2010 Benefit Year
DMC Employees (with DMC Care benefit coverage):
To better assist you with selecting a provider, please refer to the quick reference chart below.
Choose your provider carefully. Your Out-of-Pocket expense changes based on the Tier that you select.
Use the Provider Tier Level to find a provider that minimizes your Out-of-Pocket expense.
Please refer to your DMC Care Summary Plan Description (SPD) or DMC Enrollment Guide (available in Human Resources) for more detail regarding your benefits and patient responsibility.
| If you have any questions regarding your benefit information, please contact DMC Care Member Services: |
DMC Care Member Services
Call toll-free at 800-543-0161
Contact Us form |
Explanation of Provider Tier Level
Note: Tiers only apply to DMC Employees (with DMC Care benefit coverage)
| Out-of-Pocket |
Provider
Tier
Level |
Explanation |
Lowest
Out of Pocket:
Deductibles at DMC facilities are waived |
T i e r 1 |
DMC Care Providers; includes DMC facilities/ancillary and DMC Care physicians/specialists.
Tier 1 (DMC Care network) benefits apply. |
Increased
Out of Pocket:
Copay and/or Coinsurance,
after Deductible |
T i e r 2 |
Cofinity Providers: The Tier 2 Provider Tier Level pertains to eligible DMC Employees and their Dependents only.
Please refer to the on-line Cofinity Provider Directory to locate a Tier 2 provider. Tier 2 benefits apply. |
Even more
Out of Pocket:
Copay and/or Coinsurance,
after Deductible |
T i e r 3 |
MultiPlan: Tier 3 benefits apply. |
Maximum
Out of Pocket:
Copay and/or Coinsurance,
after Deductible |
T i e r 4 |
Out-of-Network: Tier 4 benefits apply. |
Only DMC Care
|