Laboratory Benefits

If your healthcare provider is in New York State and requires you to use laboratory services for testing, the In-Network Laboratory to use is Quest Diagnostics. If your provider is in New Jersey and requires you to use laboratory services for testing, the In-Network Laboratory to use is Lab Corp of America. Remember – the Laboratory to use is based on where your healthcare provider is located. (When Medicare is primary, you do not need to choose In-Network or Out-of-Network facilities. Always be sure the facility is a Medicare provider.)

To search for an in-network laboratory in your area, go to www.bcbs.com.

Examples below. For additional information, see the Plan Document.

In-Network Provider Out-of-Network Provider
Diagnostic Testing(out-patient hospital) $35 co-pay per day $70 co-pay per day, and 20% co-insurance
Imaging (CT/PET scans, MRIs)(out-patient hospital) $50 co-pay per day $85 co-pay per day, and 20% co-insurance
Chemotherapy(physician’s office) $25 co-pay per visit $25 co-pay per visit, plus deductible and 20% & co-insurance
Hemodialysis(out-patient hospital) No co-pay $0 co-pay per day, and no co-insurance
Hemodialysis(physician’s office) $25 co-pay per visit $25 co-pay per visit, plus deductible and 20% co-insurance
Radiation Therapy(out-patient hospital) $0 co-pay per day 100% of u&c (no co-pay)
Radiation Therapy(physician’s office) $25 co-pay per day $25 co-pay per visit, plus deductible and 20% co-insurance
Mammography(out-patient hospital or physician’s office) Paid in full. One baseline – women age 35- 39. Annual – Women age 40 and over. High risk, any age. 100% of U&COne baseline – women age 35- 39. Annual – Women age 40 and over. High risk, any age.
Lab & X-rays (out-patient facility) $50 co-pay per visit $85 co-pay per visit, plus deductible and 20% co-insurance
Lab & X-rays (physician’s office) $25 co-pay per visit $25 co-pay per visit, plus deductible and 20% co-insurance
Lab-Quest Labs $5 co-pay per visit N/A

 

Latest News

The OU Health Plan has arranged with EmpiRx to offer the flu vaccine to Plan members for a $0 copay

To receive your FREE Flu Vaccine, COVID-19 vaccination or COVID-19 booster shot simply go to any participating pharmacy and present your OU Health member ID card.


MEDICARE PRIMARY RETIREES:

To receive your Free Flu Vaccine or COVID-19 vaccine or booster shot, simply go to any pharmacy that participates with the CVS Caremark/ Silver Script network of pharmacies and present your Silver Script Prescription ID card.


Note to all members: This year, please consider obtaining the flu shot in October, before the flu season starts, as medical experts have advised co-exposure to both COVID-19 and the flu could result in serious illness such as pneumonia and respiratory distress, hospitalization or even death. This is possible because the flu and COVID-19 are caused by different viruses.

***OU Health announces EmpiRx Health as the new Pharmacy Benefits Manager effective July 1, 2021***

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CORONA VIRUS TESTING

The Orange Ulster School Districts Health Plan will provide 100% coverage for in-network diagnosing and laboratory testing for the potential Corona Virus office visit or Live Health Online (Telemed) visit. Click here to download

BENEFIT ENHANCEMENTS
Friday,March 8 2021

With 2021 around the corner, the Orange Ulster School Districts Health Plan is excited to announce several Plan benefit Read More

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