Insurance

GME Applicants > Insurance

Medical Insurance
Medical insurance is provided by Palmetto Health for you. Family coverage may be added by paying a premium difference. The Palmetto Care Plan maximizes your benefits using Palmetto Health facilities and physicians.

When using a Palmetto Health facility, there is no deductible for facility charges and most services are covered by a co-pay; therefore, you should know your financial liability at the time of service. Physician benefits only are available from the Palmetto Care Plan through SuperMed network providers. Preventive services are covered at 100%. To assist you with the Palmetto Health-owned and -operated facility charges for which you are responsible, you can payroll deduct amounts more than $50.

Employees who live within a 50-mile radius of a Palmetto Health facility or employees who live outside of the 50-mile radius and travel inside the 50-mile radius must use a Palmetto Health facility.

The Smart Consumer Plan is a high deductible health plan using the BlueCross BlueShield network of providers that enables you to take a more active role in managing your health care. In exchange for lower bi-weekly payroll contributions, you have a higher annual deductible. There is no co-pay for preventive services in the BlueCross BlueShield network. Preventive services include annual physicals, screening services, well-child care and child/adult immunizations. There are no lifetime maximums. When electing coverage for a spouse, employees may be eligible for a one-time cash incentive.

Residents choose from two medical plans:

Palmetto Care Plan (EPO plan)
Smart Consumer Plan (HDHP plan with Health Savings Account accessibility with the Palmetto Health Credit Union).

Palmetto Care Plan:

Lifetime Maximum: $2,000,000	Palmetto Health faciltities	SuperMed Network Providers	SuperMed Network Facilities & Laboratories
Deductible
Individual	None	$500
Family	None	$1500
Out of Pocket Maximum (co-insurance applies)
Individual	None	$1500
Family	None	$4500
Physician Office Visits (Routine and Preventative)
Primary Care	n/a	$30 co-pay	n/a
Specialist	n/a	$40 co-pay	n/a
Labs & X-rays Testing Reading	n/a n/a	100%, no deductible 100%, no deductible	50% after deductible n/a
Other Physician Office Services	n/a	$25 co-pay	n/a
Physician Office Visits (Diagnostic/Sick)
Primary Care	n/a	$30 co-pay	n/a
Specialist	n/a	$40 co-pay	n/a
Labs & X-rays Testing Reading	n/a n/a	100%, no deductible 80%, after deductible	50% after deductible n/a
Other Physician Office Services	n/a	$25 co-pay	n/a
Outpatient Hospital Charges
Surgery	$300 co-pay	n/a	not covered
Occupational, Physical, & Speech Therapy and Cardiac Rehab	$25 co-pay per visit	n/a	not covered
Labs Testing Reading	%100 n/a	n/a 80% after deductible	50% after deductible n/a
X-rays Testing Reading	$25 co-pay n/a	n/a 80% after deductible	50% after deductible n/a
MRI/CAT/PET/Nuclear Med Scans	$150 co-pay per scan	not covered	not covered
Physician/Anesthesiologist Services	n/a	80% after deductible	n/a
Inpatient Hospital Charges
Facility Charges	$250 co-pay/day ($1250 max.)	n/a	not covered
Physician/Anesthesiologist	n/a	80% after deductible	not covered
Emergency Room	$250 co-pay	n/a	80% no deductible ($250 min.)
Urgent Care	n/a	n/a	$50 co-pay (excluding Lexington Urgent Care)
Mental Health/Substance Abuse	$35 co-pay per outpatient service	80% after deductible	not covered

Prescription Drug Benefit	30 Day	30 Day	90 Day
Network	Palmetto Health Pharmacy	American Health Pharmacies	Palmetto Health Pharmacy
Deductible	$75 per individual	$75 per individual	No deductible
Generic	$10 co-pay after deductible	$15 co-pay after deductible	$10 co-pay
Preferred	$20 co-pay after deductible	$35 co-pay after deductible	$20 co-pay
Non-preferred	$50 co-pay after deductible	$65 co-pay after deductible	$100 co-pay
Specialty Drugs (only available at Palmetto Health Pharmacy)	20% ($100 max.) after deductible	n/a	n/a
Infertility Drugs	$100 co-pay/cycle ($5,000 life max.)	$100 co-pay/cycle ($5,000 life max.)	n/a

Smart Consumer Plan:

Prescription Drug Benefit
The program allows employees who are enrolled in one of the Medical Plans with Palmetto Health to obtain prescription drugs at the Palmetto Health Pharmacy, retail pharmacies, or through mail order with a co-payment. Enrollment is automatic when you enroll in one of the two medical plans.

Dental Insurance
"Low option" dental coverage is provided by Palmetto Health for you. Family coverage may be added by paying a premium difference.
Palmetto Health's dental plans promote oral health by covering preventive services at 100 percent with NO DEDUCTIBLE. You can maximize your benefits when you use a dentist in Delta Dental's Premier or PPO network. Basic services are covered at 50 percent. Major services (bridges, dentures, crowns) are covered at 50 percent. The annual maximum insurance payment is $500 per person out of network and $750 in Delta PPO and Delta Premier network."High option" coverage includes orthodontic coverage. To cover you and your dependents, both options may be purchased through payroll deduction. Deductibles are waived at the Palmetto Health Richland Dental Center.

Vision Insurance
Vision coverage is provided by Palmetto Health for you and your dependents at discounted group rates through payroll deduction. The vision plan provides reimbursement for vision exams ($45), lenses ($90), frames ($60) and contact lenses ($150) purchased by a licensed provider of your choice.

Long-Term Disability Insurance
After 90 days of continuous employment, you are provided with a long-term disability insurance plan at no cost to you. The plan includes an elimination period of 90 days. The coverage amount for approved long-term disability (LTD) is 60 percent of your base monthly earnings up to a maximum of $20,000 per month. The maximum duration of LTD will last until the Social Security normal retirement age as described in the policy. When you complete your residency, you may continue the individual basis at the same low rate.

Portable Long-Term Disability Insurance
Upon completion of the residency program, Palmetto Health will provide you an opportunity to continue the individual basis at the same low rate. This plan is especially designed for physicians. If you become sick or injured and cannot practice as a physician, this plan will protect lost earnings.

Life Insurance
Palmetto Health provides, at no cost to you, Basic Life and Accidental and Dismemberment insurance that is equal to your annual base salary. You may purchase voluntary life insurance in the amount of one to five times your base pay at a discounted group rate. You also may obtain dependent life insurance coverage at a maximum of $25,000 for your spouse and $10,000 for children. These policies may be paid through payroll deduction.

Liability Insurance
Your liability insurance is provided by Palmetto Health while you are in the Graduate Medical Education Program. Palmetto Health will assist you in obtaining additional insurance if needed for moonlighting purposes and the premium expense to you may be payroll deducted for 12 months.

*These are current resident benefits. Benefits are subject to change (eg.: insurance plan year changes on January 1).