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Auto Tire & Parts – Kentucky

Tier 1

Provider Information

https://www.multiplan.us

https://www.kentuckycare.net

Base

Deductibles

$5,200

Employee

$10,400

Family

Max Out of Pocket

$7,150

Employee

$14,300

Family

Buy Up

Deductibles

$2,200

Employee

$4,400

Family

Max Out of Pocket

$7,500

Employee

$15,000

Family

High Deductible

Deductibles

$8,700

Employee

$17,400

Family

Max Out of Pocket

$8,700

Employee

$17,400

Family

Non-Network

Provider Information

Base & High Deductible

Deductibles

$12,000

Employee

$24,000

Family

Max Out of Pocket

UNLIMITED

Employee

UNLIMITED

Family

Buy Up

Deductibles

$7,500

Employee

$15,000

Family

Max Out of Pocket

UNLIMITED

Employee

UNLIMITED

Family

Other Services

Provider Information

Pre-certification
Vendor

https://www.urmedwatch.com

800-432-8421

Telehealth
Services

https://www.memd.net

Pharmacy
Network

empirxhealth.com

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