• The Diocese offers two medical plans. The OMNIA Plan and The Direct Access Plan. These plan are provided by Horizon Blue Cross and Blue Shield. Below, you will find general information on the plans and the benefit breakdown.
   

  • OMNIA Plan General Information: This plan is a tiered In-Network only plan. If you go to a medical provider who does not participate with the Horizon network, your medical expenses will not be covered. This plan offers Tier 1 and Tier 2 benefits. Tier 1 benefits offers maximum cost savings. Tier 2 is a reduced benefit from Tier 1. You should always confirm with Horizon, if your medical provider(s) and facilities are In-Network and Tier 1.

   

  • Direct Access Plan General Information: This plan offers In and Out-of-Network. You have the ability to see medical providers outside the Horizon Network. However, an Out-of-Network provider has the ability to balance bill.

   
  Please note, if you not familiar with Insurance related terms, or prefer a video/slide show explanation slide show of our medical benefits, please refer to our Insurance 101 Video or Slideshow.
   

• Video / Slideshow Presentation

  • Insurance 101 - Direct Access Plan
  • Insurance 101 - OMNIA Plan

• OMNIA - Benefit Breakdown

  General Plan Information	Tier 1	Tier 2
  Annual Deductible / Individual	$0.00	$1,500
  Annual Deductible / Family	$0.00	$3,000
  Coinsurance	0%	20%
  Maximum Out Of Pocket / Individual	$2,500	$4,500
  Maximum Out Of Pocket / Family	$5,000	$9,000

   

  Outpatient Services	Tier 1	Tier 2
  Diagnostic X-Ray and Lab Test	$0.00 for Office Visit $15Copay for Lab	$0.00 for Office Visit 20%Coinsurance after deductible

   

  Preventive Services	Tier 1	Tier 2
  Well-Child Care	Covered 100%	Covered 100%
  Pediatric Dental	Not Covered	Not Covered
  Pediatric Vision	$15.00 Copay	$30.00 Copay
  Immunizations	Covered 100%	Covered 100%
  Adult Periodic Exam with Preventive Tests	Covered 100%	Covered 100%

   

  Maternity Care	Tier 1	Tier 2
  Pregnancy and Maternity Care (Pre-natal Care)	Prenatal Covered 100% Delivery Covered 100%	20% Coinsurance after deductible

   

  Inpatient Hospital Services	Tier 1	Tier 2
  Inpatient Hospitalization	$250 copay per day, max of 5 days	20% coinsurance after deductible

   

  Outpatient Hospital Services	Tier 1	Tier 2
  Outpatient Facility Charge	$100 Copay	20% Coinsurance after deductible
  Diagnostic X-Ray and Lab Test	$15 Copay	20% Coinsurance after deductible

   

  Emergency Services	Tier 1	Tier 2
  Outpatient Facility Charge	$100 Copay	20% Coinsurance after deductible
  Diagnostic X-Ray and Lab Test	$15 Copay	20% Coinsurance after deductible

   

  Urgent Care	Tier 1	Tier 2
  Urgent Care Facility	$15 Copay	$30 Copay

   

  Mental Health / Alcohol Abuse Benefits	Tier 1	Tier 2
  Inpatient Care	$250 Copay per day, max of 5 days	20% coinsurance after deductible
  Outpatient Care	$15 Copay	20% coinsurance after deductible

• Direct Access - Benefit Breakdown

  General Plan Information	In-Network	Out-of-Network
  Annual Deductible / Individual	$1,500	$3,000
  Annual Deductible / Family	$1,500	$3,000
  Coinsurance	10%	30%
  Maximum Out Of Pocket / Individual	$5,000	$10,000
  Maximum Out Of Pocket / Family	$10,000	$20,000

   

  Outpatient Services	In-Network	Out-of-Network
  Diagnostic X-Ray and Lab Test	10% Coinsurance after deductible	30% Coinsurance after deductible

   

  Preventive Services	In-Network	Out-of-Network
  Well-Child Care	Covered 100%	30% Coinsurance, deductible does not apply
  Pediatric Dental	Not Covered	Not Covered
  Pediatric Vision	10% Coinsurance after deductible	30% Coinsurance for office visit, after deductible
  Immunizations	10% Coinsurance after deductible	30% Coinsurance, deductible does not apply
  Adult Periodic Exam with Preventive Tests	Covered 100%	30% Coinsurance, deductible does not apply

   

  Maternity Care	In-Network	Out-of-Network
  Pregnancy and Maternity Care (Pre-natal Care)	10% Coinsurance after deductible	30% Coinsurance after deductible

   

  Inpatient Hospital Services	In-Network	Out-of-Network
  Inpatient Hospitalization	10% Coinsurance after deductible	30% coinsurance after deductible

   

  Outpatient Hospital Services	In-Network	Out-of-Network
  Outpatient Facility Charge	10% Coinsurance after deductible	30% Coinsurance after deductible
  Diagnostic X-Ray and Lab Test	10% Coinsurance after deductible	30% Coinsurance after deductible

   

  Emergency Services	In-Network	Out-of-Network
  Outpatient Facility Charge	10% Coinsurance after deductible	30% Coinsurance after deductible
  Diagnostic X-Ray and Lab Test	10% Coinsurance after deductible	30% Coinsurance after deductible

   

  Urgent Care	In-Network	Out-of-Network
  Urgent Care Facility	10% Coinsurance after deductible	30% coinsurance after deductible

   

  Mental Health / Alcohol Abuse Benefits	In-Network	Out-of-Network
  Inpatient Care	10% Coinsurance after deductible	30% coinsurance after deductible
  Outpatient Care	10% Coinsurance after deductible	30% coinsurance after deductible