Plan Overview

1. Members on this plan may see any Viva Health participating provider for their health care. However, if you see a provider within the RMC or UAB+ network, you may enjoy cost savings through lower copays, coinsurance, and deductibles.

2. The RMC network (Tier 1) offers the lowest copays, coinsurance, and deductibles of any of the three coverage tiers. The RMC network consists of Regional Medical Center, Stringfellow Memorial Hospital, and all RMC satellite clinics.

3. The UAB+ network (Tier 2) offers copays, coinsurance, and deductibles a little higher than the RMC (Tier 1) network, but includes access to University Hospital, UAB Women and Infants Center, UAB Highlands, The Kirklin Clinic, Medical West, UAB Callahan Eye Hospital, Spain Rehabilitation Center, all UAB satellite clinics, and Children’s Hospital.

4. The Viva Health network (Tier 3) has the highest copays, coinsurance, and deductibles on the Plan but includes hospitals and health centers contracted with Viva Health but outside of RMC and UAB+.

1. All physicians within Viva Health’s robust state-wide network are covered under the Viva Health-RMC Health System plan. However, your costs may be less if you use a provider at RMC Health System, UAB Health System, or Children’s of Alabama. To determine which tier your provider or a facility is in, you can call Viva Health at 1-800-294-7780. Remember: medical care you receive from providers who are not included in the Viva Health-RMC Health System Plan network will not be covered by the plan unless it is urgently needed or emergency medical care or approved by Viva Health’s medical director in advance.

1. If you are outside the service area and have an urgent and unforeseen need for care that can’t wait until you return home, you are covered. This includes care in a physician’s office for an unexpected illness or injury that would not be classified as an emergency, but does require immediate attention. Care in an emergency room is only covered for treatment of emergency medical conditions. Of course, this does not include routine or elective medical services, and you must return to the service area for any follow-up care. Still, if you’re on a weekend trip or an extended vacation, you can relax knowing that you are covered.

1. We encourage you to put us to the test: When you dial the Viva Health Customer Service department during business hours (8am - 5pm, Monday through Friday), you’ll get a real person with real answers. You can also have your questions answered at the click of the mouse! By visiting our website at www.vivahealth.com, you can access all of the following information:

a. Summary of Benefits

b. Certificate of Coverage

c. Wellness Benefits

d. Access our Member Portal (www.vivamembers.com) or send an email to vivamemberhelp@uabmc.edu to request a new ID card, change your PCP, update your mailing address, or inquire about a claim.