Plan available only to participants living in zip codes beginning with 272, 273, 275, 276, and 277. This plan uses a health care provider network unique to Duke. Since this network is unique, we encourage you to carefully review the provider listing. Out-of-network care is only covered for emergency or urgent care, and limited to 20 visits and 20 days for behavioral health or substance use disorder when out-of-network.
Duke Select HMO Frequently Asked Questions
Duke Select is a custom network HMO plan available to employees who live in zip codes that begin with the first three digits 272, 273, 275, 276, and 277. Duke Select includes access to Duke’s provider network. Out-of-network coverage is limited to emergency care, urgent care and a limited number of visits for behavioral health and substance abuse services.
Duke Select is a Health Maintenance Organization (HMO) plan. Unlike traditional HMOs, Duke Select does not require members to choose a primary care physician (PCP) and does not require referrals to see in-network specialists. The plan uses Duke’s exclusive provider network and offers predictable costs through copays.
The Duke Select HMO plan has no annual deductible for either individual or family coverage and no coinsurance for most services. The annual out-of-pocket maximum is $3,000 for individual coverage and $6,000 for family coverage. Once the out-of-pocket maximum has been met, eligible covered services are paid at 100% for the remainder of the plan year.
Yes.
- Primary care: $20 copay
- Specialist visits: $55 copay
- Urgent care visits: $35 copay
- MRI, CT, and PET scans: $150 copay
Duke Select uses a custom network of Duke providers for medical services. The plan uses Evernorth’s Behavioral Health network of providers for behavioral health and substance use disorders.
Duke Select may be a good fit if you live in an eligible zip code, are comfortable using Duke’s provider network, and want predictable healthcare costs. The plan has no deductible or coinsurance, offers low copays for many services, and allows you to see in-network specialists without a referral. It may be especially appealing for members who primarily receive care within the Duke network and prefer lower out-of-pocket costs.
If you have a student who is in college or a family member who resides outside of the Triangle area, you should select another plan that offers access to providers outside of Duke. If you regularly see a specialist at another health system, you should select another plan that offers coverage through the Cigna Open Access Plus network.
Yes. The HCFSA will compliment your medical plan by allowing you to pay for your copays, coinsurance amounts and deductibles with pre-tax dollars.
No. The HSA is paired with the Duke Advantage HDHP, and only those enrolled in that plan can participate in the HSA.
More Information
Please refer to the links below for more information:
Pharmacy Benefits
Pharmacy benefits for all medical plans are covered through Evernorth (formerly Express Scripts).
A complete description of coverage under each plan is available online at the Duke Human Resources website. All of Duke’s medical plans comply with the provisions of the Patient Protection and Affordable Care Act.
