, Wheaton-Franciscan HealthCare-Waterloo/Cedar Falls and Mercy -Des Moines) are now part of Level 1 for primary care only. For a listing of primary care providers, see UI Benefits.
- One co-payment per day when multiple UI providers are seen in one day.
- Comprehensive coverage of physicals, well-child visits, and other preventative services.
- Prescription card benefits with no deductible requirement.
- Nurse case manager in the UI Health Plans Customer Care Services to assist you with your health care needs, no matter how simple or complex.
- Assistance from UI Health Plans Customer Care Services staff with questions about your benefits, claims, and general information or concerns in accordance with the UIChoice insurance contract. Call 319-356-8442 or 800-356-8442.