2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Chapter 4: Medical Benefits Chart (what is covered and what you pay) 89 Services that are covered for you What you must pay when you get these services in-network and out-of-network Foreign travel claims^ To use this benefit, you will Worldwide coverage for non-emergency and non-urgent need to pay the full cost of the services. service and then submit a reimbursement claim. We'll reimburse 100% of the billed charges. For more information on this process, please see Chapter 7.* Foreign travel – prescription claims^ After you reach your prescription deductible (see Chapter 6), you'll pay a $45 copay for a 30 day supply. You pay this amount until you reach the out-of-pocket maximum. UnitedHealthcare Healthy at Home post-discharge $0 copayment; benefit is program available through approved With the UnitedHealthcare Healthy at Home post-discharge vendors. program, the following benefits are available to you up to 30 days following all inpatient and skilled nursing facility discharges at no cost to you: Home-delivered meals Receive 28 home-delivered meals when referred by a UnitedHealthcare Engagement Specialist. Call the number on your UnitedHealthcare member ID card to learn more or get a referral. · Restrictions, limitations and exclusions apply, including shipping and other requirements. Meals are only available through the approved vendor · If you have been recently discharged from the hospital or a skilled nursing facility and would like a referral, call