Hybrid Health Plans

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Transitional Health Plans Overview

Transitional Health Plans Overview

Benefits include:

  • Office visit copayments as low as $20.
  • Affordable annual deductibles start at only $500 and do not apply to doctor visits, urgent care, physical therapy, lab, X-ray, and many other routine office-based services.
  • 100 percent coverage with no out-of-pocket expenses after you reach a coinsurance maximum*.
  • National network access to more than half a million providers.

* When using the out-of-network benefits with the Transitional PPO plan, you are also responsible for the difference between non-participating provider charges and an allowed amount, even after the coinsurance maximum has been met.

The Transitional EPO and PPO plans are underwritten by CDPHP UBI. This summary offers highlights but does not detail all benefits, limitations, or exclusions. It is not a contract and may be subject to change. For more detailed information, a Membership Certificate is available upon request.

Easy to Use

Transitional plans have no cost for the following preventive health care services:

  • Routine annual physicals for adults and children
  • Associated laboratory tests and other ancillary services associated with annual physicals
  • Annual mammograms, cytology screenings, prostate cancer screenings, and most immunizations
  • Allergy injections
  • Large network of preferred vendors where imaging and diagnostic laboratory services are covered in full

Plan Tools

Plan Tools

Here are some tools that might be helpful to you if you have a CDPHP Transitional plan.

Secure Online Access for Members
Find answers to many of your questions, check your claims, change your primary care provider, update your address, order new ID cards, and more – all online, 24/7.

Find-A-Doc and Find-A-Doc Mobile
Search the most current listing of providers in our network.

Wellness Workshops
Sign up for a free wellness and fitness classes! See the line-up of classes and register online.

Forms
Find any forms you may need to complete for care with your transitional plan.

Is My Prescription Covered?
Use a helpful drug search tool to find information on coverage, pricing, and prescription details.

Hospital Care

Hospital Care

  • Hospital stays and most hospital outpatient services are the only services subject to the deductible and coinsurance.
  • Once you meet the deductible, CDPHP covers 80 or 90 percent of your hospital stay depending which plan you have, including all ancillary services.*
  • Physician services during hospitalization are covered in full but subject to the deductible.*

* When using the out-of-network benefits with the Transitional PPO plan, you are also responsible for the difference between non-participating provider charges and an allowed amount, even after the coinsurance maximum has been met.