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You are encouraged to read the information regarding the medical plans carefully prior to enrolling to be sure you are choosing the best coverage for you and your family. When comparing Duke's medical plans, it is important to compare the cost of out-of-pocket expenses as well
as premiums and pharmacy benefits. Here are some questions to ask yourself in choosing a health plan that
matches the needs of you and your family. For specific coverage information, please refer to the
Medical Plans Comparison Chart. |
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Duke Select (HMO) |
Duke Basic (HMO) |
Duke Options |
Blue Care (Blue Cross Blue Shield HMO) |
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In-Network |
Out-of- Network |
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| Can I select any doctor I wish? | No | No | No | Yes | No |
| Must I choose from doctors in a network? | Yes | Yes | Yes | No | Yes |
| Am I permitted to use out-of-network providers? | No, emergency care only | No, emergency care only | No, emergency care only | Yes | No, emergency care only |
| Must I select a Primary Care Physician (PCP)? | No, but you are encouraged to select a PCP | No, but you are encouraged to select a PCP | No, but you are encouraged to select a PCP | No, but you are encouraged to select a PCP | No, but you are encouraged to select a PCP |
| Can I see a specialist without a referral? | Yes | Yes | Yes | Yes | Yes |
| Will my dependent children who live in a different location be covered? | No, emergency care only | No, emergency care only | Yes, nationwide listing of doctors | Yes | Yes, if within NC - otherwise, emergency care only |
| Since I travel a lot, can I see doctors in other locations around the world? | No, emergency care only | No, emergency care only | Yes, worldwide listing of doctors | Yes | No, emergency care only |
| Do I have coverage for out-of-area/out-of-network providers so I can see providers where I work and where I live? | No | No | Yes | Yes | No, but a large statewide network of doctors is available |
| Must I meet an annual deductible? | No | Yes, for some services | Yes, for some services | Yes | No |
| Do I have lifetime maximums? | Yes | Yes | Yes | Yes | Yes |
| Do I have annual co-insurance maximums? | No | Yes | Yes | Yes | No |
| Am I responsible for filing claims? | No | No | No | Yes | No |
| What if I work or live outside of the U.S.A.? | Emergency care only | Emergency care only | Worldwide list of doctors | Yes | Emergency care only |