HEALTH

Medical and Prescription Drugs

Choose the Health Plan That Fits

You have choices at ONEOK when it comes to health care coverage for you and your family. You can choose from two medical plans — the Preferred Provider Organization (PPO) Plan and the High Deductible Health Plan (HDHP). Both are administered by UnitedHealthcare (UHC), cover the same services and have the same network. They differ in how and what you pay when you need care.

Overview

Medical

What You Pay

In Network
Out of Network2
PPO
HDHP
Annual Deductible

Per Person

$5005

N/A

You+Spouse/Domestic Partner or You+Child(ren)

$1,0005

N/A

You+Family

$1,5005

N/A

Single Coverage

N/A
$1,7005

Family Coverage

N/A
$3,3005,10
ONEOK Contribution to HSA
N/A
$500 single coverage
$1,000 family coverage
prorated based upon date of hire
Member Coinsurance
20%
15%
Out-of-Pocket Maximum

Per Person

$2,750
N/A

You+Spouse/Domestic Partner or You+Child(ren)

$5,500
N/A

You+Family

$8,250
N/A

Single Coverage

N/A
$4,000

Family Coverage

N/A
$8,00011
Preventative Care (Nondiagnostic) 

Includes Immunizations/Well-Child Care, Routine Physical, Prostate Cancer Screening, Mammogram Screening, Colonoscopy/Cologuard, Annual Wellness Exams, etc.

Plan pays 100%1,6
Plan pays 100%1,6
Common Services

CareATC Health Services

Plan pays 100%8
$505

Virtual Visit

$5
copay5,8

15%
after deductible

Primary Care Office Visit

$30
copay5,7,8

15%5

after deductible

Specialist Office Visit

$50
copay5,8

15%5

after deductible

Urgent Care Visit

$65
copay5,8

15%5
after deductible

Diagnostic X-ray/Lab

20%5
after deductible
15%5
after deductible

Emergency Room

$300 copay,8

waived if admitted,

deductible + 20%5 after deductible

15%5

after deductible

Inpatient Hospital

20%3,4,5

after deductible

15%3,4,5

after deductible

All Other Covered Services

20%5
after deductible
15%5
after deductible

Travel and Lodging Benefit Allowance

Reimbursement up to

$2,000 max after deductible

Reimbursement up to

$2,000 max after deductible

Maternity Services12

Routine Preventative Prenatal Care

Plan pays 100%1,6
Plan pays 100%1,6

Other Prenatal Care

20%3,4,5
after deductible
15%3,4,5
after deductible

Fertility

Benefits only available

through Progyny

Benefits only available

through Progyny

Delivery

20%3,4,5,9
after deductible
15%3,4,5,9
after deductible

Newborn Charges

No automatic coverage --
newborn must be added to plan within 90 days of birth

No automatic coverage --
newborn must be added to plan within 90 days of birth

PPO
HDHP
Annual Deductible

Per Person

$1,5005

N/A

You+Spouse/Domestic Partner or You+Child(ren)

$3,0005

N/A

You+Family

$4,5005

N/A

Single Coverage

N/A

$3,4005

Family Coverage

N/A

$6,6005,10

ONEOK Contribution to HSA

N/A

$500 single coverage
$1,000 family coverage
prorated based upon date of hire
Member Coinsurance

40%

40%

Out-of-Pocket Maximum

Per Person

$6,0002

N/A

You+Spouse/Domestic Partner or You+Child(ren)

$12,0002

N/A

You+Family

$18,0002

N/A

Single Coverage

N/A

$9,0002

Family Coverage

N/A

$18,0002,11

Preventative Care (Nondiagnostic) 

Includes immunizations/Well-Child Care, Routine Physical, Prostate Cancer Screening, Mammogram Screening, Colonoscopy/Cologuard, Annual Wellness Exams, etc.

Not covered

Not covered

Common Services

CareATC Health Services

Not covered

Not covered

Virtual Visit

Not covered

Not covered

Primary Care Office Visit

40%5

after deductible

40%5

after deductible

Specialist Office Visit

40%5

after deductible

40%5

after deductible

Urgent Care Visit

40%5

after deductible

40%5

after deductible

Diagnostic X-ray/Lab

40%5

after deductible

40%5

after deductible

Emergency Room

$300 copay,8

waived if admitted,

deductible + 20%5 after deductible

15%5

after deductible

Inpatient Hospital

40%3,4,5

after deductible

40%3,4,5

after deductible

All Other Covered Services

40%5
after deductible

40%5
after deductible

Travel and Lodging Benefit Allowance

Reimbursement up to

$2,000 max after deductible

Reimbursement up to

$2,000 max after deductible

Maternity Services12

Routine Preventative Prenatal Care

Not covered

Not covered

Other Prenatal Care

40%3,4,5
after deductible

40%3,4,5
after deductible

Fertility

Benefits only available

through Progyny

Benefits only available

through Progyny

Delivery

40%3,4,5,9
after deductible

40%3,4,5,9
after deductible

Newborn Charges

No automatic coverage --
newborn must be added to plan within 90 days of birth

No automatic coverage --
newborn must be added to plan within 90 days of birth

Footnotes
  1. Does not apply to annual deductible or out-of-pocket maximum.

  2. If provider is not contracted with UHC, the patient is responsible for amounts in excess of eligible expenses, which will not apply to the annual deductible or out-of-pocket maximum. 

  3. Requires preauthorization in network: provider responsibility; out of network: patient responsibility.

  4. Precertification required within 48 hours of admission.

  5. Applies to out-of-pocket maximum.

  6. 100% coverage is based on age and health condition with respect to health care reform guidelines.

  7. Family practitioner, general practitioner, internal medicine, pediatrician and mental health visits.

  8. Does not apply to annual deductible.

  9. Requires the newborn be added to the health plan for coverage.

  10. The entire family deductible must be met before coinsurance will be applied, regardless of how many individuals are covered.

  11. The entire family out-of-pocket maximum must be met before the out-of-pocket maximum has been satisfied, even if only one family member is using the plan; provided, however, that the out-of-pocket maximum for any individual shall not exceed the limit established by the IRS for the year under applicable health care reform guidelines.

  12. Fertility coverage and newborn charges do not apply to childbearing dependents.

prescription drugs

what you pay

PPO
HDHP
Select Preventative Drugs
Plan pays 100%1
Plan pays 100%1
Tier 1 Drugs

The lesser of the cost of the drug or $7.502,3

15%2
after deductible

Tier 2 Drugs

30%2,3
$25 minimum;
$75 maximum

15%2
after deductible

Tier 3 Drugs

40%2,3
$50 minimum;
$150 maximum

15%2
after deductible

Specialty Drugs

30%2,3
$100 minimum;
$300 maximum

15%2
after deductible

Mail Order
3x retail for 90-day supply
3x retail for 90-day supply

For a list of covered prescription drugs, visit myUHC.

Footnotes
  1. Does not apply to annual deductible or out-of-pocket maximum.

  2. Applies to out-of-pocket maximum.

  3. Does not apply to annual deductible.

your cost per pay period

Deductions taken from the first two pay periods per month

PPO
HDHP
You Only
$52.50
$32.00
You + Spouse/Domestic Partner
$161.00
$109.50
You + Child(ren)/Domestic Partner Child(ren)
$134.00
$92.50
You + Family
$225.50
$153.50
Per-Pay-Period Premiums
Higher
Lower
Deductibles and Out-of-Pocket Maximums

Lower

Higher

Extended Coverage

Even if you live far away from network care, we've got you covered. Take a look at the extended coverage options available to you.

Contacts

UnitedHealthcare (UHC)