What comes out of my pay?How much will I pay out of my own pocket?What is Woodbury contributing?What will I pay after I meet my deductible?Will my doctor be in-network?
Network Options: Select Med Network
You’ve built a trusting relationship, and you want to keep it. But did you know you can also save money using an in-network provider? That’s why you can choose a provider network that is right for you and your family’s health and well-being.
1 (800) 538-5038 | selecthealth.org | Group #G1020324
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Medical Plans |
This Select Med Plus Plan is a traditional PPO plan where you will only have access to the Select Med Network. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are embedded. This means that on a family plan each covered member must meet their individual deductible — up to the maximum family deductible — and each covered member has an individual out-of-pocket maximum — up to the family out-of-pocket maximum.
Please check with SelectHealth to see if your provider is in the Select Med Network so that you can take advantage of greater discounts on care for you and your family.
Embedded
January 1 — December 31
$2,000 per individual
$4,000 per family
$4,000 per individual
$8,000 per family
Embedded
January 1 — December 31
$3,000 per individual
$6,000 per family
$6,000 per individual
$12,000 per family
Urgent Care
Primary Care
Behavioral Health
Covered 100%
Covered 100%
Covered 100%
Not Covered
Not Covered
Not Covered
$0 according to government guidelines
Primary Care
Specialist
Chiropractic (20 visits / year)
$20 copay
$30 copay
$20 copay
40% AD
40% AD
Not Covered
Office Visit
Inpatient
$20 copay
20% AD
40% AD
40% AD
Urgent Care
Emergency Room
Ambulance
$35 copay
$75 copay
20% AD
40% AD
Covered as In-Network
Covered as In-Network
Inpatient Hospital
Outpatient Surgery
20% AD
20% AD
40% AD
40% AD
Mail Order (90-day supply)
You pay $15 / $60 / $150 / $100
Flexible Spending Account (FSA)
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
With this Select Med Plus HSA-Qualified $2,000 / $4,000 High Deductible Health Plan (HDHP) you will only have access to the Select Med Network and will be eligible to enroll in the Health Savings Account (HSA) offered by Woodbury Corporation. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are non-embedded. This means that on a family plan there is only a family deductible. All family members’ out-of-pocket expenses count toward the family deductible until it is met, and then they are all covered with the health plan’s usual copays or coinsurance. It doesn’t matter if one person incurs all the expenses that meet the deductible or if two or more family members contribute toward meeting the family deductible. The non-embedded deductible is most common in high deductible health plans.
Please check with SelectHealth to see if your provider is in the Select Med Network so that you can take advantage of greater discounts on care for you and your family.
Non-Embedded
January 1 — December 31
$2,000 per individual
$4,000 per family
$4,000 per individual
$8,000 per family
Non-Embedded
January 1 — December 31
$2,000 per individual
$4,000 per family
$4,000 per individual
$8,000 per family
Urgent Care
Primary Care
Behavioral Health
$69 Copay; 100% AD
Varies - See Fee Schedule
Varies - See Fee Schedule
Not Covered
Not Covered
Not Covered
$0 according to government guidelines
Not Covered
Primary Care
Specialist
Chiropractic (20 visits / year)
Covered 100% AD
Covered 100% AD
Covered 100% AD
40% AD
40% AD
Not Covered
Office Visit
Inpatient
Covered 100% AD
Covered 100% AD
40% AD
40% AD
Urgent Care
Emergency Room
Ambulance
Covered 100% AD
Covered 100% AD
Covered 100% AD
40% AD
Covered as In-Network
Covered as In-Network
Inpatient Hospital
Outpatient Surgery
Covered 100% AD
Covered 100% AD
40% AD
40% AD
Mail Order (90-day supply)
Covered 100% AD
Health Savings Account (HSA) with a company contribution match
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
With this Select Med Plus HSA-Qualified $1,650 / $3,300 High Deductible Health Plan (HDHP) you will only have access to the Select Med Network and will be eligible to enroll in the Health Savings Account (HSA) offered by Woodbury Corporation. An important thing to know about this plan is that both the family deductible and family out-of-pocket maximum are non-embedded. This means that on a family plan there is only a family deductible. All family members’ out-of-pocket expenses count toward the family deductible until it is met, and then they are all covered with the health plan’s usual copays or coinsurance. It doesn’t matter if one person incurs all the expenses that meet the deductible or if two or more family members contribute toward meeting the family deductible. The non-embedded deductible is most common in high deductible health plans.
Please check with SelectHealth to see if your provider is in the Select Med Network so that you can take advantage of greater discounts on care for you and your family.
Non-Embedded
January 1 — December 31
$1,650 per individual
$3,300 per family
$3,200 per individual
$6,400 per family
Npn-Embedded
January 1 — December 31
$3,000 per individual
$6,000 per family
$6,000 per individual
$12,000 per family
Urgent Care
Primary Care
Behavioral Health
$69 copay; 100% AD
Varies - See Fee Schedule
Varies - See Fee Schedule
Not Covered
Not Covered
Not Covered
$0 according to government guidelines
Not Covered
Primary Care
Specialist
Chiropractic (20 visits / year)
$15 copay AD
$25 copay AD
$15 copay AD
40% AD
40% AD
Not Covered
Office Visit
Inpatient
$15 copay AD
20% AD
40% AD
40% AD
Urgent Care
Emergency Room
Ambulance
$35 copay AD
$75 copay AD
20% AD
40% AD
Covered as In-Network
Covered as In-Network
Inpatient Hospital
Outpatient Surgery
20% AD
20% AD
40% AD
40% AD
Mail Order (90-day supply)
$7 AD / $42 AD / $126 AD / $100 AD
Health Savings Account (HSA) with a company contribution match
* Providers may charge more than the plan allows when you receive services out-of-network. It is recommended that you ask the out-of-network provider about their billed charges before planning care.
This information is designed to help you choose a benefit plan for 2025 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
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Additional Medical Resources |
The CancerCare Program was added to your health plan at no additional cost to you.
This is an enhanced benefit and we encourage anyone facing a cancer diagnosis to enroll in the program and take advantage of all resources that are available to you.
Participating in the CancerCare Program includes:
- Access to a team of cancer experts who guide you through your care
- Identification of commonly mis-staged diagnoses and/or cancers
- Access to national Centers of Excellence for complex surgeries, care, and second opinions
- Assistance in finding financial and community support
- Confirmation that you are receiving the most effective treatment for your diagnosis
If you have a new or existing cancer diagnosis, please register with CancerCare today.
1 (877) 640-9610 | cancercare.interlinkhealth.com/intake
Imaging, reimagined.
Tellica Imaging, a wholly owned non-profit Intermountain Healthcare company, is focused on delivering low-cost, high-quality imaging in an outpatient setting. Tellica is transforming the imaging space for patients, payers, and providers by creating a seamless scheduling system with mobile offerings, automating the claims generation process, and putting operations where the patients want them — in easily accessible facilities in the communities where they live.
With transparent pricing, Tellica Imaging creates an atmosphere that is easy for patients, payers and providers to navigate an otherwise challenging healthcare setting. Tellica offers a global transparent price that is easily understood by both patients, payers, and providers with any scan, regardless of body part or contrast administration for $350 per CT and $550 per MRI; a rate 2-2.5x cheaper than the national average. In doing this, Tellica adheres to Intermountain Healthcare’s mission of “helping people live the healthiest lives possible.”
Visit Expectations:
- Patients will receive a text message or email upon receiving an order from their provider or a call within 1 business day.
- Payment is due at time of service. lnsurance deductibles and copays apply.
- lf you don’t have insurance or we do not accept your insurance, we accept payments with automated claim generation provided on request.
Tellica Imaging offers two different types of scans; CT and MRI.
There are three locations currently available to patients, open Monday to Saturday, 7 a.m.–7 p.m.:
OGDEN
1028 Chambers Street
South Ogden, UT 84403
(801) 387-8670
WEST VALLEY
4587 South 4000 West
Salt Lake City, UT 84120
(385) 297-4290
OREM
256 East University Parkway
Orem, UT 84058
(801) 357-3255
With prescription costs out of control, the time for Clever RX is now.
CleverRX is 100% free to use and works directly with pharmaceutical companies to offer significant discounts to qualifying individuals.
Clever Rx can save you up to 80% off prescription drugs — it is often lower than the average copay. Over 70% of people can benefit from a prescription savings card due to high deductible health plans, high copays, and being underinsured or uninsured.
Download the Clever RX card or Clever RX App to unlock exclusive savings today.
This program is independent of your medical plan, and the out-of-pocket expenses DO NOT count toward your medical deductible or out-of-pocket maximum.
The IMA Pharmacy Program was added to your health plan at no additional cost to you.
This is a FREE program to you, available through your employer. This program has been particularly helpful to those employees on expensive specialty drugs, some that cost as much as $100,000 per year. Even if you are on a more moderately priced drug, this program may be able to help you as well.
Once enrolled, participants will receive specialty medications sent directly to their home with no shipping/handling costs and $0 copay.
- Specialty medication assistance
- Pharmacy related questions
- Managing medication adherence
Participation saves you and the health plan money – which translates into more stable premiums over time.
If you participate, your employer will not have access to my health information. the IMA pharmacy advocate program is separate from your employer and will not share any of your personal health information.
You are invited to call Mindy Cook at 801-325-5098 for a confidential visit to see how they might help you with your prescriptions and their costs.
The Diathrive Solution.
The Diathrive Health solution solves key problems with diabetes care: access and affordability.
Diathrive Health’s unique diabetes management solution saves employers money by providing top-quality glucose management supplies, and by helping members uncover and address psychosocial barriers to managing a chronic disease. With our immersive, engaging platform, people are improving medication adherence, lowering A1c, reducing diabetes distress, and achieving better health.
Diathrive is available to employees who are enrolled in a Woodbury Medical Plan.
Unlimited Supplies
Team members get access to unlimited supplies with NO out-of-pocket cost so they always have what they need to check blood sugar and get the info needed to make health decisions.
Diathrive Health App
The Diathrive Health mobile app is the hub for everything members need:
- Sync and review health data
- Reorder supplies
- Access our library of educational articles
- Connect with a personal Health Advisor
Health Advisor
This is more than just health coaching. Members get access to a personal Health Advisor to review health data, assess personal psychosocial and behavioral barriers, and help create an individualized care plan. Health Advisors are credentialed in diabetes care: CDCES, RN, NP, RD RDN, and others.
For those who are currently utilizing the group medical plan for their diabetes management, you will receive a Diathrive Starter Kit that will include instructions on how to get started and use the program.
